For today’s Daily Report, PERF Executive Director Chuck Wexler spoke with four police officials from Massachusetts and Maine about their harm reduction strategies for reducing opioid overdoses, including the distribution of fentanyl test strips, which individuals can use to detect the presence of fentanyl in their drugs.

These four agencies are part of a program organized by the Police Assisted Addiction and Recovery Initiative (PAARI) to distribute fentanyl test strips.

New Bedford, MA Lt. Scott Carola

For the last several decades, New Bedford has had issues with opiates. It was heroin for many years when I first came on the job, then it moved into our current state of affairs, with fentanyl and the unfortunate return of heroin. So we’ve had a problem, like many places around the country. We attribute a great number of overdose-related deaths to fentanyl and heroin. I think those numbers have been pretty consistent over the last several years, with maybe a slight decline.

We are distributing fentanyl strips through our outreach team. The team has police officers, clergy members, and drug counselors. We go to the houses of people who have experienced an overdose and check up on them. If somebody overdosed two days ago and we have an address for them, we’ll go knock on their door.

If they’re home, we can counsel them and give them harm reduction items. If they’re not home, we may be able to speak with their family, and provide them with treatment information and maybe give them Narcan. Because family members and friends may be the ones who encounter a person in a state of overdose, we try to get Narcan in as many hands as we can.

Once we’re done with these house visits, we go out on the street to the hotspots where there are drug users, and the drug counselors will hand out Narcan, bleach and cleaning materials, and fentanyl strips.

The police officers themselves are not handing out Narcan, although we wouldn’t necessarily discourage that. But normally our drug counselors who are part of our outreach team handle all the Narcan, fentanyl strips, and cleaning materials, because handing that out is their foot in the door to try to refer people to treatment.

Police go out with our outreach team for safety and security. When I go out and our counselors start talking about treatment or handing out items, I walk 5 or 10 feet away to let them have a little more privacy, because I feel like they may be more open to talking to a drug counselor without us standing right there.

I’m hearing reports that the fentanyl strips are helpful, and we’re glad to have that extra tool in our toolbelt.

Wexler: How do the New Bedford officers and the community at large feel about this?

Lt. Carola: There has always been a segment of society who say, “A couple strikes and you’re out. We shouldn’t be Narcan-ing people.” I have an optimistic view and think it’s just a loud minority of people who talk like that.

For law enforcement, I think the program is good because it gives officers an opportunity to encounter drug users in an atypical setting. You’re not rolling up on them because you think they just engaged in a deal, and you’re not searching them. You’re talking to them and hearing about their issues, so it opens up a lot of opportunities for empathy. For the police, involvement in this is voluntary, so we have a group of people who want to be there.

I think the program has been good for our department and the city. Years ago there may have been people in the city saying that we shouldn’t hand out Narcan, but those voices have seemed to fade away. People who have said those things in the past may have later known somebody who has fallen victim to a drug habit. So I think we’re all getting a little more educated about it.

Edgartown, MA Chief Bruce McNamee

Edgartown is on Martha’s Vineyard, and the island has a long history of addiction issues, possibly because of the isolation. We’ve been no stranger to heroin use and other matters of mental illness and chemical dependence.

When this program first came out, I was a new chief in this department. I had some reluctance initially, because I didn’t know how it would be received. But it has worked very well. We have a detective and a sergeant, both of whom are trained recovery coaches, who work with civilian recovery coaches on an outreach program.

If we have an overdose reported or a Narcan deployment comes to our attention, we’ll have a plainclothes officer go with a recovery coach to try to encounter the person who had the overdose or a family member. We leave behind literature and fentanyl test strips. A lot of our past overdoses involved fentanyl.

I haven’t gotten a sense from the community that they feel this could be enabling somebody. The reaction has been nothing but positive. The island has a substance use disorder coalition, and we’re a sitting member of that group. We’ve been welcomed there, and I think this helps us show the community that we’re interested in getting people help, and we’re not just trying to have them arrested.

Wexler: How do the recipients of the fentanyl strips respond when your officers hand them out?

