Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP): Law Enforcement-First Responder Partnership Training and Technical Assistance Program
The IACP partners with the Center for Health and Justice (CHJ) at Treatment Alternatives to Safe Communities (TASC) to help state, local, and tribal jurisdictions implement evidence-based, systemic solutions at the front end of the justice system to respond to the substance misuse that often underlies justice system involvement. This includes assisting law enforcement in developing pathways to treatment for individuals at risk for substance use disorder. This initiative is funded by the Bureau of Justice Assistance (BJA) to provide training, technical assistance, resources, and a variety of learning opportunities to build and sustain multidisciplinary efforts to reduce the impact of opioids, stimulants, and other substances on individuals and communities.
Pathways to Diversion
Law enforcement and other first responders are on the front lines of addressing illicit substance use and misuse, frequently encountering individuals with substance use disorder and responding to drug overdose calls. A variety of multidisciplinary overdose prevention, response, and diversion and referral pathways, led by law enforcement and other first responders, have emerged in communities throughout the nation. These pathways often include first responders working in partnership with substance abuse treatment providers and peer recovery coaches to help individuals access treatment and recovery support services.
Individuals with substance use disorder (SUD)
Individuals in crisis or with non-crisis mental health disorders (MHD) and/or SUD, or in situations involving homelessness
Individuals with opioid use disorder
Individuals in crisis or with non-crisis MHD and/or SUD, or in situations involving homelessness, theft, or prostitution
Individuals in crisis or with non-crisis MHD and/or SUD, or in situations involving homelessness, theft, or prostitution
Pathways to Diversion Case Study Series
- Pathways to First Responder Diversion Case Studies Series: Self-Referral
- Pathways to First Responder Diversion Case Studies Series: Naloxone Plus
- Pathways to First Responder Diversion Case Studies Series: Officer Intervention
- Pathways to First Responder Diversion Case Studies Series: Active Outreach
- Pathways to First Responder Diversion Case Studies Series: Officer Prevention
Articles and other resources
Critical Elements of Successful First Responder Diversion Programs— The opioid crisis has generated an increase in calls for service by individuals with substance use and co-occurring disorders. In response, new law enforcement-led diversion and fire/emergency medical services-led initiatives are helping to reduce overdoses and overdose-related deaths by connecting individuals to community-based treatment and services.
Firefighters and Diversion: Spotlight on Arlington County (Virginia)—Arlington County, Virginia—the smallest county in the United States and one of the most densely populated—employs a countywide approach to its substance use challenges that depends on a collaboration of multiple partners. This article provides a close look (with assistance from the International Association of Fire Chiefs) at the important role that fire departments, including fire/emergency management services, can play in first responder-led diversion initiatives.
COSSAP Webinar: Arlington County Public Safety Response to the Opioid Crisis—Arlington County (Virginia) leaders will provide an overview of their Operation Safe Station program, a multidisciplinary effort designed to reduce the dangerous impacts of opioids and other drugs in the community and promote treatment options. The prosecutor, police department, sheriff's office, and department of human services collaborated to develop a process by which individuals who seek help with their drug use can self-report and receive services without fear of prosecution and incarceration.
Program Documentation: First Responder Deflection Resource Library—This is a repository of foundational documents that were submitted by existing first responder deflection (FRD) programs from across the United States. These documents comprise some core elements of FRD programs, such as release of information forms, policies and procedures, program brochures, intake forms, and memoranda of understanding. The library also houses a growing collection of process and outcome evaluations of existing FRD programs. If you are interested in contributing documents from your pre-arrest diversion or deflection program, please contact COSSAP@theiacp.org.
Featured Content for Law Enforcement and Other First Responders
Implementing Law Enforcement and First Responder Diversion Programs
Treatment Capacity: Divert to What?—Law enforcement and first responder diversion offers a connection to treatment and recovery for individuals with SUDs. But before a referral system is implemented within a community, local availability and treatment options must be assessed to establish capacity. Put another way, treatment capacity answers the question, “Divert to what?"
Building an Organizational Culture That Values Law Enforcement Diversion—Police leaders across the country have recognized the need to connect individuals with substance use disorders to treatment services through diversion programs. Critical to this effort is the necessity to build a culture within their own departments that embraces the mission and goals of front-end/pre-arrest diversion.
