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Police and Population-Level Intervention in the Opioid Crisis

Notes From the Field
Date Published
June 13, 2018

If cholera hit Burlington, Vermont, the police department would be on the streets giving out 30,000 bottles of water and dropping off latrines to stop the disease from spreading. If there was a radiation exposure incident, we’d distribute massive quantities of potassium iodide. I grew up in New York City in the ’80s and couldn’t walk to the subway from high school without virtually slipping on the condoms that were widely distributed to curb the spread of AIDS, which was claiming thousands of lives a year.

In responding to large-scale epidemics, I see the role of the police as collaborating in the development and execution of these population-level interventions, institutions, and systems. We should be partners in creating the infrastructure to reduce morbidity and mortality.

The opioid epidemic remains a true crisis: the overdose death toll in 2017 surpassed the American troop casualties of the entire Vietnam War. Such a sweeping and multifaceted crisis demands an equally strong response at a systems level. For a police department, this means large-scale interventions that evidence and science have proven effective.

The Burlington Police Department has focused on these system-level, data-driven interventions in our response. We’ve instituted no-arrest and no-prosecute policies for individuals who overdose, and instead help these individuals access treatment. We treat fatal overdose cases as crime scenes, investigating these deaths in an attempt to trace the high-level sources of the drugs that kill our residents. Several years ago we deployed Narcan to all of our officers, which has since become standard practice across the country.

The Burlington Police Department also partners with every organization and agency involved in the opioid response: fire and emergency medical services, community organizations, health clinics, and the mayor’s office. These partnerships include interagency data-sharing, which is vital in understanding the nature and scope of the problem, crafting an effective response, and evaluating interventions for impact. We need to pursue interventions that are rooted in and proven by science and evidence, and the only way we can do this is through partnerships and data-sharing.

Like many smaller cities, Burlington doesn’t have its own department of health, leaving police to shoulder many aspects of the public health response. I take this role seriously and research relevant studies and literature, the background and biology of the crisis, and trends across the country and locally. But I also acknowledge our limitations as a police department in facilitating a public health response. To compensate, we have established relationships with a community of epidemiologists and public health officials, who vet all of our policing policies for public health outcomes.

Burlington has also hired an opioid data analyst and an opioid policy coordinator. Our opioid analyst enables us to draw on data to understand the scope of the problem, track trends, and gauge the value of interventions. Our opioid policy coordinator leads our coordination efforts with other agencies, departments, and institutions. In a department of 100 officers, these two civilian positions are a substantial investment of resources. I see the positions as essential because they facilitate effective partnerships and help us use data to understand what works in terms of opioid policy and response.

In responding to the crack epidemic of the eighties and nineties, American law enforcement learned the hard way — and in some ways too late — that drug addiction is first a public health problem, not a criminal justice problem. As the nature of the crisis and our corresponding response evolve, we continue to learn from our experiences and those of our colleagues. In our response, we draw on research and evaluation of intervention programs across the country. In February, a study was published out of Rhode Island that showed that medication-assisted therapy administered to incarcerated opioid addicts led to a 60-percent decrease in post-incarceration deaths, contributing to a 12-percent reduction in overall overdose deaths in the state.[1] These are impressive and promising results, and Burlington and the rest of Vermont are exploring how we can implement a similar program.

Police chiefs have the obligation to know and learn from what other jurisdictions, states, and agencies are doing across the country. Ancillary, small-scale, or untested programs can have value, but with overdose fatalities comparable to fighting the entire Vietnam War every year, the brunt of our efforts need to focus on large-scale, population-level interventions.

About Notes From the Field

The National Institute of Justice (NIJ) is the research, development, and evaluation arm of the U.S. Department of Justice. NIJ aims to address the critical questions of the criminal justice field, particularly at the state and local levels.

NIJ Director David Muhlhausen developed the Notes From the Field series to allow leading voices in the field to share their strategies for responding to the most pressing issues on America’s streets today.

Notes From the Field is not a research-based publication. Instead, it presents lessons learned by on-the-ground leaders, from years of experience and thinking deeply about criminal justice issues.

Date Published: June 13, 2018