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Boston University Slideshow Title Goes Here Boston University School of Public Health If we build it will they come? Police deflection programs; Gloucester Ma and PAARI David Rosenbloom, PhD Boston University School of Public Health Boston


  1. Boston University Slideshow Title Goes Here Boston University School of Public Health

  2. If we build it will they come? Police deflection programs; Gloucester Ma and PAARI David Rosenbloom, PhD Boston University School of Public Health Boston University School of Public Health

  3. Thanks to § SPH colleagues Boston University Slideshow Title Goes Here § Davida Schiff, MD § Mari Lynn Drainoni, PhD § Howard Cabral, PhD § Gloucester Police Department § Former Chief Leonard Campanello § Chief John McCarthy § Lt. David Quinn § Officers on the desk Boston University School of Public Health

  4. Deflection: a new term in policing Boston University Slideshow Title Goes Here Key elements Types § Avoid arrest § Naloxone Plus: opiate response teams, STEER (MD) · § Prevent overdose deaths § Active Outreach: Arlington Model § Facilitate access to treatment (MA) § Self-Referral: Angel (MA) § Officer Prevention Referral: LEAD (WA), STEER (MD) § Officer Intervention Referral: Civil Citation (FL), STEER (MD) Boston University School of Public Health

  5. Police Assisted Addiction Recovery Initiative Boston University Slideshow Title Goes Here § NFP to support PD programs § Founded May, 2015 § Volunteer Board § TA for Departments § Treatment Center linkage § Policy advocacy Boston University School of Public Health

  6. Deflection growing Rapidly; Gloucester two years old; now more than 250 PAARI PD’s Boston University Slideshow Title Goes Here Boston University School of Public Health

  7. MA overdose deaths increasing but rate is moderating Boston University Slideshow Title Goes Here Boston University School of Public Health

  8. MA Deaths may have peaked Boston University Slideshow Title Goes Here Boston University School of Public Health

  9. Fentanyl growing; Fentanyl laced cocaine coming to a street near you soon Boston University Slideshow Title Goes Here Boston University School of Public Health

  10. Gloucester Police Angel Program May 5, 2015 Press Program designed rapidly Boston University Slideshow Title Goes Here announcement: evolved § Gloucester Police Chief Announces Major § Announced; little formal Drug Policy Changes planning § Addicts Who Surrender their Drugs and Ask for Help will NOT be Charged — Will be § Hospital role reduced Offered Treatment § Professional screeners § Partnership with Lahey Hospital and Medical Center and Addison Gilbert Hospital eliminated § Nasal Narcan to be Made Available for Free at Local Pharmacy § Direct placement by cops Chief to travel to Washington Next Week to § § Addition of PAARI Meet with Senators Warren and Markey and Representative Moulton counselor GPD Facebook Post Reaches 800,000 § People as of Tuesday Morning Boston University School of Public Health

  11. Gloucester Angel Program’s First Year BUSPH Team Initial First 100 429 total visits involved, announcement visits to for ANGEL refines intake on Facebook GPD program form March June 2015 Aug 2015 May 2016 July 2015 2015 Program adapts Program adapts ANGEL to find placement to bring case Program directly by GPD managers into begins officers GPD

  12. Formative Evaluation using mixed methods Quantitative Data Boston University Slideshow Title Goes Here Qualitative Data § Collection § Collection § Follow-up calls to all participants § Intake form filled out by 3-6 months after participation to officers at Police Department assess experience using the program § Placement Data from Police § Trained medical students, semi- Department structured questionnaire, § Analysis transcribed verbatim § Descriptive Statistics § Analysis § Frequencies, Means for § Coded in Excel by three members demographic data and drug use of the study team coding 75% of history the interviews, met to review data, establish consensus Boston University School of Public Health

  13. Boston University Slideshow Title Goes Here Schiff et al, NEJM, Boston University School of Public Health 2016

  14. Results - Participant Characteristics Boston University Slideshow Title Goes Here Between June 1, 2015 – May 31, 2016: § 429 total visits § 376 unique individuals § 11% (n=40) returned for two or more visits Where were participants coming from?: § 12% resided in Gloucester § 25% Essex County (surrounding Gloucester) § 41% Elsewhere in MA § 17% were homeless § 6% from other states Boston University School of Public Health

  15. Participants by Zip Code - MA

  16. Many from in and around Gloucester, but broader Boston University Slideshow Title Goes Here Boston University School of Public Health

  17. ANGEL MA Sub Abuse Tx Adm NSDUH, OUD Characteristic PROGRAM (BSAS FY 2014) (2009-2013) (6/2015- 5/2016) Total # participants 376 85,823 6770 Gender, % male 70% 68.4% 59.2% Age (Mean) 29.4 yrs % < 18 1% 2% 9% % 18-25 30% 21% 30% % >26 69% 77% 61% % Insured 85% 70% % Past needle/heroin 84% 59% 35% use Education < High School 14% 24% Completed HS 50% 46% > High School 36% 29% Marital Status Married/In a committed 14% 11% rel. 80% 73% Single, never married 6% 15% Separated/Divorced

