{"id":66043,"date":"2021-12-08T08:00:57","date_gmt":"2021-12-08T13:00:57","guid":{"rendered":"https:\/\/www.policechiefmagazine.org\/?p=66043"},"modified":"2025-03-04T13:41:31","modified_gmt":"2025-03-04T18:41:31","slug":"pre-arrest-deflection-programs","status":"publish","type":"post","link":"https:\/\/www.policechiefmagazine.org\/pre-arrest-deflection-programs\/","title":{"rendered":"Pre-Arrest Deflection Programs"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p><strong>Substance use disorder has taken a tremendous toll in the United States in lives lost, families destroyed, personal incomes disrupted, and the associated childhood trauma causing intergenerational substance use disorder.<\/strong> This has devastating consequences for the health of communities collectively, adding to the structural stress of neighborhoods through the grief of fatal overdoses, lost income, suboptimal parenting, the harms of arrest and incarceration, and the collateral consequences that spin off from the disease of substance use disorder and addiction. From 2010 to 2019, fatal overdoses in Pima County, Arizona, home to Tucson, have increased by over 52 percent. In this same period, there have been increases in costs to health care, criminal justice, and behavioral health systems related to substance use disorder.<sup>1<\/sup> For the past five years, fatal overdoses in Pima County have eclipsed the number of deaths from homicides and motor vehicle collisions combined.<sup>2<\/sup><\/p>\n<p>The opioid epidemic has challenged public health, harm reduction organizations, and the criminal justice system, specifically police, to find alternatives to address this crisis rather than arrest and incarceration. Creative and innovative strategies put forth by thought leaders in policing, social services, and public health have grown in size and scope over the past several years.<\/p>\n<p>The pre-arrest or public health\u2013based models that address nonviolent substance users stem, in part, from a growing realization that aggressive policing strategies may actually cause harm by increasing overdoses and stigmatization and decreasing the efficacy of prevention programs.<sup>3<\/sup> Police leaders increasingly recognize that arrest and incarceration for drugs have had little impact on drug use over time, disproportionately impact communities of color, and criminalize what is widely viewed in the medical and behavioral health fields as a treatable pathological disease. Whether a scientific consensus exists on the point of addiction as a disease is debatable, but many in the medical and behavioral field view substance use disorder as a disease of the brain.<sup>4<\/sup><\/p>\n<p>In Tucson, the why behind a pre-arrest deflection program is explained by the excessive number of deaths previously cited. The realization that reflexive arrest and incarceration of drug users had little to no effect on the number of fatal overdoses compelled Tucson police to relearn and rethink the purpose of policing and public safety while considering the community harms of criminalizing and punishing drug use. Hundreds of lives are lost each year with little media coverage, little community outrage, and little effort by the criminal justice system to effect a meaningful change. Deaths that were and continue to be virtually invisible to the community at large. The deceased were, in fact, sons and daughters, brothers and sisters, and fathers and mothers of someone. Their deaths matter.<\/p>\n<p>There also existed a growing realization over the past several years, locally and nationally, that the traditional approach of criminalizing substance use disorder has done little to reduce or control the problem and may even exacerbate the harms suffered by the community through cycles of arrest, incarceration, and release. Having a sincere desire to address the root causes of a massive social issue in a fashion that decreased harm rather than increased it, Tucson Police Department (TPD) leadership recognized that a new tool, a new process, a new system, was necessary. That tool is pre-arrest deflection.<\/p>\n<h3><span style=\"color: #9a1b22;\"><strong>The Program<\/strong><\/span><\/h3>\n<p>In 2018, after more than a year of planning and preparation, TPD launched a pre-arrest deflection program for people with substance use disorder (SUD). The model integrates the components of different programs seen throughout the United States into a \u201chybrid systems\u201d model that offers multiple routes (both passive and active) for officers to deflect individuals who have SUD from the criminal justice system (arrest and incarceration) to a treatment system. Such pathways include the following routes:<\/p>\n<ul>\n<li><strong>Deflection.<\/strong> Where criminal charges (felony or misdemeanor) are present; however, the offer of treatment and services are made in lieu of arrest, at the officer\u2019s discretion.<\/li>\n<li><strong>Self-Referral.