Research Questions What promising practices exist that would help law enforcement mitigate the opioid crisis? What issues and challenges does law enforcement face in combating the crisis? What are the high-priority needs associated with law enforcement efforts to solve the opioid epidemic?
The United States is grappling with an opioid crisis that continues to cause devastation from addiction and massive numbers of deaths from overdose. Law enforcement has a unique role in addressing this crisis because it is directly tasked with interacting with those affected by the crisis on a day-to-day basis.
On September 25 and 26, 2018, the National Institute of Justice (NIJ), supported by the RAND Corporation in partnership with the Police Executive Research Forum, hosted an event that brought together subject-matter experts to identify and prioritize promising approaches for responding to the opioid crisis. After a series of panels and discussions, participants produced 13 high-priority needs, including strategies that were perceived to be ready for immediate implementation and those with remaining challenges that should inform the research agenda. The high-priority needs reflect an assessment by the group that one primary solution to the opioid crisis will be a focus on connecting individuals with opioid use disorder (OUD) to the medications that can treat them. It will be important to pursue solutions that reduce barriers to the use of medication-assisted treatment (MAT) and expand access and funding for it. Connecting individuals with OUD to treatment will require effective collaborations among law enforcement officers, social workers, and other stakeholders. Finally, in addition to removing legal barriers, community and other stakeholder concerns will need to be addressed before high-priority harm-reduction approaches, such as safe injection sites or syringe exchanges, can be implemented.
Key Findings Connecting individuals with OUD to treatment will be essential to solve the opioid crisis The use of MAT should be broadened in the general population, and accessibility should be increased. Nonenforcement police outreach should be promoted to connect individuals to treatment. Alternative treatment models should be explored to better serve individuals with OUD. Medication-assisted and other treatment models should be used in institutional and community corrections. The use of safe injection locations should be explored to facilitate incident response and provide treatment promotion opportunities. Same-day, low-barrier access to treatment with a medication-first model of care should be provided. Syringe services should be provided to reduce associated harms and create treatment intervention opportunities. Lasting partnerships are key to the success of many of the recommended initiatives Syndromic surveillance or sentinel indicators should be used to recognize spikes in overdoses, new opioids, or emerging drug crises. Care must be taken to protect officers from the physical dangers, mental stress, and trauma they face A trauma awareness early warning system should be created for law enforcement stress exposure. Mental health interventions should be provided for officers affected by the stresses of policing during the opioid crisis. The ability of laboratories to respond to the epidemic is constrained Funding models should be developed to allow labs to be agile in responding to needs for new equipment, methods, and safety issues. The frequency and scope of drug screens in death investigations should be increased to identify novel opioids and effects. Data from rapid analysis of seized materials should be used to inform public health and law enforcement interventions.
Recommendations A strong body of evidence suggests that MAT is an effective means to treat OUD and reduce harm from opioid abuse as a long-term solution, and this is reflected by the high priority and perceived readiness of solutions that reduce barriers to MAT use, expand access and funding for it, and foster collaborations that can more effectively direct individuals with OUD to MAT options. Effective collaborations are key to the success of many of the high-priority needs identified in the workshop. Connecting individuals with OUD to treatment will require effective collaborations among law enforcement officers, social workers, and other stakeholders. Creating effective syndromic surveillance to monitor spikes in various indicators, increasing the utility of drug screens in death investigations, and better utilizing data from analyses of seized materials will require collaboration among law enforcement, emergency medical services, and community groups, among others. Finally, in addition to removing legal barriers, community and other stakeholder concerns will need to be addressed before high-priority harm-reduction approaches, such as safe injection sites or syringe exchanges, can be implemented. Law enforcement must play a central role in many of these partnerships, and often might take on a leadership role, because it will continue to most frequently and most directly interact with those affected by the opioid crisis. As a result of this interaction, care must be taken to protect the officers on the front lines of the crisis from the physical dangers, mental stress, and trauma they face. Protecting the mental health of officers was seen as a high priority, and law enforcement organizations will need to find ways to increase awareness and effectively implement mental health and occupational stress and trauma interventions for officers.
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The research described in this report was sponsored by the National Institute of Justice and conducted in the Justice Policy Program within RAND Social and Economic Well-Being.
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