  18. ANGEL MA Sub Abuse Tx Adm NSDUH, OUD Characteristic PROGRAM (BSAS FY 2014) (2009-2013) (6/2015- 5/2016) Total # participants 376 85,823 6770 Gender, % male 70% 68.4% 59.2% Age (Mean) 29.4 yrs % < 18 1% 2% 9% % 18-25 30% 21% 30% % >26 69% 77% 61% % Insured 85% 70% % Past needle/heroin 84% 59% 35% use Education < High School 14% 24% Completed HS 50% 46% > High School 36% 29% Marital Status Married/In a committed 14% 11% rel. 80% 73% Single, never married 6% 15% Separated/Divorced

  19. ANGEL MA Sub Abuse Tx Adm NSDUH, OUD Characteristic PROGRAM (BSAS FY 2014) (2009-2013) (6/2015- 5/2016) Total # participants 376 85,823 6770 Gender, % male 70% 68.4% 59.2% Age (Mean) 29.4 yrs % < 18 1% 2% 9% % 18-25 30% 21% 30% % >26 69% 77% 61% % Insured 85% 70% % Past needle/heroin 84% 59% 35% use Education < High School 14% 24% Completed HS 50% 46% > High School 36% 29% Marital Status Married/In a committed 14% 11% rel. 80% 73% Single, never married 6% 15% Separated/Divorced

  20. ANGEL MA Sub Abuse Tx Adm NSDUH, OUD Characteristic PROGRAM (BSAS FY 2014) (2009-2013) (6/2015- 5/2016) Total # participants 376 85,823 6770 Gender, % male 70% 68.4% 59.2% Age (Mean) 29.4 yrs % < 18 1% 2% 9% % 18-25 30% 21% 30% % >26 69% 77% 61% % Insured 85% 70% % Past needle/heroin 84% 59% 35% use Education < High School 14% 24% Completed HS 50% 46% > High School 36% 29% Marital Status Married/In a committed 14% 11% rel. 80% 73% Single, never married 6% 15% Separated/Divorced

  21. ANGEL MA Sub Abuse Tx Adm NSDUH, OUD Characteristic PROGRAM (BSAS FY 2014) (2009-2013) (6/2015- 5/2016) Total # participants 376 85,823 6770 Gender, % male 70% 68.4% 59.2% Age (Mean) 29.4 yrs % < 18 1% 2% 9% % 18-25 30% 21% 30% % >26 69% 77% 61% % Insured 85% 70% % Past needle/heroin 84% 59% 35% use Education < High School 14% 24% Completed HS 50% 46% > High School 36% 29% Marital Status Married/In a committed 14% 11% rel. 80% 73% Single, never married 6% 15% Separated/Divorced

  22. ANGEL MA Sub Abuse Tx Adm NSDUH, OUD Characteristic PROGRAM (BSAS FY 2014) (2009-2013) (6/2015- 5/2016) Total # participants 376 85,823 6770 Gender, % male 70% 68.4% 59.2% Age (Mean) 29.4 yrs % < 18 1% 2% 9% % 18-25 30% 21% 30% % >26 69% 77% 61% % Insured 85% 70% % Past needle/heroin 84% 59% 35% use Education < High School 14% 24% Completed HS 50% 46% > High School 36% 29% Marital Status Married/In a committed 14% 11% rel. 80% 73% Single, never married 6% 15% Separated/Divorced

  23. Question # of Frequency (n) Responses Prior drug arrests (% yes) 295 54.6% (161/295) Last Opioid Use: Same day (130, 53.9%) 55% (178/326) Boston University Slideshow Title Goes Here Yesterday (76, 31.5%) 29% (94) 2-4 days (21, 8.7%) 10% (33) 5 days or more (14, 5.8%) 6% (21) Age started using drugs 281 15.3 yrs (sd 3.6) Age started using opioids 287 20.4 yrs (sd 5.6) Prior detox visits (% yes) 285 82% (234/285) Others types of Tx for opioids: 202 Methadone 29% Buprenorphine 47% Self-Help Group 82% Counseling 28% Long term outpatient 7% Residential Treatment 9% Boston University School of Public Health Sober house 7%

  24. Question # of Frequency (n) Responses Prior drug arrests (% yes) 295 54.6% (161/295) Last Opioid Use: Boston University Slideshow Title Goes Here Same day (130, 53.9%) 55% (178/326) Yesterday (76, 31.5%) 29% (94) 2-4 days (21, 8.7%) 10% (33) 5 days or more (14, 5.8%) 6% (21) Age started using drugs 281 15.3 yrs (sd 3.6) Age started using opioids 287 20.4 yrs (sd 5.6) Prior detox visits (% yes) 285 82% (234/285) Others types of Tx for opioids: 202 Methadone 29% Buprenorphine 47% Self-Help Group 82% Counseling 28% Long term outpatient 7% Boston University School of Public Health Residential Treatment 9% Sober house 7%

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