<\/strong> Where an individual presents at a police substation requesting treatment assistance. They will not be arrested for any narcotics or paraphernalia they may possess.<\/li>\n<li><strong>Social-Referral.<\/strong> Where an individual presents to an officer in the field requesting treatment.<\/li>\n<li><strong>Active Outreach.<\/strong> Officers and peer support specialists seek out at-risk individuals or those who have recently survived an overdose to engage in treatment while also providing Naloxone, harm reduction material, and other services.<\/li>\n<\/ul>\n<p>The Tucson pre-arrest deflection model was intentionally constructed as a collaborative effort with treatment providers. This required sincere engagement with the different social service providers in the region to build the necessary trust in a police-led initiative. A series of collaboration meetings during the planning phase brought key players to the table. Service providers, public health, the regional behavioral health authority, and the state Medicaid agency, which funds health care programs for low-income residents, met in a series of meetings facilitated by TPD staff.<\/p>\n<p>The meetings activated the critical process of relationship building and establishing the five conditions of collective success: a common agenda, shared measurement systems, mutually reinforcing activities, continuous communication, and a supporting organization.<sup>5<\/sup> The complexity involved in social and cultural change of this magnitude requires a collective approach where partners have an equal voice and focused goals. With a common agenda or vision expressed, the other components begin to fill in organically, at least in Tucson\u2019s case.<\/p>\n<blockquote><p><span style=\"color: #9a1b22;\">\u201cDeflections saved the city hundreds of thousands of dollars in jail booking and board fees\u2026\u201d<\/span><\/p><\/blockquote>\n<p>Determining service providers\u2019 ability and capacity to provide effective substance use disorder treatment is a foundational element of any nascent deflection or diversion program. Any police-led strategy can be only as dynamic as the treatment opportunities available to that jurisdiction. Without the support of a medication-assisted treatment (MAT) clinic, crisis center, or other treatment facilities to divert those in need of treatment, the police\u2019s default response to SUDs is often jail. The capacity and ability of treatment service providers will determine the program\u2019s parameters and what can realistically be achieved with the resources at hand. Building a cooperative process that is easier and quicker for officers to divert to treatment rather than arrest and book into jail was a critical requirement of this program for all partners.<\/p>\n<p>The deflection pathway specifically required considerable thought in building appropriate eligibility criteria to assist the officers in becoming comfortable with the decision-making process that provided an alternative to arrest. In Tucson, personal use narcotics, pills, and paraphernalia are deflection eligible felonies. Nearly all non-domestic violence misdemeanors and nonviolent charges, misdemeanor or felony, are eligible, the most common being trespassing, disorderly conduct, and other low-level order-maintenance crimes. Crimes involving a victim require the victim\u2019s consent before deflection is offered.<\/p>\n<h3><span style=\"color: #9a1b22;\"><strong>Training and Officer Buy-In<\/strong><\/span><\/h3>\n<p>Arrest has long been viewed in policing as the only, or at least the primary, problem-solving tool available to officers. Introducing a new strategy or tool to address a complex social problem that does not include arrest can (and continues to) cause considerable discomfort and resistance by police department staff at all levels. To address this challenge, a mandatory four-hour training module was created in partnership with medical and behavioral health specialists to address anticipated discomfort and resistance to the program. As a result, nearly 400 patrol staff received training on<\/p>\n<ul>\n<li>the neuroscience of addiction and substance use disorder, including information on the ways in which SUDs are a disease and a public health issue, and how relapse is a part of recovery so that personnel have increased tolerance for deflecting the same individual multiple times;<\/li>\n<li>the concept of adverse childhood experiences and the role of trauma in addiction;<\/li>\n<li>the stigma associated with addiction and substance use disorder;<\/li>\n<li>the components of the treatment process, such as medication-assisted treatment, cognitive behavioral therapy, and others;<\/li>\n<li>the structure of the program and eligibility requirements; and<\/li>\n<li>the goals of the program and how it was to be evaluated.