Police Diversion to Treatment for Opioid Use Disorder: A Mixed Methods Study - Abstract Text
This timely and significant K01 award will provide the PI, Dr. del Pozo, with the training and expertise
necessary to achieve his long-term goal of becoming a leading investigator of the health outcomes of policing
in relation to substance use disorders. Drug overdose deaths have reached record proportions in the United
States, driven by powerful synthetic opioids. At the same time, police departments are being called upon to
emphasize public health approaches to behaviors that have traditionally generated arrests. For people with
opioid use disorder (OUD), a way to address these concerns is the practice of diverting them to treatment
using medications for opioid use disorder (MOUD) as an alternative to arrest. These connections can be an
effective upstream health intervention, but success relies on an officer’s discretionary judgment, which can be
negatively influenced by a variety of barriers as well as stigma-based norms, attitudes, and beliefs about
MOUD and people with OUD. Effective diversion requires research on why police officers choose to divert or
arrest, how stigma affects these decisions, and how programs and systems can positively influence this
practice. To conduct this research, the proposed award augments the PI’s unique and valuable experience as a
chief of police and his training as a postdoctoral researcher in substance use at Miriam Hospital/Brown
University with a comprehensive plan that provides training in (1) qualitative methods, (2) the science of
stigma, (3) psychometric measurement, (4) analysis of survey data, and (5) implementation science and study
design in police settings. Training will be guided by mentors with exceptional expertise: Dr. Jody Rich (primary
mentor), Dr. Michael Compton, Dr. Beth McGinty, Dr. Valerie Earnshaw, and Dr. Steven Belenko. The training
plan strategically aligns with mixed-methods research that will 1) develop and validate an instrument to
measure police stigma toward people who use drugs, 2) use the Theory of Planned Behavior to identify other
key variables that determine police officers’ intentions to divert people to MOUD, and 3) determine the
officer-perceived barriers and facilitators of effective diversion. Conducted in collaboration with leading police
research organizations and a community advisory board, the project will produce actionable training, policy,
and process recommendations for communities seeking to increase connections to care for OUD, while
meeting several priorities outlined in NIDA’s RFI for its 2021-2025 Strategic Plan: 1) Implementing evidence-
based strategies in real world settings by integrating treatment services into justice settings; 2) Translating and
disseminating research to inform policy and practice; 3) Identifying and developing approaches to reduce
stigma; 4) Developing approaches to reduce health disparities. By the conclusion of this award, the PI will be
positioned to conduct independent research on responses to substance use in police settings, including an R01
Hybrid Type-2 study of the effectiveness and implementation of diversion to MOUD in a sample of US police
departments.