Chief McNamee: From what I’ve been told, it’s been very positive. Some individuals ask for additional kits. We usually leave two kits, each with three test strips, as well as literature about local resources.

Wexler: Were you expecting to do this sort of work earlier in your policing career?

Chief McNamee: No. I’m a new chief, and I’ve seen how things have evolved over the past several years with the outreach program. I don’t think anyone saw us going down that road, but it sure has been a positive one for us. In a time when we’re looking to remind people of the strong relationships we have with our community, these kinds of programs are great to show that we really want to be part of the solution, and we’ve been doing that since long before the recent dark light was cast on our profession.

We do care. This is outside the traditional scope of law enforcement, but we’re not afraid to take it on. We understand that police work evolves, and you have to be prepared to change with it.

Wexler: Have you seen any recent trends in your overdose data, particularly since the pandemic began?

Chief McNamee: Our overdose data has been pretty consistent over the last three years. But those are just the ones that are brought to the attention of the police department, and Narcan is so prolific now that overdoses could be occurring that we don’t know about. But what has been reported to the Edgartown Police Department has been consistent.

As far as addiction during COVID, it seems like a big part of having an addiction issue is having a sense of isolation, at least initially. That can only be worsened at a time when everything is locked down. Even the Alcoholics Anonymous and Narcotics Anonymous meetings are happening on Zoom, and I can’t imagine that has the same effectiveness as sitting across from somebody. So our hope is that once we have more people vaccinated, these processes can happen in person to maintain a personal touch.

Wexler: How is the fentanyl test strip program funded?

Chief McNamee: The initial program we participated in was sponsored by a grant from the Massachusetts Department of Public Health. Brandeis University has since picked that up. I don’t know if they’ll be looking for agencies to pay to participate in the future, but we would pay to participate if we had the ability to do so fiscally. So initially it didn’t cost us anything, and we’re not sure what it will be going forward.

But you can’t put a price tag on somebody’s life. We’re happy to incur that expense if we can prevent overdoses in our community.

Taunton, MA Officer Steve Turner

I’ve been a police officer for 33 years, and about 7 years ago, the chief asked me if I wanted to be involved in the Taunton Opiate Task Force. I declined, but I found out that chiefs don’t ask, they tell. So I was told I would be involved in the Taunton Opiate Task Force, which I’ve been doing for 7 years. I’ve been in charge of the outreach team for the last four years.

My reluctance about this quickly turned into passion and empathy.

We have about 160 people on our Taunton Opiate Task Force, and I coordinate the Taunton Opiate Outreach Team. I’m the only police officer on the outreach team, and we have 11 members of the community, including teachers, counselors, nurses, clergy, and probation officers. It’s a marvelous team. We just finished our fourth year, and during that time we’ve done 3,570 outreach visits.

People don’t know we’re coming, but we’ve never been turned away from a house. If somebody is home, we’ve always been able to engage in a conversation. Sometimes we’re invited in, and sometimes we talk on the porch. More often than not, people thank us for coming. They are thankful and amazed that the police chief and community put together this team.

We go out three times a week. We visit anyone who has overdosed. If they aren’t home or say they aren’t up for it right now, we’ll go back next time.

The packets we hand out that include fentanyl strips are very well-received. I think we’ve given out about 150 packets.

As part of this outreach team, I can get anyone into rehab right away. If I go to your house and you tell me you’re ready to go to rehab, I make a call. I have three facilities that reserve a bed for me each week, and I try to use them each week.

This would not have happened when I came on in 1987, or in 1997, or 2007. I see younger officers much more equipped with the right mentality and the empathy, who are trained and maybe were just brought up differently than I was. The younger officers are so much more empathetic and caring than I was when I came on, to be honest.

Years ago, I would’ve said that addiction only happens to people I don’t know. But I go to houses of people who are my son’s age and who I coached, and families I grew up with. It can happen to any one of us. This program has made me a better person and a better police officer.

Wexler:  Have your overdoses increased because of COVID?

Officer Turner:  We have seen that our overdoses were up about 60% in 2020.

Wexler: What about the argument that some people may use the strips to look for fentanyl, because they are seeking out stronger drugs?