<\/li>\n<\/ul>\n<p>A critical component of the training itself was that key command staff, including at the chief level, attended each training session to emphasize the importance of the initiative, answer questions openly without defensiveness, and show top-down support for the program. An unanticipated but compelling dynamic occurred in several of these sessions. Officers related personal experiences with substance use disorder involving their children, parents, friends, and other loved ones. It became apparent to the officers that the SUD is not cowed by the badge. These personal testimonials became powerful mitigators to cynicism and resistance.<\/p>\n<h3><span style=\"color: #9a1b22;\"><strong>Resource Allocation: Scalability and Adaptability<\/strong><\/span><\/h3>\n<p>Resource allocation can be scaled to the program design and capacity of the jurisdiction. While the TPD Executive Leadership Team recognized the value of having staff dedicated solely to the program, this could be problematic for some agencies and may even be unnecessary depending on the program\u2019s design.<br \/>\n<aside class=\"pullout alignleft\"><\/p>\n<p style=\"text-align: center;\"><em><big><strong>Quick Facts<\/strong><\/big><\/em><\/p>\n<p>&nbsp;<\/p>\n<p>Tucson is the second-largest city in Arizona, with a metro area nearing 1 million in population. The city itself has a population approaching 550,000 within 250 square miles. The police department is budgeted for 885 sworn positions and 263 professional staff positions.<\/p>\n<p><\/aside><\/p>\n<p>To adapt to the needs of this program TPD expanded upon the existing Mental Health Support Team (MHST), and eventually divided this team into two teams: The MHST primarily addresses behavioral health issues, and the (new) Substance Use Response Team (SURT) leads the active outreach to at-risk individuals and overdose survivors. The SURT also conducts all ongoing deflection-related training, including naloxone training, surrounding substance abuse. If the at-risk subjects refuse to engage in treatment, they are provided with naloxone, treatment options, contact numbers for the officers, and harm reduction material. SURT officers will continue to follow up with the same individuals over time, hoping to build trust and engage in a treatment option at some point.<\/p>\n<p>Over time, the SURT has grown to embed peer support specialists who co-respond with the SURT officers to field calls and outreach efforts. Peer support specialists are in recovery from SUDs, and their lived experience makes them incredibly valuable team members. The MHST, SURT, and newly formed Homeless Outreach Team (HOT) are physically and organizationally located together as they often address the same individuals and are cross-trained, to a basic level, to each specialty.<\/p>\n<h3><span style=\"color: #9a1b22;\"><strong>Research<\/strong><\/span><\/h3>\n<p>While planning and building the program, scant empirical research could be found on pre-arrest deflection or diversion programs\u2019 efficacy. Working together with the Pima County Criminal Justice Reform Unit (CJRU) and a research partner from the University of Arizona, TPD obtained a patchwork of grants to fund the three-year academic study. Currently, the study is in its second year.<\/p>\n<p>While space restricts the discussion of the research design and metrics involved in the evaluation, TPD leadership believes that any initiative, strategy, or policy should include an evaluative aspect, if for no other reason than to ensure that the initiative captures demographic data and that no harm, unintentional or unintended, is produced by the program. With a profound belief in the value of evidence-based strategies, TPD staff sincerely believed that a robust process, impact, and efficiency evaluation was necessary. Additionally, evidence to determine the worth of such programs can benefit other agencies and communities beyond Tucson, now and in the future.<\/p>\n<h3><span style=\"color: #9a1b22;\"><strong>Challenges<\/strong><\/span><\/h3>\n<p>The Tucson deflection program has been in place for over three years, having grown and expanded in that time. However, it is still woefully inadequate to address the challenges of addiction and substance use disorder fueled by the region\u2019s opioid and meth epidemics. Challenges in implementing and sustaining this program or ones like it can be daunting for police executives, and much courage is needed. These programs are big, bold steps that mark meaningful police reform to save lives and reduce community harm in no uncertain terms. The challenges usually found with policy and program implementation in policing\u2014funding, resource and staffing allocations, shifting political winds, and the sheer amount of time and effort involved in building a program collaboratively with service providers and the community\u2014are formidable in their own right, but it is not what TPD and other agencies found to be the biggest challenge.