An Antidote to Overdose, in Time to Save Lives

The Law Enforcement Assisted Diversion (LEAD) program in Alamosa, Colorado, gives police officers the option of sending people to substance abuse treatment rather than straight into the criminal justice system. Used in non-violent cases, the diversion program is based on a harm-reduction model that uses a health-care approach rather than a punitive approach to address the underlying issues when a crime is committed. Some police officers object to the program's mission, but proponents say that forcing compliance would be counterproductive.

By prioritizing treatment over law enforcement, Switzerland dramatically reduced its drug problem. In 1994, the country adopted a progressive policy to treat heroin addiction as a public health crisis, focusing on harm reduction, treatment, and prevention in addition to traditional law enforcement. The policy, which embraces medicated-assisted treatment and universal access to services, helped greatly reduce issues such as the incidence of HIV, drug overdoses, and deaths over the long-term.

When inmates enter prison, they are required to discontinue use of any substances, causing many of them to suffer symptoms of detox. Medication-assisted Treatment combines use of slow-release opiates and cognitive behavioral therapy to help opiate addicts get sober and deal with the underlying issues associated with addiction. The Rhode Island Department of Corrections is piloting a program that streamlines opiate addicts entering prison into a MAT program that they participate in while behind bars.

By addressing drug addiction as a medical—rather than criminal—issue, Portugal has been able to reduce drug use as well as deaths caused by drugs. Strategies implemented include decriminalization, increased access to treatment, changes in prescribing patterns related to opioids, and ‘dissuasion’ courts.

Prevention Point Philadelphia provides needle-exchange, HIV and Hepatitis C testing, counseling groups, mailboxes, and Naloxone (an opioid overdose reversal drug) training to 18,000 people. The center also connects addicts to addiction services and other social programs if they want to seek recovery.

After recognizing that just-released inmates were more likely to overdose on opioids, Cook County Jail partnered with Cook County Health to train at-risk detainees how to administer Naloxone nasal spray. This program also provides released detainees with Naloxone kits, and has recorded significant success from this process.

While the decriminalization effort Measure 110 failed to fully meet the mark, the Health Justice Recovery Alliance joined forces with local law enforcement to create a pilot program that helped locals struggling with addiction. Through the program, police can contact an outreach worker who will come to the scene and connect the person struggling with addiction to support services such as detox care and housing, helping lead them toward long-term recovery. So far, the pilot program has helped over 200 people.

Drug court programs serve as an alternative to incarceration for people dealing with substance abuse. The treatment-based approach provides medical treatment, counseling, education assistance, and employment assistance.

Since 2018, Judge Jason Lidyard of Rio Arriba County, N.M., has forged a new model for a drug court. Instead of demanding abstinence from drugs as the price to stay out of jail, Lidyard uses respect and personal relationships to seek a redefinition of success: making substance abuse less deadly and less socially crippling. Violating the court's requirements to get treatment results in more help, not jail. The less punitive approach seemed to reduce overdoses until a new fentanyl surge complicated the picture. Almost all of the people who've gone through the court have avoided new felony arrests.

In less than three and a half years, Safeworks, the only supervised drug-use site in Calgary, saved thousands of people from opioid-overdose deaths and helped users for whom abstinence-based treatment didn't work. The government of Alberta deemed the site a scene of "chaos" and ordered it closed once two new sites open. Safeworks supporters oppose the disruption in harm-reduction work that move would bring, considering how critical personal relationships built on trust are to this kind of service.