The City of Brockton's "Champion Plan": The Role of Police Departments in Facilitating Access to Treatment

Engaging Adolescents in the Fight Against Drug Abuse and Addiction: A Concept Mapping Approach

BACKGROUND

To identify contextually-relevant strategies for reducing and eventually eliminating addiction, it is imperative to engage stakeholders that are most affected by drug abuse but typically left out of the conversation, such as adolescents.

AIM

The aim of this study was to collaborate with 45 adolescent stakeholders participating in a school-based research program to identify areas to address addiction.

METHODS

Guided by a modified version of the mixed-methods concept mapping approach, adolescents were asked to brainstorm and sort a list of statements about how to address addiction in their community. The data were then analyzed via multidimensional scaling and hierarchical cluster analysis.

RESULTS

The concept map identified eight clusters from 75 edited statements: policing/security (e.g., increase punishment for selling drugs), helping community (e.g., create more jobs), treatment (e.g., make treatments more affordable), increased awareness (e.g., identify and help at-risk youth), communication (e.g., more communication with people who are abusing drugs), increased understanding/education (e.g., online communities for people who are abusing drugs), clean up community (e.g., clean up abandoned houses) and prevent addiction (e.g., effectively deal with peer pressure).

DISCUSSION

These stakeholder-driven ideas are consistent with the socioecological framework of addressing substance use and add to the credibility and transferability of individual and systemic level approaches to reducing substance use in marginalized communities.

CONCLUSION

This study emphasizes the feasibility of engaging adolescents in the development of contextually-relevant addiction education, prevention, and treatment interventions in underserved communities.

Impact of a community-policing initiative promoting substance use disorder treatment over criminal charges on arrest recidivism

BACKGROUND

Overdose deaths, addiction, and drug-related crime have increased in the United States over the past decade. Treatment improves outcomes, including reducing crime, but few individuals with addiction receive treatment. Here, we determine whether the Madison Addiction Recovery Initiative (MARI), a community policing program implemented by the City of Madison (Wisconsin) Police Department (MPD) that diverts adults who committed a non-violent, drug use-related crime from criminal prosecution to addiction treatment, reduces the risk of recidivism (i.e., an arrest) in the 6-month period following the index crime.

METHODS

Observational data were collected by the MPD for 12 months before through 6 months after an index crime from participants in the MARI program (n = 263) who referred to MARI between September 1, 2017 and August 31, 2020 and a Historical Comparison group (n = 52) who committed a comparable crime between September 1, 2015 and August 31, 2016. Average effects were estimated using intention-to-treat (ITT), a per-protocol, and a complier average causal effects (CACE) analyses, adjusted for covariates.

RESULTS

ITT analysis did not show that MARI assignment lowered adjusted odds of 6-month recidivism (aOR = 0.59 [0.32, 1.12], p = 0.11). Per-protocol analysis showed that completing MARI lowered the adjusted odds of 6-month recidivism (aOR = 0.23 [0.10, 0.52], p < 0.001). CACE analysis indicated that assignment to MARI among individuals who would complete the MARI program if assigned to the program lowered the adjusted odds of 6-month recidivism (aOR = 0.85 [0.80, 0.90], p < 0.001).

CONCLUSIONS

Diverting adults who committed a non-violent, drug use-related crime from criminal prosecution to addiction treatment may reduce 6-month recidivism.

Contextual challenges in police-assisted substance use referral programs: Impact of COVID-19 and Black Lives Matter movement

Background: Police assisted referral (PAR) programs provide people with substance use disorders (SUD) with a non-arrest treatment pathway, yet systemic barriers, including stigma and access to treatment services, may limit engagement. We sought to understand how the dual contextual challenges of COVID-19 and the Black Lives Matter movement have impacted PAR programs. Methods: Participants completed semi-structured interviews between July and September 2020. Transcribed interviews were analyzed qualitatively to extract emergent codes and themes. Results: Key themes included: adoption and reach of adapted remote services, and barriers to access; and questions on the role of police as health service providers, including police embeddedness in the community. COVID-related social distancing demands undermined police engagement with people with SUD. Treatment providers and advocates reported moderate success in utilizing remote interventions as workarounds. While participants acknowledged the Black Lives Matter movement's criticism of police, many saw continued value in police involvement in substance use interventions, due to their accessibility in communities and capacity for rapid response. Conclusions: PAR programs quickly adapted to a largely remote format, increasing longer-term accessibility. While Black Lives Matter had little direct impact on PAR programs, concerns about police-community relations were acknowledged. Recommendations include further police training to enhance trust and reduce stigma, and wider integration of digitally-based substance use referral options.

A brief history of the criminalization of mental illness

This article traces the history of the way in which mental disorders were viewed and treated, from before the birth of Christ to the present day. Special attention is paid to the process of deinstitutionalization in the United States and the failure to create an adequately robust community mental health system to care for the people who, in a previous era, might have experienced lifelong hospitalization. As a result, far too many people with serious mental illnesses are living in jails and prisons that are ill-suited and unprepared to meet their needs.

An assessment of officer attitudes toward the training and use of a pre-booking diversionary program

The opioid epidemic in the United States has led police departments and other professionals to examine the current approach to drug enforcement. Different law enforcement diversionary programs, centered on public health approaches, have emerged. One such program, the "pre-booking" diversionary program, has been the subject of limited research. The current research assessed officer attitudes toward the training and execution of one such diversionary program in two urban police departments. Results from more than 100 surveys provide officers' perceptions of the training they received and their involvement in the program. We provide their detailed feedback and suggestions for law enforcement, outreach workers, and treatment program personnel in hopes that such diversionary programs will become widespread and effectively utilized in more communities.