How a pre-arrest opiate diversion program is saving lives in Wisconsin

Policeone.com 5-28-2019 by Capt Cory Nelson, Madison Police Department:

At a recent training I attended, one of the presenters struck a chord with me. A sergeant from the Greenfield (Wisc.) Police Department talked about the success his agency had with a heroin recovery program. The agency had an agreement with a local hospital to provide immediate treatment to those who came to the police asking for help. I thought to myself, “What a great idea! We are also struggling with opiate abuse in our community and this is something that may work for us.”

I returned home and spoke to my chief who agreed that it sounded very interesting. Our overdose statistics had increased 266% over a three-year period, so he gave me the green light to put together a proposal for a similar program.

IDENTIFYING FUNDING, PARTNERSHIP OPPORTUNITIES
At about the same time, the Bureau of Justice Assistance came out with a grant announcement under the Smart Policing Initiative (SPI) Grant program to develop a practitioner-researcher partnership that uses data, evidence and innovation to create effective approaches to crime challenges in our communities.

Since I am no expert in substance abuse or the treatment options, I decided to get some more expertise on board. Eventually we were able to start a partnership with Public Health Madison & Dane County, Dane County Human Services, Connections Counseling and Aleksandra Zgierska, MD, PhD, DFASAM, a nationally known opiate abuse researcher at the University of Wisconsin-Madison (UW) School of Medicine and Public Health.

With this group in place, we started to frame out what a successful program would look like. Although we were all from very different backgrounds and agencies, we were all thinking alike. We were on board with the idea that addiction should be treated as a disease and not a crime.

OUTLINING THE PRE-ARREST DIVERSION PROGRAM
We decided to use a “carrot and stick” approach with those suffering from opiate abuse. If a person commits a low-level crime to support an opiate addiction, we would be willing not to arrest them if they were willing to enter a treatment program. We knew we had to have a narrow list of crimes that would qualify. We decided that we would consider:

Retail theft;
Theft from auto;
Familial related burglary with victim consent;
Possession of heroin;
Prostitution.
It was agreed that if someone successfully completed a treatment program and was crime free for six months, the original charges would not be filed. Most of these cases are very low on the District Attorney’s priority list and were the ones the DA’s office agreed to let go if treatment was successfully completed.

For those who were not interested in treatment, they were treated as normal with an arrest or court order in date. For those individuals who do not successfully complete treatment within the six-month window or are re-arrested, the original charges are filed.

What makes our program unique is that it is pre-arrest, therefore for a first-time offender who completes a treatment program, a criminal arrest history is never generated. This helps first-time offenders avoid the stigma of listing a drug arrest later in life when applying for jobs or college entrance applications.

ALLOCATING GRANT MONIES
With lots of grant-writing assistance from our Grant Manager Jim Powell, we found out we were awarded the SPI grant! Though the Madison Police Department was the driving force behind the program and were the grant writers, we did not receive any of the money. It was allocated to:

An intake counselor and recovery coaches for Connections Counseling;
Project coordination with Public Health Madison & Dane County;
Research and clinical expertise with the University of Wisconsin’s Dr. Aleksandra Zgierska and her team;
Naloxone to be placed in known public locations where overdoses are likely to occur.
The Madison Police Department provides an in-kind donation of an officer who coordinates and filters all the criminal referrals. The officer also keeps track of successful treatment completions and those who did not and now need to be formally charged.

NAVIGATING ROADBLOCKS, GETTING OFFICER BUY-IN
We had some struggles at the outset. One issue was trying to get the proper stakeholders on board who could help move things forward. A lot of groups wanted to help in framing the concept, but the larger the group, the more difficult it is to get anything accomplished. We ended up narrowing participation down to a core group that focused on getting the grant up and running. We still use a larger group of interested parties to meet quarterly or so to get updates and discuss larger opiate-related issues in the county.

Some of our officers didn’t think the program was a good idea and felt we should continue to just make arrests. As we tried to get buy-in from officers who would be doing the referrals, we decided it would be helpful to improve their understanding of addiction. At a department wide in-service, we brought in a panel of people who were in recovery to speak to our officers about their lives before, during and after their experience with addiction. These panel members attended about two dozen different in-service trainings to educate every one of our officers, and they did it for free. They were just excited to be able to share their story and give officers an inside look at addiction.

We heard about the normal lives these people lived prior to addiction, the families they were a part of, and the jobs and friends they had. We heard how they fell into addiction, and about how horrible it is and the crimes that were committed to support their habits. We heard about the car shopping, the burglaries and the prostitution, all to obtain heroin.

We found out that our known overdose statistics are much lower than what we thought. One person told us she overdosed 25 times, yet only three were reported to police. That was a common theme with other panel members.

We learned how hard it is for people to pull themselves out of the addiction hole, their repeated attempts at recovery and why rehab eventually worked for them. A common denominator for a successful recovery included a strong recovery coach that addicted individuals were able to bond with.

Officers get sent to so many overdose calls that it is easy to become a little hardened when finding another person overdosing on the floor of a public bathroom. After our in-services, we received a ton of positive feedback from officers. They gained some compassion, which was our goal, by listening to panel members relate how addiction changed their lives.

MEASURING OUR PROGRAM’S SUCCESS
After listening to our recovery panel, we found out that many property crimes are committed to support an addiction. One panel member admitted to committing 10-20 thefts from autos a night and sometimes a burglary or two as well. That is 300-600 thefts from autos and 30 or more burglaries a month committed by one person. Just think about the reduction in property crime your community could have just by getting one person into a treatment program for a month. Then imagine the results you may have by getting 10 people into treatment!

Since the fall of 2017 when our program started, we have 39 citizens who have successfully completed treatment and are now living normal lives in Madison. We have another 26 people currently in treatment. Just knowing that we helped this many community members get their lives back on track demonstrates this was a very good partnership for our community.

There are many opioid-response programs in cities and towns. There is no one-size-fits-all solution, so I encourage you to take best practices from around the nation to develop a program that is a fit for your unique community.

About the author
Cory Nelson is a captain with the Madison Police Department (MPD) in Wisconsin where he has served for 30 years. He is currently assigned as the commander of the South Police District. His past assignments included narcotics, SWAT, persons crimes, investigative services, focused deterrence, and professional standards and internal affairs. He was also responsible for bringing the concept of an opiate-related criminal diversion program to the MPD.

He is an alumnus of the National Institute of Justice’s LEADS Scholar program and is currently serving as an executive fellow of the National Police Foundation. He is a Wisconsin Law Enforcement Command College graduate, and now serves on the board of directors. He is an instructor for internal affairs investigations for the Wisconsin Department of Justice and has taught focused deterrence for the U.S. Department of Justice at a variety of national venues.

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