Evaluation of an Experimental Educational Module on Opioid-Related Occupational Safety among Police Officers: Protocol for a Randomized Pragmatic Trial to Minimize Barriers to Overdose Response (Preprint)

2021 ◽  
Author(s):  
Janie Simmons ◽  
Luther Elliott ◽  
Alexander Bennett ◽  
Leo Beletsky ◽  
Sonali Rajan ◽  
...  
Keyword(s):  
Public Health ◽  
Law Enforcement ◽  
Risk Reduction ◽  
Police Officers ◽  
Occupational Safety ◽  
Pragmatic Trial ◽  
Occupational Risk ◽  
People Who Use Drugs ◽  
Safety Study ◽  
Mixed Methods Approach

BACKGROUND As drug-related morbidity and mortality continue to surge, police officers are on the front lines of the North American overdose crisis. Drug law enforcement shapes health risks among people who use drugs (PWUD), while also impacting occupational health and wellness of officers. Effective interventions to align law enforcement practices with public health and occupational safety goals remain under-researched. OBJECTIVE The Opioids and Police Safety Study (OPS) aims to shift police practices relating to people who use drugs (PWUD). It adapts and evaluates the relative effectiveness of a curriculum that bundles content on public health promotion with occupational risk reduction (ORR) to supplement a web-based overdose response and naloxone training platform (GetNaloxoneNow or GNN). This novel approach has the potential to improve public health and occupational safety practices, including using naloxone to reverse overdoses, referring PWUD to treatment and other supportive services, and avoiding syringe confiscation. METHODS This longitudinal study employs a randomized pragmatic trial design. A sample of 300 active-duty police officers from select counties in Pennsylvania, Vermont and New Hampshire with high overdose fatality rates will be randomized (150 each) to either the experimental arm (GNN + OPS) or the control arm (GNN + COVID-19 occupational risk reduction). A pre- and post-training survey will be administered to all 300 officers, after which they will be administered quarterly surveys for 12 months. A sub-sample of police officers will also be followed qualitatively in a simultaneous embedded mixed-methods approach. RESULTS Research ethics approval was obtained from the NYU Institutional Review Board. Findings will be disseminated widely, and the training products will be available nationally once the study is completed. CONCLUSIONS The Opioids and Police Safety Study is the first study to longitudinally assess the impact of an opioid-related occupational risk reduction intervention for law enforcement in the U.S. Our randomized pragmatic clinical trial aims to remove barriers to life-saving police engagement with PWUO/PWID by focusing both on the safety of law enforcement and evidence-based and best-practices for working with persons at risk of an opioid overdose. Our simultaneous embedded mixed-methods approach will provide empirical evaluation of the diffusion of naloxone-based response among law enforcement. CLINICALTRIAL ClinicalTrials.gov #NCT05008523

scholarly journals “We're actually more of a likely ally than an unlikely ally”: relationships between syringe services programs and law enforcement

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Carol Y. Franco ◽  
Angela E. Lee-Winn ◽  
Sara Brandspigel ◽  
Musheng L. Alishahi ◽  
Ashley Brooks-Russell
Keyword(s):  
Law Enforcement ◽  
Police Officers ◽  
Wound Care ◽  
Phenomenological Approach ◽  
Treatment Programs ◽  
People Who Use Drugs ◽  
Positive Relationships ◽  
Structured Interviews ◽  
Program Staff ◽  
Compliance With The Law

Abstract Background Syringe services programs provide sterile injection supplies and a range of health services (e.g., HIV and HEP-C testing, overdose prevention education, provision of naloxone) to a hard-to-reach population, including people who use drugs, aiming to prevent the transmission of infectious diseases. Methods We performed a qualitative needs assessment of existing syringe services programs in the state of Colorado in 2018–2019 to describe—their activities, needs, and barriers. Using a phenomenological approach, we performed semi-structured interviews with key program staff of syringe services programs (n = 11). All interviews were digitally recorded, transcribed, and validated. A data-driven iterative approach was used by researchers to develop a coding scheme to organize the data into major themes found across interviews. Memos were written to synthesize main themes. Results Nearly all the syringe program staff discussed their relationships with law enforcement at length. All syringe program staff viewed having a positive relationship with law enforcement as critical to the success of their program. Main factors that influence the quality of relationships between syringe services programs and law enforcement included: (1) alignment in agency culture, (2) support from law enforcement leadership, (3) police officers’ participation and compliance with the Law Enforcement Assisted Diversion (LEAD) program, which provides intensive case management for low-level drug offenders, and (4) implementation of the “Needle-Stick Prevention Law” and Drug Paraphernalia Law Exemption. All syringe program staff expressed a strong desire to have positive relationships with law enforcement and described how a collaborative working relationship was critical to the success of their programs. Conclusions Our findings reveal effective strategies to foster relationships between syringe services programs and law enforcement as well as key barriers to address. The need exists for both syringe services programs and law enforcement to devote time and resources to build a strong, positive partnership. Having such positive relationships with law enforcement has positive implications for syringe services program clients, including law enforcement being less likely to ticket persons for having used syringes, and encourage people who use drugs to seek services from syringe services programs, which can then lead them to other resources, such as housing, wound care, and substance use treatment programs.

