We Can't Arrest Our Way Out of the Opioid Crisis

By Wendy Shang posted 04-04-2018 14:14


We Can’t Arrest Our Way Out of the Opioid Crisis

When you read about our nation’s opioid crisis and law enforcement’s response to it, you will first confront a host of shocking statistics that try to capture the magnitude of this issue. In Ohio, 11 people died every 24 hours from drug overdoses in 2016. The latest, provisional data from the Centers for Disease Control report that drug overdose deaths in 2016 totaled 64,070, a 21-percent increase over the year before.

Then you will usually find some variation of this phrase:  “We can’t arrest our way out of this problem.”

It is more than just a feeling from those who are on the front lines of the opioid epidemic. A study from the Pew Charitable Trusts looking at all 50 states shows that “there is no statistically significant relationship between state drug offender imprisonment rates and... rates of illicit drug use, drug overdose deaths, and drug arrests.” Instead, law enforcement agencies are increasingly trying to focus on connecting community members to treatment, rather than arrest. Focusing on arrest and release of people with substance use disorders, in the minds of many law enforcement officers, simply results in a revolving door at the jail. Organizations of prosecutors and law enforcement officials are calling for alternatives as a matter of policy. Law Enforcement Leaders has called for alternatives to arrest and prosecution for those with mental health and drug addiction issues, and Law Enforcement Action Partnership has stated that adult drug abuse is a public health problem and not a law enforcement matter.

A report from the Police Executive Research Forum acknowledges, though, that beginning such a program presents a challenging cultural shift to the perceived role of law enforcement. “[I]t can sometimes be difficult to secure support for programs that shift a police department’s focus away from traditional drug enforcement and towards connecting people to treatment. Some officers may feel that it is not their responsibility to act as social service providers, and some members of the public may fear that de‐emphasizing arrest will lead to an increase in crime.” In spite of these doubts, programs that encourage a treatment-based approach by law enforcement have begun to show promising outcomes. Not only are they seeing a reduction in drug overdose deaths, but they are also reporting concomitant outcomes, such as lower rates of crime associated with substance use, such as shoplifting; improved relations with the community; and reduced costs.

In the past, many  courts may have relied on unattainable bond amounts to keep people with substance abuse issues off the street—even though a week in jail does not “cure” addiction. As jurisdictions move away from bond schedules and consider assessments of risks and needs, communities are concerned about the availability of treatment-based alternatives available to people with substance abuse issues. The Frederick News-Post (Maryland) recently issued an editorial, praising courts for increasing the use of personal recognizance, but also lamenting an increase in detention without bail, attributing this increase mainly to opioid-related cases, and the fact that Frederick County only offers addiction treatment to those who have pleaded guilty. “Preventive detention of poor defendants is wrong. Dangerous career criminals cannot be permitted to roam free, but drug addicts accused of minor crimes deserve better,” concluded the newspaper.

According to the CDC, the rate of deaths from drug overdoses in rural areas is increasing, surpassing rates in urban areas. Nearly half of all Americans have a family member or close friend who is or has been addicted to drugs, and this number cuts equally across political ties. So it should not come as a surprise that communities both large and small, red and blue, can and do support pretrial treatment-based programs. One of the most widely-replicated law enforcement treatment referral programs, Angel, began in a community of less than 30,000. Frederick, home to the aforementioned paper, has voted Republican for the last several presidential elections. Supporters need to show that these programs produce results, can be tailored to the needs of the community, and that the community has an appetite for them.




04-09-2018 17:26

Thank you for your comment, Benjamin. The statistic I've seen that goes along with your comment came from a NYT article - out of 5100 jails and prisons, fewer than 30 offer methadone or beprenorphine. https://www.nytimes.com/2017/08/04/us/heroin-addiction-jails-methadone-suboxone-treatment.html

04-09-2018 11:24

Thank you, @Wendy Shang! For me the most important part of the piece was the following.

"In the past, many courts may have relied on unattainable bond amounts to keep people with substance abuse issues off the street—even though a week in jail does not “cure” addiction."

Forcing people to detox in jail is not only cruel, it is dangerous and life threatening. Currently there are no reliable estimates of how many people have died in from drug withdrawal in jail, but in 2017 Mother Jones found "20 lawsuits filed between 2014 and 2016 alleging that an inmate died from opiate withdrawal complications. That number likely represents just a fraction of all jail withdrawal deaths". 

According to the United Nations Office on Drugs and Crime (UNODC), 43 countries worldwide have methadone or buprenorphine, the gold standard treatment for opioid use disorders, available in correctional settings. Unfortunately the U.S. does not fare well in this department, however, Rhode Island has recently expanded treatment to all people within it's jails and prisons and multiple peer-reviewed studies have shown that people who received methadone or buprenoprhine in correctional settings were less likely to inject while incarcerated, had lower recidivism rates and greater treatment engagement after release.