Diversion programs tackle drug abuse without punishment

Health

A photo of Makayla Cox, who died of a fentanyl overdose at age 16, is displayed among other portraits on “The Faces of Fentanyl” wall, which displays photos of Americans who died from a fentanyl overdose, at the Drug Enforcement Administration (DEA) headquarters in Arlington, Virginia, on July 13, 2022. – America’s opioid crisis has reached catastrophic proportions, with over 80,000 people dying of opioid overdoses last year, most of them due to illicit synthetics such as fentanyl — more than seven times the number a decade ago. “This is the most dangerous epidemic that weve seen,” said Ray Donovan, chief of operations at the US Drug Enforcement Agency (DEA). “Fentanyl is not like any other illicit narcotic, its that deadly instantaneously.” (Photo by Agnes BUN / AFP) (Photo by AGNES BUN/AFP via Getty Images)

(NewsNation) — America’s approach to curbing the drug epidemic has been two-pronged: the threat of arrest and criminal conviction or mandated treatment and testing through drug courts. Chicago’s Narcotics Arrest Diversion Program (NADP) is trying a third approach.

NADP is one of several diversion programs around the United States. First piloted in 2018 on the city’s West Side, it’s now a citywide program that doesn’t rely on the threat of criminal sanctions at all.

Instead, when Chicagoans are arrested for low-level and nonviolent drug offenses, they’re offered the chance at diversion. There’s no formal criminal charge levied; instead, they’re connected to access to drug treatment.

“Then the treatment provider is the one who’s going to talk to you and do an intake process,” said Ashna Arora, research director at the University of Chicago Crime Lab. “What that means is, they’re going to talk to you, they’re going to decide what is best for you. Do you need individual counseling? Do you need group counseling? Do you need medication-assisted treatment?”

People who are referred to treatment are then free to choose whether to stick with it. There’s no punishment for dropping out of treatment.

Arora studied the program’s use in its first two years and found that despite the lack of coercion, many people chose to get help.

Almost 80% of people contacted by law enforcement chose to opt into treatment and more than half stayed in treatment for at least 30 days. By 90 days, a little under a third were still in treatment.

It’s not clear how successful treatment is for these participants, but Arora and her researchers estimated that the retention rate is similar to substance use treatment programs more broadly.

Arora also found that NADP participants were about 72% less likely to be rearrested in the future; that includes being less likely to be rearrested for both drug and violence charges — suggesting that the program may be helping improve public safety.

“So we really do think the program is working, in that it is reducing further involvement with the criminal justice system,” she said.

The main treatment provider that’s worked with the City of Chicago on this program is called Thresholds, which has long worked with people with mental health and substance abuse problems. Anne Brekke, who serves as its program director, described how its staff approach NADP participants.

“We really try to be as compassionate as possible and ask them, have you been in treatment before? What worked for you? What did you like? What didn’t you like?” she said.

Much of what Thresholds does is provide wraparound services, like finding participants an apartment or getting them a state ID or driver’s license.

“Most of the people coming from NADP might be in a contemplation or precontemplation stage of change. We don’t judge that, and we say, OK, what are some things you need?” Brekke said.

While Arora’s research has found that the program has been associated with a reduction in rearrests, there are still some outstanding questions on how effective it is in combatting substance abuse overall.

One of Chicago’s reasons for adopting NADP was to combat the opioid crisis.

“We don’t actually understand if drug arrest diversion is actually able to reduce the risk of overdose. Obviously the hope is that the treatment is like Step One of moving that very important outcome, but we don’t actually know if that’s true,” she said, adding that they are trying to study that right now.

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