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 approaches are referred to as “pathways” because, in contrast to justice system interventions, programs in these pathways enable first responders to offer access, or pathways, to community-based treatment and resources to support individuals in need. These pathways often include first responders working in partnership with case managers, treatment providers, and peer recovery coaches to help individuals access treatment and recovery support services.

Resources

The Six Pathways: Frameworks for Implementing Deflection to Treatment, Services, and Recovery—This article describes the difference between “deflection” and “pre-arrest diversion,” explains the term “pathway,” provides descriptions of each pathway and explains how programs in each pathway work. This article provides a good introduction to the publications in the “Pathways to Deflection Case Study Series.” 

Pathways to Deflection Case Study Series

All of the publications in the Pathways to Deflection Case Study Series start with an overview of deflection and pre-arrest diversion, define the term, “pathway,” and describe the six pathways of deflection and pre-arrest diversion. Each publication then provides an in-depth examination of one of the pathways, including its origin story, how programs in that pathway work, and 10 critical elements for planning and implementing programs in that pathway. Finally, each publication features case studies from five sites that are implementing programs in that pathway.

• Pathways to First Responder Diversion Case Studies Series: Self-Referral
• Pathways to First Responder Deflection Case Studies Series: Active Outreach
• Pathways to First Responder Diversion Case Studies Series: Naloxone Plus
• Pathways to First Responder Deflection Case Studies Series: First Responder and Officer Referral
• Pathways to First Responder Diversion Case Studies Series: Officer Intervention

Coming soon!

• Pathways to First Responder Deflection Case Studies Series: Community Response

Implementing Law Enforcement and First Responder Diversion Programs

Reassessing Arrest: Exploring Pre-Arrest Diversion as an Alternative to Arrest for Vulnerable Populations— This publication is one in a series and is based on a literature review examining the factors associated with arrest and alternatives to arrest.

Building Healthier Communities through Pre-Arrest Diversion— This factsheet outlines collaborative pre-arrest diversion strategies that offer connections to treatment and recovery for individuals in need, while enhancing community safety and engagement

Law Enforcement Response to People with Developmental Disabilities: Steps for Deflection or Pre-Arrest Diversion— This multipage guide provides insights into the developmental disability community, offers suggestions for successful interactions with people with developmental disabilities, and outlines options for safe and effective deflection and pre-arrest diversion when people with developmental disabilities encounter law enforcement and may be experiencing a crisis or are otherwise in need of services.

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.

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.

 Trauma and the Opioid Crisis: Perceived Impacts on First Responders— This publication explores the mental and emotional impact of the opioid and other drug crises on first responders who address these issues daily, as well as tools and strategies to help support them. 

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.

Effective Youth Diversion Strategies for Law Enforcement— This webinar consists of a panel composed of a police chief, county prosecutor, and division director of juvenile services provides information on their youth diversion programs, including program development, successes, and challenges faced during implementation. A discussion of lessons learned assists law enforcement agencies as they consider starting or improving a youth diversion program.

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.

The COSSUP TTA Program offers learning opportunities and assistance to support BJA COSSUP 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.

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 substance use disorders, some of whom may have experienced an overdose.

The ten mentor sites listed below represent a diverse cross-section of model strategies and examples of successful collaborations between law enforcement and first responders, behavioral health providers, and other community partners to connect individuals with substance use disorders to treatment and resources. As host agencies, these mentor sites will offer their experience and expertise to visiting mentees.

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 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.]

For any questions or information about COSSUP TTA or Peer-to-Peer Learning, please email [email protected] or [email protected].  

Mentor Sites

• Chapel Hill Police Department Crisis Unit, North Carolina
• City of Columbus Department of Public Safety Rapid Response Emergency Addiction 
  Crisis Team (RREACT) EMS Outreach Program, Ohio
• Fort Wayne FWPD Hope and Recovery Team (HART), Indiana
• Hamilton County Office of Addiction Response QRT, Ohio
• City of Northampton DHHS Drug Addiction Recovery Team (DART) Division of Community Care (DCC), Massachusetts
• Plymouth County Outreach, Massachusetts
• Tucson Police Department Community Outreach Resource and Engagement (CORE)- Deflection Program, Arizona
• New Castle County's Hero Help Addiction and Behavioral Health Unit, Delaware
• Newark's Community Street Team (NCST) Overdose Response Program, New Jersey
• Stanly County's Paramedic Division, North Carolina