scholarly journals Suicide mortality data from the Italian police during the COVID-19 pandemic

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sergio Garbarino ◽  
Michele Fornaro ◽  
Rita Messina ◽  
Maurizio Pompili ◽  
Fabrizio Ciprani
Keyword(s):  
Public Health ◽  
Law Enforcement ◽  
Police Officers ◽  
Suicide Mortality ◽  
Public Health Issue ◽  
Mortality Data ◽  
Major Public Health Issue ◽  
Difficult Time ◽  
State Police ◽  
The Many

AbstractSuicide is a major public health issue worldwide, with about 880,000 dying annually for such a cause. The COVID-19 pandemic has led to severe social disruption both from health and economic standpoints. Law enforcement personnel have been significantly involved in helping to face the many difficulties due to the pandemic. Police officers have been subjected to further stress from managing social restrictions imposed by governments to contain the pandemic. The Italian State Police steadily approximate 100,000 people aged 25–65 years: 14 subjects (mean age 43.64 years) died by suicide in 2015, 7 (mean age 47.5 years) in 2016, 13 (mean age 45.62 years) in 2017, 10 (mean age 48.1 years) in 2018, 18 (mean age 46.78 years) in 2019, and 12 (mean age 52 years) in 2020. Our records excluded significant changes in suicide incidence rate within 2015–2020 (till December 2020). However, the COVID-19 pandemic spread faster in Italy than in other regions, meaning that the Italian State Police possibly faced prolonged, intense stress. Suicide prevention, therefore, remains a priority, especially during this difficult time.

scholarly journals Legal Considerations in a Nuclear Detonation

2011 ◽  
Vol 5 (S1) ◽  
pp. S65-S72 ◽  
Author(s):  
Susan E. Sherman
Keyword(s):  
Public Health ◽  
Law Enforcement ◽  
Occupational Safety ◽  
Geographic Area ◽  
Federal State ◽  
Effective Response ◽  
Scarce Resources ◽  
Local Law ◽  
State And Local ◽  
Medical Countermeasures

ABSTRACTThis article summarizes public health legal issues that need to be considered in preparing for and responding to nuclear detonation. Laws at the federal, state, territorial, local, tribal, and community levels can have a significant impact on the response to an emergency involving a nuclear detonation and the allocation of scarce resources for affected populations. An understanding of the breadth of these laws, the application of federal, state, and local law, and how each may change in an emergency, is critical to an effective response. Laws can vary from 1 geographic area to the next and may vary in an emergency, affording waivers or other extraordinary actions under federal, state, or local emergency powers. Public health legal requirements that are commonly of concern and should be examined for flexibility, reciprocity, and emergency exceptions include liability protections for providers; licensing and credentialing of providers; consent and privacy protections for patients; occupational safety and employment protections for providers; procedures for obtaining and distributing medical countermeasures and supplies; property use, condemnation, and protection; restrictions on movement of individuals in an emergency area; law enforcement; and reimbursement for care.(Disaster Med Public Health Preparedness. 2011;5:S65-S72)

scholarly journals STUDY OF THE IMPACT OF MEASURES OF THE HIERARCHY OF CONTROL ON OCCUPATIONAL RISK

2021 ◽  
Vol 37 (3) ◽  
pp. 8-13
Author(s):  
O. Kruzhilko ◽  
N. Volodchenkova ◽  
V. Maistrenko ◽  
I. Tkalych ◽  
O. Polukarov
Keyword(s):  
Risk Assessment ◽  
Risk Reduction ◽  
Working Conditions ◽  
Occupational Safety ◽  
Occupational Risk ◽  
Occupational Safety And Health ◽  
Administrative Control ◽  
Safety And Health ◽  
The Impact ◽  
And Training

