Characteristics of post-overdose public health-public safety outreach in Massachusetts

Formica, Scott W.; Waye, Katherine M.; Benintendi, Allyn; Yan, Shapei; Bagley, Sarah M.; Beletsky, Leo; Carroll, Jennifer; Xuan, Ziming; Rosenbloom, David; Apsler, Robert; Green, Traci C.; Hunter, Allie; Walley, Alexander Y.

doi:10.1016/j.drugalcdep.2020.108499

Cited by 19 publications

(31 citation statements)

References 50 publications

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“…Law enforcement officers have a unique opportunity to save lives using an easy-to-use public health tool (naloxone). Some jurisdictions are even using the overdose reversal incident as a stepping stone for law enforcement and its partners to connect individuals to treatment and social services (e.g., Bagley et al,2019;Formica et al,2021). Our findings suggest re-imagining trainings and policies for law enforcement that engender community trust during overdose emergencies are needed.…”

Section: Discussionmentioning

confidence: 90%

“…Notably, law enforcement agencies serving jurisdictions with high overdose rates are increasingly engaging in programs designed to link people who use drugs with referrals and treatment programs (e.g., Angel programs), deflection or diversion programs, and/or are collaborating with other community partners in co-response overdose programs. Broad reviews of these programs have shown that they vary in their timing, components, services, and follow-up and, as a whole, have not been evaluated (Bagley et al,2019;Formica et al,2021;Yatsko et al,2020) with few exceptions. The Gloucester Police Department's Angel program was assessed to determine treatment accessibility, participant sobriety, and treatment retention with a 6-month follow up period (Schiff et al,2017).…”

Section: Discussionmentioning

confidence: 99%

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Perspectives from law enforcement officers who respond to overdose calls for service and administer naloxone

et al. 2022

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Background Many law enforcement agencies across the United States equip their officers with the life-saving drug naloxone to reverse the effects of an opioid overdose. Although officers can be effectively trained to administer naloxone, and hundreds of law enforcement agencies carry naloxone to reverse overdoses, little is known about what happens on scene during an overdose call for service from an officer’s perspective, including what officers perceive their duties and responsibilities to be as the incident evolves. Methods The qualitative study examined officers’ experiences with overdose response, their perceived roles, and what happens on scene before, during, and after an overdose incident. In-person interviews were conducted with 17 officers in four diverse law enforcement agencies in the United States between January and May 2020. Results Following an overdose, the officers described that overdose victims are required to go to a hospital or they are taken to jail. Officers also described their duties on scene during and after naloxone administration, including searching the belongings of the person who overdosed and seizing any drug paraphernalia. Conclusion These findings point to a pressing need for rethinking standard operating procedures for law enforcement in these situations so that the intentions of Good Samaritan Laws are upheld and people get the assistance they need without being deterred from asking for future help.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Perspectives from law enforcement officers who respond to overdose calls for service and administer naloxone

et al. 2022

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“…We classi ed population size as urban (> 50,000), metro (< 50,000 but within large metro area), and non-metro/rural (less than 25,000 and not within large metro area). Finally, we classi ed overdose rates (de ned as fatal opioid overdoses per 100,000 population in 2021) as very high (50-69), high (40-49), average (30-39) or lower (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) relative to all participating sites. While monthly monitoring to obtain indicator data occurred at all sites, more in-depth evaluation involving semi-structured interviews, eld observations, and site visits occurred only at 12 selected sites.…”

Section: Evaluation Designmentioning

confidence: 99%

“…With these programs, selected o cers are trained to engage with PWUDs about referrals to treatment or other community services. [20][21][22][23] The present study presents ndings from the One2One project, a police-driven program spearheaded in Massachusetts and Maine in 2021. The Police-Assisted Addiction and Recovery Initiative (PAARI) implemented the project in collaboration with the Brandeis University's Opioid Policy Research Center that also conducted a formative mixed-methods evaluation.…”

Section: Introductionmentioning

confidence: 99%

Police-led Fentanyl Test Strip Distribution Program in Maine and Massachusetts: An Evaluation

