People addicted to opioids don’t need to be in jail, they need help

People addicted to opioids don’t need to be in jail, they need help
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Time is running out for legislators to seize a rare bipartisan opportunity to extend support for local law enforcement’s efforts to help those affected by the opioid crisis.

As police officers, we have become the frontline dealing with the effects of opioid addiction and overdose, but we are not mental health professionals. We do not have the training and resources to respond to these crises.

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Yet, increasingly, inmates are in jail for addiction-related offenses and the calls we get are overdose-related. We do what we can to help stabilize these folks, but often they are severely impaired, so we take them to hospital emergency departments and stay with them until they are discharged. Often, this means spending between five and 12 hours of a shift attending to a single addiction-related call.

When the episode is over, typically, they end up having other addiction-related incidents and the arrest cycle continues. Many local jails are overcrowded with these persistent offenders.

We can’t keep arresting our way out of this problem. People addicted to opioids don’t need to be in jail, they need help.

Our communities are lucky, we have access to a new kind of clinic that provides expanded capacity to support our officers responding to people with addictions and mental illness. Unfortunately, without swift action by Congress to extend the program in 2019, we will lose all the gains we have made.

In 2017, eight states launched a demonstration project that supports Certified Community Behavioral Health Clinics (CCBHCs) in expanding services to complex populations. Innovative law enforcement leaders have found ways to partner with these CCBHCs to offer mental health services instead of jail time, provide treatment in jail and post-release connection to ongoing care in the community for people suffering from serious mental illnesses, including opioid addiction.

This has not only eased jail overcrowding and recidivism, but even more importantly, has already ensured that people receive the life-saving medication-assisted treatment (MAT) they need.

Funding for this project will run out in Oklahoma and Oregon on March 31, 2019, and in Minnesota, Missouri, Nevada, New Jersey, New York and Pennsylvania on June 30, 2019, unless Congress acts now. Bipartisan legislation has been introduced to extend funding for another year and expand the project to 11 other states.

If this does not happen, not only will the more than 9,000 people who now receive MAT from a CCBHC risk losing access to care, clinics will have to sharply cut their capacity to serve our communities.

In places where same-day access to treatment is the norm, waitlists for services will be re-established. Clinics that have expanded their addiction service lines will have to close programs and turn clients away with no other option for treatment available.

In addition, more than 3,000 newly-hired addiction and mental health professionals may be laid off — further decimating the treatment gains we’ve seen as a result of the CCBHC model. Most critically for us as law enforcement professionals, the clinics we collaborate with would have to end their support of the programs that have helped reduce the toll that untreated addiction and mental illness take on our officers and our communities.

Patrolling officers in Springfield, Mo., offer people involved in addiction-related incidents video access to a CCBHC clinician via a digital tablet. This helps de-escalate potentially volatile situations and makes it easier for officers to identify true mental health emergencies. In 2017, of the people who chose the use the video option, none were incarcerated, 87 percent avoided being taken to inpatient psychiatric care and only 16 percent were referred to hospital emergency departments. Prior to the partnership, most of these individuals would have been taken directly to the emergency room or our at-capacity jail, where 85 percent of inmates have a mental illness or substance use disorder.

In Niagara County, N.Y., where addiction is implicated in 70 percent of offenses leading to incarceration, a CCBHC partnership includes a mobile unit staffed with a counselor, a peer support specialist and telemedicine services that meets inmates at the door when they are released. The unit provides screening and assessment services and immediate transportation for individuals addicted to opioids to their first MAT appointment. This has helped lead to a reduction in recidivism.

A recently announced CCBHC-funded partnership with local law enforcement in Shepherdsville, Ky., will offer a similar mobile unit, 24/7 crisis care and addiction treatment and recovery services. The partnership has the potential to become a game-changer for the community where opioids abuse is particularly high.

If Congress fails to act, these programs could cease to exist. What’s more, the impact will be felt before the deadline: MAT patients will need months to be transitioned off their medication or referred to other providers who can accommodate them, an unlikely possibility since few facilities offer MAT. 

Paul Williams is the chief of police at the Springfield Police Department in Missouri. Rick McCubbin is the chief of police Shepherdsville Police Department in Kentucky. McCubbin served eight years in President George W. Bush’s administration as the United States Marshal for the Western District of Kentucky. Daniel Engert is the deputy chief of Niagara County Sheriff’s Office in New York.