The article analyzes the international and domestic experience in building a safety and hygiene management system. It is noted that the priorities in the process of ensuring safe and harmless working conditions for many developed countries are: revision and improvement of the legal framework for occupational safety and health, encouraging employers to ensure proper working conditions, and raising awareness of managers and employees on occupational safety and health. Recommendations for planning measures depending on the hazards present in enterprises and the results of risk assessment are contained in the documents of the International Labor Organization. Methods and methods of detection and assessment of risk factors can be chosen according to the characteristics of the workplace. Effective occupational risk reduction activities involve the implementation of a certain sequence of tools and management methods (control hierarchy), as specified in the international standard ISO 45001. It is proposed to use the following priorities for risk reduction: elimination of hazards, replacement of processes, operations, materials or equipment for less dangerous, the use of technical means and methods of management, reorganization of work and training of employees, administrative control of hazards, personal protective equipment. According to the results of the research, in the absence of resources for the implementation of measures of the highest priorities, the most effective approach was the combination of technical means and management methods, reorganization of work and training, as well as administrative control of hazards. To implement occupational health and safety management systems based on a risk-based approach, it is necessary, first of all, to develop and approve a methodology that determines the procedure for calculating occupational risk and ensure that the results of risk assessment are taken into account when planning preventive measures.

scholarly journals Pre-arrest diversion to addiction treatment by law enforcement: protocol for the community-level policing initiative to reduce addiction-related harm, including crime

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Aleksandra E. Zgierska ◽  
Veronica M. White ◽  
Joseph Balles ◽  
Cory Nelson ◽  
Jason Freedman ◽  
...  
Keyword(s):  
Public Health ◽  
Law Enforcement ◽  
Police Officers ◽  
Addiction Treatment ◽  
Outcome Evaluation ◽  
Community Level ◽  
Diversion Program ◽  
Historical Comparison ◽  
Criminal Charges ◽  
Group 1

Abstract Background Despite evidence that treatment reduces addiction-related harms, including crime and overdose, only a minority of addiction-affected individuals receive it. Linking individuals who committed an addiction-related crime to addiction treatment could improve outcomes. Methods The aim of this city-wide, pre-arrest diversion program, Madison Addiction Recovery Initiative (MARI) is to reduce crime and improve health (i.e., reduce the overdose deaths) among adults who committed a minor, non-violent, drug use-related offense by offering them a referral to treatment in lieu of arrest and prosecution of criminal charges. This manuscript outlines the protocol and methods for the MARI program development and implementation. MARI requires its participants to engage in the recommended treatment, without reoffending, during the six-month program, after which the initial criminal charges are “voided” by the law enforcement agency. The project, implemented in a mid-size U.S. city, has involved numerous partners, including law enforcement, criminal justice, public health, and academia. It includes training of the police officer workforce and collaboration with clinical partners for treatment need assessment, treatment placement, and peer support. Program evaluation includes formative, process, outcome (participant-level) and exploratory impact (community-level) assessments. For outcome evaluation, we will compare crime (primary outcome), overdose-related offenses, and incarceration-related data 12 months before and 12 months after the index crime between participants who completed (Group 1), started but not completed (Group 2), and were offered but did not start (Group 3) the program, and adults who would have been eligible should MARI existed (Historical Comparison, Group 4). Clinical characteristics will be compared at baseline between Groups 1–2, and pre-post the program within Group 1. Participant baseline data will be assessed as potential covariates. Surveys of police officers and program completers, and community-level indicators of crime and overdose pre- versus post-program will provide additional data on the program impact. Discussion By offering addiction treatment in lieu of arrest and prosecution of criminal charges, this pre-arrest diversion program has the potential to disrupt the cycle of crime, reduce the likelihood of future offenses, and promote public health and safety.

The Public Health Crisis Survival Guide

2018 ◽  
Author(s):  
Joshua M. Sharfstein
Keyword(s):  
Public Health ◽  
Police Officers ◽  
Health Agency ◽  
Health Improvement ◽  
Strong Response ◽  
Popular Imagination ◽  
Health Crisis ◽  
The Public ◽  
Public Health Crisis ◽  
Critical Skills

Firefighters fight fires. Police officers race to crime scenes, sirens blaring. And health officials? Health officials respond to crises. There are infectious disease crises, budget crises, environmental health crises, human resources crises—and many more. At such critical moments, what happens next really matters. A strong response can generate greater credibility and authority for a health agency and its leadership, while a bungled response can lead to humiliation and even resignation. Health officials must be able to manage and communicate effectively as emotions run high, communities become engaged, politicians lean in, and journalists circle. In popular imagination, leaders intuitively rise to the challenge of a crisis: Either they have what it takes or they do not. In fact, preparation is invaluable, and critical skills can be learned and practiced. Students and health officials alike can prepare not only to avoid catastrophe during crises, but to take advantage of new opportunities for health improvement. The Public Health Crisis Survival Guide provides historical perspective, managerial insight, and strategic guidance to help health officials at all levels not just survive but thrive in the most challenging of times.

