The Unprecedented Opioid Epidemic: AS OVERDOSES BECOME a LEADING CAUSE of DEATH, POLICE, SHERIFFS, and HEALTH AGENCIES MUST STEP up THEIR RESPONSE
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The Unprecedented Opioid Epidemic: AS OVERDOSES BECOME A LEADING CAUSE OF DEATH, POLICE, SHERIFFS, AND HEALTH AGENCIES MUST STEP UP THEIR RESPONSE DEATHS IN THE UNITED STATES, PEAK YEAR 64,070 Drug Overdoses, 2016 54,589 Car Accidents, 1972 50,628 HIV/AIDS, 1995 44,193 Suicides, 2015 24,703 Homicides, 1991 16,899 Vietnam War, 1968 The Unprecedented Opioid Epidemic: AS OVERDOSES BECOME A LEADING CAUSE OF DEATH, POLICE, SHERIFFS, AND HEALTH AGENCIES MUST STEP UP THEIR RESPONSE SEPTEMBER 2017 This publication was supported by the Howard G. Buffett Foundation. The points of view expressed herein are the authors’ and do not necessarily represent the views of the Howard G. Buffett Foundation or of all Police Executive Research Forum members. Police Executive Research Forum, Washington, D.C. 20036 Copyright © 2017 by Police Executive Research Forum All rights reserved. Printed in the United States. ISBN: 978-1-934485-39-2 Graphic Design by Dave Williams. Photographs by Greg Dohler. CONTENTS Acknowledgments | PAGE 4 Summary: Police Agencies Are Rushing to Save Lives, Help Addicted Persons, and Reduce Drug Abuse | 8 10 Actions Police Chiefs and Sheriffs Can Take | 14 The Extent and Nature of the Opioid Epidemic | 15 PERF Survey Shows Dramatic Spike in Heroin and Fentanyl Deaths | 19 New York City Offers a Model for a Data-Driven, Collaborative Response | 22 How Do Police, Public Health Agencies, and Other Organizations Share Information about Overdoses? | 33 Federal Perspectives from ONDCP and DEA | 42 Police Are Increasingly Active in Getting Addicted Persons into Treatment | 46 Teaching Communities about the Addiction Risks of Opioid Medication | 67 Prosecutors Face Difficult Questions About Their Role in Reducing Overdose Deaths | 71 Conclusion: A Worsening National Crisis Requires a Stronger Response | 80 Participants: “Responding to the Opioids Epidemic” Conference | 84 ACKNOWLEDGMENTS In PERF’s 40-year history, we have taken on many are being undertaken to address the crisis with a difficult, sensitive issues: police use of force, racial Compstat-like approach. Deputy Commissioner bias, terrorism, active shooters, sexual assault, Susan Herman, Chief of Crime Control Strategies immigration issues, killings of police officers, riots Dermot Shea, Chief of Detectives Robert Boyce, and major demonstrations, the police response to Chief Edward Delatorre, Chief Kevin Ward, and natural disasters, and so many more. many others from NYPD shared their expertise But never has PERF worked on an issue more at our meeting and in interviews we conducted to vexing and painful than the opioids crisis that the prepare for the conference. Dr. Denise Paone of United States is now facing. In just one year, 2016, New York City’s Department of Health and Mental nearly as many people died from opioid overdoses Hygiene provided important information about as all U.S. fatalities during the entire course of the public health perspectives. And Chauncey Parker Vietnam War. And despite the huge amount of of the New York County DA’s Office, who played a hard work and thoughtful strategies that police key role in New York City’s response to the opioid chiefs and sheriffs have thrown at this problem crisis, gave us the benefit of his expertise and over the last few years, the crisis has not yet insights from his remarkable career. peaked. It is still getting worse, according to federal I also want to thank all of the police chiefs statistics. and other officials from across the country who This report is PERF’s third major report on came to New York to share their expertise with us. the opioids crisis. We keep coming back to this The opioids crisis is hitting cities and towns of all issue precisely because the fatalities continue to sizes across the nation, and this report provides increase. a sense of how the situation is not the same in I am grateful to everyone who has contributed every jurisdiction, so there are some differences in to helping PERF maintain its focus on this issue. how agencies are responding. I’m grateful to the Many people deserve thanks for organizing public health and drug treatment professionals and participating in the project that led to this who participated, because there is universal agree- report. I would like to begin by thanking the New ment that the response must be a joint effort York City Police Department for hosting our April by many stakeholders. And DEA Acting Admin- 6, 2017 conference at their headquarters building istrator Chuck Rosenberg and ONDCP Acting in lower Manhattan. Commissioner James O’Neill Director Richard Baum provided important federal could not have been more generous, in terms of perspectives. providing much of the content for our meeting, Thanks also to all of the PERF members who as well