COSSAP Webinar: Building an Organizational Culture That Values Law Enforcement Diversion—The success of law enforcement and first responder-led diversion programs relies on the willingness of frontline officers, firefighters, and emergency medical service (EMS) technicians to participate in their implementation. This IACP webinar addresses how law enforcement leaders can successfully advance change within their agencies. Whether introducing new policies, procedures, or programs, it is important to build an organizational culture where change is readily accepted. The presenter discussed how challenges driven by organizational culture were overcome when the new Pre-Arrest Deflection Program was introduced at the Tucson, Arizona, Police Department, and provided steps for working within agency cultures to build support for front-end diversion.
Panel Session—2021 National COSSAP Forum: One Key to Program Success: How to Obtain Officer Buy-In for Your First Responder Diversion Program— How can the leaders of deflection programs secure the buy-in and participation of first responders—especially law enforcement officers who have the discretion to deflect or arrest? The presenters in this IACP workshop shared their experiences and perspectives on obtaining officer buy-in. A leader from the Tucson Police Department provided detailed steps and guidance on working with officers to obtain the support needed to implement Tucson’s Deflection Program, and a community-based clinician who partners with the Charlotte-Mecklenburg Police Department explained how officers can become more connected to the communities they serve, as well as the benefits to law enforcement and the community when frontline officers serve as liaisons between the justice system and community-based treatment and service providers. As reported in the newsletter, Catching up with COSSAP, “This session should be required viewing for any local stakeholder interested in responding effectively to substance use in their community.”
COSSAP Webinar: Innovative EMS Response to Overdoses: Beyond Naloxone— Four panelists described how their EMS systems have piloted/implemented creative responses that go a step beyond reversing overdoses. While lifesaving interventions are critical, some EMS agencies have been able to implement additional measures to help break the cycle of addiction.
COSSAP Webinar: How Police and Other First Responders Can Create Recovery Pathways for People with Substance Use Disorders—This IACP webinar explains how many people begin to misuse both legal and illegal drugs including the impact of childhood trauma, the effects of substances on brain chemistry and how changes to brain chemistry can impact an individual’s behavior, and barriers to treatment for people with SUD. Presenters demonstrate how police officers, other first responders, and medical, behavioral health, and human services staff can contribute to, and more effectively support, long-term recovery and other positive outcomes for individual’s affected by opioids, stimulants, and other substances.
COSSAP Webinar: Engaging Your Community—First Responder Strategies—A representative from the Charlotte-Mecklenburg Police Department (CMPD) discussed programs CMPD created to educate young people in their community on how to make better decisions, provide life-changing experiences, and create positive interactions with law enforcement resulting in reductions in adolescent arrest rates and racial and ethnic disparities, as well as the "school-to-prison pipeline." In addition, a licensed clinical therapist specializing in substance use disorder (SUD) discussed how police officers can support people with SUD in their communities by serving as linkages to SUD treatment and support services, and describes the benefits of doing so to both the community and to the officers. Both panelists explained strategies for engaging the community and ways that treatment alternatives can be identified and utilized to create safer communities.
Collaboration, Treatment, and Recovery
COSSAP Webinar: Closing the Gap: A Case Study on Collaborative Work Between First Responders and Recovery Support Services—First responders are facing increased burdens related to the rise of opioid-involved overdoses, contributing to stress and burnout. Frequently they are left with limited information about resources and time to connect people to care; however, this connection is often crucial for people who use drugs. Instructing first responders about “bridge programming” from first responder to treatment services, and their part within a larger collaboration, is a critical piece in the continuum of care. This webinar covers how to identify gaps in service accessibility for people with SUDs and provides information on strategies to implement collaborative responses between first responders and recovery agencies in the community.
COSSAP Webinar: Peer Support in Law Enforcement-Led Diversion Programs—To achieve positive outcomes, peer recovery support services (PRSS) are increasingly offered across diverse criminal justice settings, including within law enforcement-based programs, to address opioid and other substance misuse. A panelist from the Tucson Police Department will describe two police-led diversion programs and how they integrate peer specialists, identify changes to organizational practices and procedures necessary for the successful integration of peer work, discuss training for peer specialists and departmental staff to prepare for peer services, and describe the outcomes of Tucson's program.