Documenting Contact and Thinking with Skin: A Dermatological Approach to the Study of Police Street Checks

2021 ◽  
pp. 1-21
Author(s):  
Anita Lam ◽  
Timothy Bryan
Keyword(s):  
Law Enforcement ◽  
Racial Disparities ◽  
Lived Experience ◽  
Police Officers ◽  
Qualitative Methodology ◽  
Numerical Data ◽  
Quantitative Studies ◽  
Primary Object ◽  
Practice Projects

Abstract In contrast to quantitative studies that rely on numerical data to highlight racial disparities in police street checks, this article offers a qualitative methodology for examining how histories of anti-Blackness configure civilians’ experiences of present-day policing. Taking the Halifax Street Checks Report as our primary object of analysis, we apply an innovative dermatological approach, demonstrating how skin itself becomes meaningful when police officers and civilians make contact in the process of a street check. We explore how street checks become an occasion for epidermalization, whereby a law enforcement practice projects onto the skins of civilians locally specific histories and emotions. To think with skin, we focus on the narratives shared by African Nova Scotians, a group that has been street checked at higher rates than their white counterparts. By doing so, we argue that current debates about police street checks in Halifax must attend to the emotional stakes of police-initiated encounters in order to fully appreciate the lived experience of street checks for Black civilians.

scholarly journals The Fine Line: Rural Justice, Public Health and Safety, and the Coronavirus Pandemic

2021 ◽  
pp. 000276422110031
Author(s):  
Jennifer Sherman ◽  
Jennifer Schwartz
Keyword(s):  
Public Health ◽  
Law Enforcement ◽  
Rural Communities ◽  
Health And Safety ◽  
Criminal Activity ◽  
Personal Liberty ◽  
Local Law Enforcement ◽  
Local Law ◽  
Sheriff's Department ◽  
Public Health And Safety

In this article, we provide an early glimpse into how the issues of public health and safety played out in the rural United States during the coronavirus pandemic, focusing on Washington State. We utilize a combination of news articles and press releases, sheriff’s department Facebook posts, publicly available jail data, courtroom observations, in-depth interviews with those who have been held in rural jails, and interviews with rural law enforcement staff to explore this theme. As elected officials, rural sheriffs are beholden to populations that include many who are suspicious of science, liberal agendas, and anything that might threaten what they see as individual freedom. At the same time, they expect local law enforcement to employ punitive measures to control perceived criminal activity in their communities. These communities are often tightly knit, cohesive, and isolated, with high levels of social support both for community members and local leaders, including sheriffs and law enforcement. This complex social context often puts rural sheriffs and law enforcement officers in difficult positions. Given the multiple cross-pressures that rural justice systems faced in the wake of the COVID-19 pandemic, we explore the circumstances in which they attempted to protect and advocate for the health and safety of both their incarcerated and their nonincarcerated populations. We find that certain characteristics of rural communities both help and hinder local law enforcement in efforts to combat the virus, but these characteristics typically favor informal norms of social control to govern community health. Thus, rural sheriff’s departments repeatedly chose strategies that limited their abilities to protect populations from the disease, in favor of appearing tough on crime and supportive of personal liberty.

Auras of Detection: Power and Knowledge in Drug Prohibition

2021 ◽  
pp. 009145092110354
Author(s):  
Jennifer J. Carroll
Keyword(s):  
Law Enforcement ◽  
Knowledge Production ◽  
Illicit Drug ◽  
Drug Market ◽  
Epistemic Authority ◽  
People Who Use Drugs ◽  
Drug Supply ◽  
Political Implications ◽  
Starting Point ◽  
Drug Checking

Drug checking is an evidence-based strategy for overdose prevention that continues to operate (where it operates) in a legal “gray zone” due to the legal classification of some drug checking tools as drug paraphernalia—the purview of law enforcement, not public health. This article takes the emergence of fentanyl in the U.S. drug supply as a starting point for examining two closely related questions about drug checking and drug market expertise. First, how is the epistemic authority of law enforcement over the material realities of the drug market produced? Second, in the context of that authority, what are the socio-political implications of technologically advanced drug checking instruments in the hands of people who use drugs? The expertise that people who use drugs maintain about the nature of illicit drug market and how to navigate the illicit drug supply has long been discounted as untrustworthy, irrational, or otherwise invalid. Yet, increased access to drug checking tools has the potential to afford the knowledge produced by people who use drugs a technological validity it has never before enjoyed. In this article, I engage with theories of knowledge production and ontological standpoint from the field of science, technology, and society studies to examine how law enforcement produces and maintains epistemic authority over the illicit drug market and to explore how drug checking technologies enable new forms of knowledge production. I argue that drug checking be viewed as a form of social resistance against law enforcement’s epistemological authority and as a refuge against the harms produced by drug criminalization.

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