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-66053\" src=\"https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Brendan_Travis_Paul-300x225.jpg\" alt=\"\" width=\"400\" height=\"300\" srcset=\"https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Brendan_Travis_Paul-300x225.jpg 300w, https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Brendan_Travis_Paul-1024x768.jpg 1024w, https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Brendan_Travis_Paul-768x576.jpg 768w, https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Brendan_Travis_Paul-1536x1152.jpg 1536w, https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Brendan_Travis_Paul-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>At a national level, but more importantly at the local level, organizational culture in policing continues to be the largest hurdle for police executives to overcome in making systemic changes like pre-arrest deflection. This aspect of program and policy development and implementation should never be underestimated, but that point is particularly acute with programs like pre-arrest deflection or diversion, which fundamentally change a cultural status quo that has existed for decades. It is at the intersectionality of old and new paradigms that unlearning and rethinking occurs, leading to true social innovation, the process of designing, gaining support for, and implementing unique solutions to complex social problems.<sup>6<\/sup> The scope, complexity, and controversy surrounding significant social issues, such as addiction and substance use disorder as they transect policing, requires thoughtful, intentional, and bold leadership if authentic and sustainable reform and resolution are the desired outcomes.<\/p>\n<h3><span style=\"color: #9a1b22;\"><strong>The Role of Leadership<\/strong><\/span><\/h3>\n<p>The term leadership is used purposefully in this context so as not to confuse with authority. Leadership in the context of this space is an activity, a behavior that is devoid of the positional power that accompanies authority. Authority is useful and can be powerful in its own right; however, leadership is necessary when affecting culture change, with or without accompanying authority. Ronald Heifetz and Marty Linsky make an essential and critical distinction between technical and adaptive problems and the leadership skills necessary to resolve them in their book <em>Leadership on the Line<\/em>. Technical problems are well defined with traditional expertise and capacity available to resolve the issue. Adaptive problems, however, are entirely different. These are the large, intricate, systemic problems that require new, challenging, and innovative thinking that pushes out old ideas and concepts and requires an ability to recognize the necessity of an adaptive leadership style.<sup>7<\/sup> This is a form of change leadership that requires flexibility in thought and action; however, adaptive problems are about value and belief change, which require the hard work of managing preexisting beliefs and values against the necessity of new concepts to push forward substantial social change. Inevitably there will be friction and conflict; managing those natural components of change is at the core of adaptive leadership. The most common mistake seen in this space is a leaders\u2019 tendency to attempt to solve adaptive problems with technical tools and perspectives, avoiding the necessary friction and conflict that leads to change.<sup>8<\/sup><\/p>\n<p>There is no silver bullet\u2014no one answer to the question of successful culture transformation. However, knowing the different perspectives of adaptive versus technical responses is a useful tool for any executive leadership team. Recognizing that changing social systems is most often an adaptive problem is the first step. Conflict that is managed thoughtfully and purposefully within the confines of the mission, vision, and goals of the organization can be functional by generating higher individual and group performance.<sup>9<\/sup> Change will always be uncomfortable. How change is managed from a leadership role can determine the efficacy of the organization\u2019s cultural shift.<\/p>\n<p>Solutions for significant and complex social change require the broad outlook of adaptive leadership combined with a systems leadership perspective to manage productive tension in the context of the social systems that the problems exist in.<sup>10<\/sup> Effective social change is systemic change, and pre-arrest deflection and other alternatives to arrest represent systemic social change. This type of change can best be achieved by adaptive leaders. Systems leadership is a broad set of skills that supports the process of sustainable system-level change collaboratively with cross-system partners.<sup>11<\/sup> To be candid, systemic change requires systems leaders, and systems leaders are adaptive leaders.