COSSAP Webinar: A Path to Recovery—The Story of a Peer Support Specialist—A peer support specialist shared her experiences of addiction, the trials of an overdose, and how she ultimately found the path to recovery. Throughout the story, the webinar pauses to discuss the effects of addiction on the brain and demonstrate that substance use disorder is a disease rather than a choice. It also highlights how educating first responders and treatment providers about addiction and stigma can help people with SUD by reducing barriers to entering treatment and sustaining recovery. Finally, it discusses evidence-based programs shown to help build relationships between certified peer specialists and first responders.
Peer Support in First Responder-Led Diversion and Deflection Programs: Necessary Tools in the Fight Against COVID-19—During the COVID-19 pandemic, more than 40 states have reported increases in opioid-related deaths and ongoing concerns about individuals with mental illness or substance use disorder. Linking people who are struggling with an opioid use disorder with treatment has been particularly challenging. First responder-led diversion and deflection programs that incorporate peer supports into their work have found them to be an invaluable addition. Peer supports provide connection and hope during this challenging time, offering innovative approaches to saving lives.
First-Responder Trauma and the Opioid Crisis—The opioid crisis has placed increasing demands on first responders, compounding already high levels of job-related stress. To reduce its impact and prevent burnout, TASC’s Center for Health and Justice and Advocates for Human Potential, Inc. (AHP) interviewed personnel from first-responder agencies working on the front lines of the crisis. Among their findings: Compassion fatigue and a sense that their efforts are failing to make a difference are hampering first responders’ work, as is the stigma many attach to requesting help, all of which underscore the need for career-long self-care.
Data, Research, and Evaluation
Report of the National Survey to Assess First Responder Deflection Programs in Response to the Opioid Crisis—This report provides the results of the first national survey of first responder deflection (FRD) and pre-arrest diversion (PAD) programs in the United States. It represents the most comprehensive overview of the practice of deflection and its role in responding to the opioid crisis, as well as insights on how FRD and PAD offer alternative means to law enforcement and other first responders in how they address people with substance abuse disorder.
Report of the National Survey to Assess First Responder Deflection Programs in Response to the Opioid Crisis (Infographic)—This infographic illustrates the key findings from the report of the national survey.
Data-Driven Responses to the Opioid Crisis (and Beyond)—Timely information sharing between law enforcement and public health agencies is one way to facilitate implementation of strategies to curb substance abuse. Using analysis results obtained in drug seizures, DEA’s NFLIS-Drug program illustrates changes in indicators of drug patterns; provides information about the diversion of prescription drugs; and identifies emerging drugs of abuse.
COSSAP Webinar: Making Data-Driven Decisions to Enhance Your Diversion or Deflection Program—Data are critical to understanding the individual- and community-level impacts of pre-arrest diversion and deflection programs over time. This IACP webinar highlights how administrators of these programs can apply evaluation recommendations to adjust program implementation for improved outcomes. Click on the links for Information about the two programs that are discussed in this webinar: Hero Help in New Castle County, Delaware and Longmont, Colorado's diversion programs.
Stimulants: Recent Trends and Prevention Resources—The use of illicit stimulants and the misuse of prescription stimulants present a daunting public health challenge across the United States. This article presents recent trends in the misuse of stimulants, and information on selecting appropriate prevention strategies that focus on stimulant drugs.
Children and Families
Considerations for Deflection and First Responder Diversion Programs: Taking a Trauma-Informed Approach—Substance use disorder not only affects individuals but also their families and communities. The opioid crisis, particularly in its effect on children, presents an ongoing challenge that deflection programs have begun to address. For first responders, minimizing repeated trauma in children through a trauma-informed approach is critical. Deflection offers first responders a way to connect children with treatment and services to help interrupt the impacts of trauma and produce positive outcomes for children.
The Opioid Crisis: The Critical Role of Law Enforcement—Law enforcement agencies can play an important role in mitigating the effects of the nation’s opioid crisis on its youngest victims by leveraging deflection strategies to identify and protect drug-endangered children and to connect them to community-based treatment, which is critical to reducing their exposure to substance use at home.