Larson

Silcox

Olson

et al. 2022

Preprint

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Background: The increase of illicitly manufactured fentanyl in the drug supply and the lack of a reliable fentanyl detection method have led to a public health innovation: the community distribution and use of fentanyl test strips (FTS) to detect presence of fentanyl in drugs. The One2One project, based on a 2020 six-site pilot project, was a police-driven project spearheaded in Massachusetts and Maine in 2021 that consisted of police and community collaborators using FTS distribution as a low barrier tool to engage with people who use drugs and connect them to harm reduction supplies, services and referrals. Methods: Implementation and evaluation of the program occurred over 8-months. Policeofficers and program staff were trained on community use of FTS and were provided technical and logistical supports to encourage broad-scale local distribution of FTS kits to people who use drugs. The structure of the program encouraged departments to be innovative around FTS distribution and to use test strips as tools to support PWUDs with referrals, direct services and other harm reduction resources. The evaluation included site observations, interviews of staff and recipients, a community stakeholder survey, and analysis of administrative and demographic data to measure uptake and reach (engagement ratio and kit distribution impact rate) of the project as well as catalog implementation successes and challenges across participating police departments.Results: Twenty-one police departments and their collaborators distributed 2,556 FTS kits and reported a combined 3,703 referrals or direct services, yielding an engagement ratio of 1.44 (one referral or service per FTS kit distributed) and a kit distribution impact rate (kits distributed per overdose mortality rate) of 4.37 conveying substantial public health reach of FTS in high overdose burden communities. Qualitative data analysis captured the nuances across police departments of FTS kit distribution approaches, engagement methodologies, and the shift in willingness to embrace harm reduction principles through police-led efforts. Conclusion: FTS distribution through the One2One program exemplifies new and evolving shifts in public health and harm reduction policing roles and strategies. Further research should investigate how FTS distribution can be integrated across more geographies and implemented by other institutions.

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“…Finally, police education can disseminate promising policing protocols to divert and deflect PWUD to lifesaving health and supportive services in lieu of arrest. Reducing the confrontational nature and frequency of contact with law enforcement is especially salient in the context of racial disparities in US drug law enforcement, although the footprint of the police’s role in treatment and other service navigation remains controversial [ 18 , 59 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an Experimental Web-based Educational Module on Opioid-related Occupational Safety Among Police Officers: Protocol for a Randomized Pragmatic Trial to Minimize Barriers to Overdose Response

Simmons¹,

Elliott²,

Bennett³

et al. 2022

JMIR Res Protoc

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Background As drug-related morbidity and mortality continue to surge, police officers are on the front lines of the North American overdose (OD) crisis. Drug law enforcement shapes health risks among people who use drugs (PWUD), while also impacting the occupational health and wellness of officers. Effective interventions to align law enforcement practices with public health and occupational safety goals remain underresearched. Objective The Opioids and Police Safety Study (OPS) aims to shift police practices relating to PWUD. It adapts and evaluates the relative effectiveness of a curriculum that bundles content on public health promotion with occupational risk reduction (ORR) to supplement a web-based OD response and naloxone training platform (GetNaloxoneNow.org, or GNN). This novel approach has the potential to improve public health and occupational safety practices, including using naloxone to reverse ODs, referring PWUD to treatment and other supportive services, and avoiding syringe confiscation. Methods This longitudinal study uses a randomized pragmatic trial design. A sample of 300 active-duty police officers from select counties in Pennsylvania, Vermont, and New Hampshire with high OD fatality rates will be randomized (n=150 each) to either the experimental arm (GNN + OPS) or the control arm (GNN + COVID-19 ORR). A pre- and posttraining survey will be administered to all 300 officers, after which they will be administered quarterly surveys for 12 months. A subsample of police officers will also be qualitatively followed in a simultaneous embedded mixed-methods approach. Research ethics approval was obtained from the New York University Institutional Review Board. Results Results will provide an understanding of the experiences, knowledge, and perceptions of this sample of law enforcement personnel. Generalized linear models will be used to analyze differences in key behavioral outcomes between the participants in each of the 2 study arms and across multiple time points (anticipated minimum effect size to be detected, d=0.50). Findings will be disseminated widely, and the training products will be available nationally once the study is completed. Conclusions The OPS is the first study to longitudinally assess the impact of a web-based opioid-related ORR intervention for law enforcement in the U.S. Our randomized pragmatic clinical trial aims to remove barriers to life-saving police engagement with PWUD/people who inject drugs by focusing both on the safety of law enforcement and evidence-based and best practices for working with persons at risk of an opioid OD. Our simultaneous embedded mixed-methods approach will provide empirical evaluation of the diffusion of the naloxone-based response among law enforcement. Trial Registration ClinicalTrail.gov NCT05008523; https://clinicaltrials.gov/show/NCT05008523 International Registered Report Identifier (IRRID) DERR1-10.2196/33451

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Characteristics of post-overdose public health-public safety outreach in Massachusetts

Cited by 19 publications

References 50 publications

Perspectives from law enforcement officers who respond to overdose calls for service and administer naloxone

Perspectives from law enforcement officers who respond to overdose calls for service and administer naloxone

Police-led Fentanyl Test Strip Distribution Program in Maine and Massachusetts: An Evaluation

Evaluation of an Experimental Web-based Educational Module on Opioid-related Occupational Safety Among Police Officers: Protocol for a Randomized Pragmatic Trial to Minimize Barriers to Overdose Response

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