<\/p>\n<h3><span style=\"color: #9a1b22;\"><strong>Outcomes<\/strong><\/span><\/h3>\n<aside class=\"pullout alignleft\"><strong>IACP RESOURCES<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.theiacp.org\/resources\/webinar\/pre-arrest-diversion-webinar-series\" target=\"_blank\" rel=\"noopener\">Pre-Arrest Diversion Webinar Series<\/a><\/li>\n<\/ul>\n<p><strong><a href=\"https:\/\/www.theiacp.org\/\" target=\"_blank\" rel=\"noopener\">theIACP.org<\/a><\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/learn.theiacp.org\/products\/alternatives-to-arrest\" target=\"_blank\" rel=\"noopener\">Alternatives to Arrest<\/a> (video)<\/li>\n<\/ul>\n<p><a href=\"https:\/\/learn.theiacp.org\/\"><strong>learn.theIACP.org<\/strong><\/a><\/p>\n<ul>\n<li>\u201c<a href=\"https:\/\/www.policechiefmagazine.org\/building-a-multijurisdictional-deflection-program\/\">Building a Multijurisdictional Deflection Program<\/a>\u201d (article)<\/li>\n<li>\u201c<a href=\"https:\/\/www.policechiefmagazine.org\/changing-the-goal-to-relationship-building\/\">Changing the Goal to Relationship Building<\/a>\u201d (article)<\/li>\n<\/ul>\n<p><\/aside>\n<p>At the time of writing this article, Tucson police officers have been involved in over 2,100 deflection actions since July 1, 2018, with the majority being unique or non-repeated deflections. That is 2,100 nonviolent interactions in which people with SUDs were offered treatment instead of arrest and incarceration. Both internal and external preliminary evaluations found that deflections take less time to complete than either a misdemeanor or felony arrest. Deflections saved the city hundreds of thousands of dollars in jail booking and board fees, and there is no indication that crime rates have been influenced, positively or negatively, by the program.<\/p>\n<p>Meaningful criminal justice reform has to move beyond providing implicit bias or enhanced use-of-force training. Though both are important, they do not represent systemic change. The evolution of the criminal justice system in the United States has reached a point of becoming overwhelmingly punitive. Reform can occur with consequential results for the community, the police, and the U.S. criminal justice system. Communities are demanding such action. Pre-arrest deflection programs represent a change that could potentially spread to other components of the system, acting as a springboard to other alternatives to arrest strategies involving the mentally ill, juveniles, and low-order maintenance crimes to address the root causes of crime; build trust and support; and provide a humane, potential resolution to a chronic, intractable, and deadly disease.<\/p>\n<p>&nbsp;<\/p>\n<table style=\"width: 100%; border-collapse: collapse; background-color: #102c4e;\">\n<tbody>\n<tr>\n<td style=\"width: 100%;\">&nbsp;<\/p>\n<p style=\"padding-left: 40px;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-66056\" src=\"https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Kevin-Hall-222x300.jpg\" alt=\"\" width=\"175\" height=\"236\" srcset=\"https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Kevin-Hall-222x300.jpg 222w, https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Kevin-Hall-759x1024.jpg 759w, https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Kevin-Hall-768x1037.jpg 768w, https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Kevin-Hall-1138x1536.jpg 1138w, https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Kevin-Hall-1517x2048.jpg 1517w, https:\/\/www.policechiefmagazine.org\/wp-content\/uploads\/Kevin-Hall-scaled.jpg 1896w\" sizes=\"auto, (max-width: 175px) 100vw, 175px\" \/><span style=\"color: #ffffff;\"><big>Assistant Chief <strong>Kevin Hall<\/strong> is a 29-year member of the Tucson, Arizona, Police Department. He has held the position of patrol officer, detective, patrol sergeant, SWAT sergeant, investigative sergeant, patrol lieutenant, Field Services Bureau executive officer, patrol captain, and now assistant chief. He has worked in a variety of assignments within the department to include Operations Divisions South, Midtown, East, the Gang Unit, Physical Child Abuse Unit, Internal Affairs, Homicide, and the Home Invasion\/Kidnapping Unit.<\/big><\/span><\/p>\n<p>&nbsp;<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p><strong>Notes: <\/strong><\/p>\n<p><sup>1<\/sup>Pima County Office of the Medical Examiner, <em>Annual Report 2019<\/em> (2020).<\/p>\n<p><sup>2<\/sup>Pima County Office of the Medical Examiner, <em>Annual Report 2019<\/em>.<\/p>\n<p><sup>3<\/sup>Amy Bohnert et al., \u201cPolicing and Risk of Overdose Mortality in Urban Neighborhoods,\u201d <em>Drug and Alcohol Dependence<\/em> (2010): 62\u201368; Saba Rouhani et al., \u201cPolice Attitudes Towards Pre-booking Diversion in Baltimore, Maryland,\u201d <em>International Journal of Drug Policy<\/em> 65 (2018): 78\u201385.<\/p>\n<p><sup>4<\/sup>Nora D. Volkow, George F. Koob, and A. Thomas McLellan, \u201cNeurobiologic Advances from the Brain Disease Model of Addiction,\u201d <em>New England Journal of Medicine<\/em> 374, no.4 (January 2016): 363\u2013371.<\/p>\n<p><sup>5<\/sup>John Kania and Mark Kramer, \u201c<a href=\"https:\/\/ssir.org\/articles\/entry\/collective_impact\">Collective Impact<\/a>,\u201d <em>Stanford Social Innovation Review<\/em> 9, no. 1 (Winter 2011): 36\u201341.