as in flawlessly hosting a daylong event for completed our 2017 national survey about the more than 150 officials from across the country. opioids crisis. We conducted a similar survey on Commissioner O’Neill led off our meeting the opioids crisis back in 2014, and it’s striking with a powerful summary of the opioids crisis and how many police agencies across the country have New York City’s comprehensive initiatives that taken concrete actions to address the issue since 4 Acknowledgments then. In 2014, only 4 percent of our survey respon- thank Craig Fischer, our Communications Director, dents were equipping officers with naloxone; by who spent considerable time reviewing transcripts 2017, that figure had risen to 63 percent. of our meeting and drafting this well-organized I’m also deeply grateful to the Howard G. and compelling report. Buffett Foundation for supporting this project. There is no more important issue in many Howard Buffett is a businessman, farmer, author, cities and towns today than the opioids epidemic. and philanthropist with an interest in a wide Police and sheriffs’ agencies across the country range of issues, including poverty and hunger, have undertaken brilliant new approaches to the conservation and the environment, and law crisis, in many cases taking on entirely new roles enforcement. Howard recently was named Sheriff for law enforcement officers. Thousands of police of the Macon County, IL Sheriff’s Office, after officers are carrying naloxone and saving lives by serving in a number of other positions in that the hour. Some officers are even knocking on the department since 2012. He has seen the opioid front doors of people who suffered a recent over- problem first hand and taken a personal interest dose, asking if they can help them get into treat- in this issue. I’m proud to call him my friend, and ment. Others are working with their forensics labs PERF is very grateful for his generous support. and medical examiners to analyze overdose cases as Many PERF staffers worked together to quickly as is humanly possible, in order to stop the organize this project. Assistant Communica- deadly spikes in heroin or fentanyl overdoses. tions Director James McGinty provided overall Unfortunately, this epidemic is not yet direction and used his excellent research skills to showing signs of abating. So we must continue to develop the agenda for our conference at NYPD. expand the programs that we know are working, Research Assistant Allison Heider, Senior Research while reassessing our strategies and searching for Assistants Sarah Mostyn and Matt Harman, and new approaches. Research Associate Jason Cheney interviewed PERF is grateful to the people who contributed police executives and other experts to gather infor- to this report, who are at the front lines of this mation about how police and other agencies are crisis every day. responding to the crisis. Senior Research Criminol- ogist Sean Goodison conducted PERF’s survey, with tenacious support from Research Assistant Nate Ballard. My executive assistant, Soline Simenauer, once again anticipated and managed 100 logistical issues, ensuring that everything went smoothly at Chuck Wexler the conference. Director of Applied Research Tom Executive Director Wilson and Chief of Staff Andrea Luna provided Police Executive Research Forum guidance to the entire project. And lastly, I want to Washington, D.C. Acknowledgments 5 More people are dying of opioid overdoses than are dying on our highways in motor vehicle accidents. In Camden, a city of 77,000, by the end of this month of April, we will exceed the number of fatal overdoses that we had all of last year. We’ve already eclipsed 30. There are times when our ambulance crews can’t even keep up with the overdose calls that are coming in. And overall, we are still losing this battle. We must not relent, because this is about preventing parents from having to bury their children, and there’s nothing more significant than that. —Scott Thomson, Camden County, NJ Police Chief and PERF President Make no mistake about this: The opioid epidemic is a national crisis. Here in New York City, it’s happening in all five of our boroughs. It’s affecting people from all walks of life, of all races, ages, and financial backgrounds. No facet of our society is immune. I’m confident that we can turn the tide on this. But it’s going to take cooperation at every level of government, and working in public- and private-sector partnerships. That’s our way forward. —James O’Neill, New York City Commissioner of Police We all remember that awful shooting in Orlando at the Pulse nightclub last year, in which 49 people were slaughtered by a madman. Imagine that happening three times a day, every day, for 365 days in a row. That’s roughly what we’re talking about with fatal drug overdoses. So we truly have an epidemic; that’s not hyperbole. This is unique and unprecedented. TOP: Chief Scott Thomson, Commissioner James O’Neill.