Officer Turner: I’ve heard from a few people that they’ve used it to make sure it does have a little fentanyl in it, which blows my mind. They want that extra ride. So I think it goes both ways.

But to show you the trust we’ve developed, I’ve had 12 to 15 visits where they’ve pulled out the drugs they had in front of me. They ask if I’m going to take it away from them. I say I’m not going to take it away, though I want to, but let’s just test it. More than half of those have found fentanyl when they’ve tested it in front of me, and it scares them. Everyone who has found fentanyl in front of me has asked me to get rid of it for them. That’s potentially several lives saved right there.

I’ve given the strips to family members to pass along. I’ve received calls back saying that they’ve gotten rid of drugs because the stuff was loaded with fentanyl.

Westbrook, ME Chief Sean Lally

Maine is known as “Vacationland,” with beautiful beaches, lighthouses, lobsters, and all that. But we also have a serious opioid problem. Last year we had the most overdose deaths in history, and it was more than our COVID deaths. So the opioid crisis is alive and well here.

Wexler: Do you think there’s a connection between the pandemic and your record number of overdoses?

Chief Lally:  I do. A lot of people were out of work, so a lot of people were bored and couldn’t go anywhere. The drug trafficking organizations take advantage of that.

Wexler: How does your fentanyl test strip program operate?

Chief Lally: We have a total of 42 officers. We have a substance use disorder counselor on staff. She’s a recovering addict herself, so she has a lot of credibility within the user community.

She works to remove obstacles to recovery for people. Let’s say you’re a mom with two kids and you need to go to rehab, but you can’t go to rehab if you don’t have anyone to watch your children. She tries to help the woman find day care, to remove those obstacles and connect people to services so they can be successful in recovery.

She responds to overdoses with our officers. We hand out her card at every overdose to encourage people to seek treatment.

Early on in my tenure, we stopped arresting people at overdose scenes. Basically, if you call for help during an overdose, we’re not going to arrest you. That doesn’t mean we’re not going to charge you later if there’s a significant amount of drugs or you’re trafficking, but we’re not going to arrest you there. We’re going to try to steer you towards treatment.

One of the things we’ve seen recently is counterfeit prescription pills. They’re made to look like oxycodone, Xanax, or some other pill, but it’s counterfeit, made in a pill press, and contains fentanyl. People are taking these pills thinking they’re getting Xanax and are overdosing on fentanyl.

To prevent harm and prevent deaths, we entered into this program to receive fentanyl test strips. We just started and have been handing them out over the last couple weeks.

Wexler: Is the entire program expensive?

Chief Lally:  Our licensed substance use disorder counselor is a full-time position, with pay and benefits. But for us, the return on investment is worth it. We go to overdoses almost every day. When you take someone out of the crime cycle that they’re using to fuel an addiction, whether that’s drug trafficking or theft, you free up resources. When that person isn’t committing 100 crimes a year, that’s 100 fewer calls you have to go on. So it is worth the investment.

Wexler: Has your thinking on this issue evolved over your career?

Chief Lally: I’ve been on the department for 24 years, and I started as chief on the 1^st of this year. When I was a young officer, I was on the state drug task force, so I arrested a lot of people with substance use disorders. We called them addicts back then. We kind of marginalized and dehumanized them. It was easy to just call them an addict and arrest them.

Thank God we’ve evolved to treat them as human beings who have a disorder. They’re not all criminals, and they’re not all there because they want to be. If you went for knee surgery back in 2001, they would’ve handed you as many 80mg oxycodone pills as you could take. The pharmaceutical companies created a bunch of people with addiction issues. Through no fault of your own, you go from knee surgery to being desperate for drugs, because you’ve developed that dependence.

So I’m glad we’ve evolved, and we’re starting to treat people as human beings with an issue we can try to handle with treatment. I’ve never arrested someone with an addiction problem and cured that addiction. But our recovery people have gotten people on the road to recovery. I think our approach now is much better than it once was, and it’s more cost-effective.

The PERF Critical Issues Report is part of the Critical Issues in Policing project, supported by the Motorola Solutions Foundation.

PERF also is grateful to the Howard G. Buffett Foundation for supporting this work.