<\/p>\n<p><sup>6<\/sup>Kriss Deiglmeier, Dale T. Miller, and James A. Phills Jr., \u201c<a href=\"https:\/\/ssir.org\/articles\/entry\/rediscovering_social_innovation\">Rediscovering Social Innovation<\/a>,\u201d <em>Stanford Social Innovation Review<\/em> 6, no. 4 (Fall 2008): 34\u201343.<\/p>\n<p><sup>7<\/sup>Ronald Heifetz and Martin Linsky, <em>Leadership on the Line: Staying Alive Through the Dangers of Change<\/em> (Boston, MA: Harvard Business School Press, 2002).<\/p>\n<p><sup>8<\/sup>Heifetz and Linsky, <em>Leadership on the Line<\/em>.<\/p>\n<p><sup>9<\/sup>Terri A. Scandura, <em>Essentials of Organizational Behavior: An Evidence-Based Approach<\/em> (London, UK: Sage, 2016).<\/p>\n<p><sup>10<\/sup>Ronald Heifetz, John Kania, and Mark Kramer, \u201c<a href=\"https:\/\/ssir.org\/articles\/entry\/leading_boldly\">Leading Boldly<\/a>,\u201d <em>Stanford Social Innovation Review<\/em> 2, no. 3 (Winter 2004): 20\u201331.<\/p>\n<p><sup>11<\/sup>Lisa Dreier, David Nabarro and Jane Nelson, <em><a href=\"https:\/\/www.hks.harvard.edu\/sites\/default\/files\/centers\/mrcbg\/files\/Systems%20Leadership.pdf\">Systems Leadership for Sustainable Development: Strategies for Achieving Systemic Change<\/a><\/em> (Cambridge, MA: CR Initiative, Harvard Kennedy School, 2019).<\/p>\n<hr \/>\n<p>Please cite as<\/p>\n<p>Kevin Hall, \u201cPre-Arrest Deflection Programs: A Lesson in Leadership, Reform, and Compassion,\u201d <em>Police Chief<\/em> 88, no. 12 (December 2021): 28\u201333.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Substance use disorder has taken a tremendous toll in the United States in lives lost, families destroyed, personal incomes disrupted, and the associated childhood trauma causing intergenerational substance use disorder. This has devastating consequences for the health of communities collectively, adding to the structural stress of neighborhoods through the grief of fatal overdoses, lost income, suboptimal parenting, the harms of arrest and incarceration, and the collateral consequences that spin off from the disease of substance use disorder and addiction. From 2010 to 2019, fatal overdoses in Pima County, Arizona, home to Tucson, have increased by over 52 percent. In this same period, there have been increases in costs to health care, criminal justice, and behavioral health systems related to substance use disorder. For the past five years, fatal overdoses in Pima County have eclipsed the number of deaths from homicides and motor vehicle collisions combined.<\/p>\n<p>The opioid epidemic has challenged public health, harm reduction organizations, and the criminal justice system, specifically police, to find alternatives to address this crisis rather than arrest and incarceration. Creative and innovative strategies put forth by thought leaders in policing, social services, and public health have grown in size and scope over the past several years.<\/p>\n","protected":false},"author":4042,"featured_media":66052,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[129],"tags":[782,1817,616,2045],"class_list":["post-66043","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-criminal-justice-reform","tag-criminal-justice-reform","tag-deflection","tag-naloxone","tag-self-referral"],"acf":{"subtitle":"A Lesson in Leadership, Reform, and Compassion","post_author":"Kevin Hall, Assistant Chief, Tucson Police Department, Arizona","main_category":"Criminal Justice Reform","legacy_article_id":"","legacy_issue_id":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.4 (Yoast SEO v24.5) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Pre-Arrest Deflection Programs - Police Chief Magazine<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.policechiefmagazine.org\/pre-arrest-deflection-programs\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pre-Arrest Deflection Programs\" \/>\n<meta property=\"og:description\" content=\"Substance use disorder has taken a tremendous toll in the United States in lives lost, families destroyed, personal incomes disrupted, and the associated childhood trauma causing intergenerational substance use disorder. This has devastating consequences for the health of communities collectively, adding to the structural stress of neighborhoods through the grief of fatal overdoses, lost income, suboptimal parenting, the harms of arrest and incarceration, and the collateral consequences that spin off from the disease of substance use disorder and addiction. From 2010 to 2019, fatal overdoses in Pima County, Arizona, home to Tucson, have increased by over 52 percent. In this same period, there have been increases in costs to health care, criminal justice, and behavioral health systems related to substance use disorder. For the past five years, fatal overdoses in Pima County have eclipsed the number of deaths from homicides and motor vehicle collisions combined.  The opioid epidemic has challenged public health, harm reduction organizations, and the criminal justice system, specifically police, to find alternatives to address this crisis rather than arrest and incarceration. 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