Law Enforcement Collaborations to Support Children Affected by the Opioid Epidemic—The 2020 Comprehensive Opioid Abuse Program National Forum highlighted the importance of law enforcement collaboration across systems to support children exposed to adverse childhood experiences (ACEs). This report describes how programs leverage cross-system collaborations, discusses ACEs and their connection to substance misuse, and details initial considerations and helpful resources for communities interested in replicating successful programs.
COSSAP Webinar: The Youngest Victims of the Opioid Epidemic: Law Enforcement's Role in the Response—The opioid crisis and its effect on children present a range of challenges for individuals, their children, and their families. First responders, particularly law enforcement, are in a unique position to help identify and divert children to community-based treatment and other services, thus diverting them away from the consequences of exposure to drug use. Such steps can have significant effects in identifying and addressing the needs of children exposed to and endangered by the presence of illegal drugs in their lives and homes. Panelists in this webinar defined “drug endangered children” and associated risk factors and identified three ways law enforcement and community-based organizations can collaborate in their response to drug endangered children.
Opportunities for Training and Technical Assistance and Peer-to-Peer Learning
IACP works with the Center for Health and Justice at TASC to provide training and technical assistance (TTA) to state, local, and tribal jurisdictions looking for evidence-based, systemic solutions at the front end of the justice system to respond to the substance misuse that often underlies justice system involvement. The Center for Health and Justice is the training and technical assistance provider for law enforcement and first responder led diversion under the COSSAP initiative.
This initiative provides communities interested in starting diversion and/or referral programs the opportunity to learn from established or innovative programs that have shown success in meeting the treatment needs of individuals with a substance use disorder, some of whom may have experienced an overdose.
The scope of this effort is limited to programs that have been created to serve individuals with opioid use disorder and other substance use disorders (not including marijuana) that have substantial law enforcement, fire services, or EMS engagement. [Note: Diversion or referral programs operated by prosecutors or the courts are not within the scope of this effort. Likewise, programs with a primary focus on addressing homelessness, untreated mental health disorders, and/or public nuisance offenses are not within the scope of this effort.]
- Huntington QRT, West Virginia
- Colerain Township QRT, Ohio
- Seattle LEAD, Washington
- Pima County’s U-Matter, Arizona
- Philadelphia PAD, Pennsylvania
- Plymouth County Outreach, Massachusetts
- Lake County’s “A Way Out,” Illinois
- Blue Earth County’s Yellow Line Project, Minnesota
The COSSAP TTA Program offers learning opportunities and assistance to support BJA COSSAP grantees and other local, tribal, and state stakeholders to build and sustain multidisciplinary collaborative responses to address illicit substance use and misuse.
Training and technical assistance is provided in a variety of formats, including virtual and in-person training events, workshop and meeting presentations, and online resources.
First Responder Deflection Resource Library: This is a repository of foundational documents that were submitted by existing first responder deflection (FRD) programs from across the United States. These documents comprise some core elements of FRD programs, such as release of information forms, policies and procedures, program brochures, intake forms, and memoranda of understanding. The library also houses a growing collection of process and outcome evaluations of existing FRD programs. If you are interested in contributing documents from your pre-arrest diversion or deflection program, please contact COSSAP@theiacp.org.
Articles and other Resources
Opportunities for Peer-to-Peer Connections: Commonalities Among FY2019 Statewide COAP Grantees: One of the goals of COSSAP (and its predecessor, the Comprehensive Opioid Abuse Program (COAP)) is sharing information about effective strategies to combat substance abuse. While each grantee’s activities are tailored to specific circumstances, there are commonalities in approaches that grantees may wish to explore through peer-to-peer connections. This article provides a snapshot of activities being prioritized by 13 fiscal year 2019 statewide COAP grantees and suggestions for how grantees can connect with their peers.
For more information, please contact: COSSAP@theiacp.org
This project is supported by Grant No. 2019-AR-BX-K055 awarded by the Bureau of Justice Assistance Office of Justice Programs, U.S. Department of Justice. The opinions contained herein are those of the author(s) and do not necessarily represent the official position or policies of the U.S. Department of Justice. References to specific agencies, companies, products, or services should not be considered an endorsement by the author(s) or the U.S. Department of Justice. Rather, the references are illustrations to supplement discussion of the issues.