Police Diversion to Treatment for Opioid Use Disorder: A Mixed Methods Study

Abstract Text This timely and significant K01 award will provide the PI, Dr. del Pozo, with the training and expertise necessary to achieve his long-term goal of becoming a leading investigator of the health outcomes of policing in relation to substance use disorders. Drug overdose deaths have reached record proportions in the United States, driven by powerful synthetic opioids. At the same time, police departments are being called upon to emphasize public health approaches to behaviors that have traditionally generated arrests. For people with opioid use disorder (OUD), a way to address these concerns is the practice of diverting them to treatment using medications for opioid use disorder (MOUD) as an alternative to arrest. These connections can be an effective upstream health intervention, but success relies on an officer’s discretionary judgment, which can be negatively influenced by a variety of barriers as well as stigma-based norms, attitudes, and beliefs about MOUD and people with OUD. Effective diversion requires research on why police officers choose to divert or arrest, how stigma affects these decisions, and how programs and systems can positively influence this practice. To conduct this research, the proposed award augments the PI’s unique and valuable experience as a chief of police and his training as a postdoctoral researcher in substance use at Miriam Hospital/Brown University with a comprehensive plan that provides training in (1) qualitative methods, (2) the science of stigma, (3) psychometric measurement, (4) analysis of survey data, and (5) implementation science and study design in police settings. Training will be guided by mentors with exceptional expertise: Dr. Jody Rich (primary mentor), Dr. Michael Compton, Dr. Beth McGinty, Dr. Valerie Earnshaw, and Dr. Steven Belenko. The training plan strategically aligns with mixed-methods research that will 1) develop and validate an instrument to measure police stigma toward people who use drugs, 2) use the Theory of Planned Behavior to identify other key variables that determine police officers’ intentions to divert people to MOUD, and 3) determine the officer-perceived barriers and facilitators of effective diversion. Conducted in collaboration with leading police research organizations and a community advisory board, the project will produce actionable training, policy, and process recommendations for communities seeking to increase connections to care for OUD, while meeting several priorities outlined in NIDA’s RFI for its 2021-2025 Strategic Plan: 1) Implementing evidence- based strategies in real world settings by integrating treatment services into justice settings; 2) Translating and disseminating research to inform policy and practice; 3) Identifying and developing approaches to reduce stigma; 4) Developing approaches to reduce health disparities. By the conclusion of this award, the PI will be positioned to conduct independent research on responses to substance use in police settings, including an R01 Hybrid Type-2 study of the effectiveness and implementation of diversion to MOUD in a sample of US police departments.