Offering recovery rather than punishment: Implementation of a law enforcement-led pre-arrest diversion-to-treatment program for adults with substance use disorders.

Background: The opioid epidemic has negatively impacted the U.S. criminal justice system, with law enforcement agencies frequently encountering persons with substance use disorder (SUD). Law enforcement-led pre-arrest diversion programs linking individuals with SUD to addiction treatment instead of arrest and prosecution can reduce crime, overdoses, and community harms. We implemented a pre-arrest diversion program, the Madison Addiction Recovery Initiative (MARI), from September 2017 – August 2020. Methods: In the MARI program, adults suspected of committing an eligible, drug use-related crime were offered referral to treatment in lieu of arrest. Successful completion of the 6-month program resulted in that charge being “dismissed.” Formative evaluation assessed key factors influencing implementation through stakeholder feedback and team meeting minutes, which prompted protocol changes. Process evaluation consisted of tracking participant referrals, enrollment and engagement. Police officers, participants, and treatment staff members were surveyed on program experiences and attitudes. Descriptive statistics were used for quantitative survey responses while qualitative analyses identified major themes in qualitative responses. Results: Of 263 eligible referred participants, 160 started addiction treatment, with 100 successfully completing the MARI program. Interim evaluations informed program adjustments, such a Mobile Outreach Team to increase participant enrollment, increasing diversity of recovery peer specialists, streamlining the referral process for police officers, increasing the frequency of team meetings to monitor participant engagement and enrollment, and transitioning to telehealth assessments and treatment during the COVID-19 pandemic. Conclusion: Multidisciplinary stakeholder feedback and involvement, as well as regular, interim evaluations can ensure the success and sustainability of a law enforcement-led pre-arrest diversion program. Implementing such programs across the country can not only reduce crime and criminal justice system involvement, but also change the lives of people with SUD.

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