SPECIAL ISSUE: SUBSTANCE USE AND CRIMINAL JUSTICE REFORM
The eruption of civil unrest this year across the country over race, policing and incarceration has led to calls for radical reforms in law enforcement and drug laws. At the same time, the nation continues to grapple with the opioid epidemic and a surge in overdose fatalities and illicit drug use. To address these unprecedented challenges, two innovative programs in upstate New York—in Albany and Buffalo—are re-imagining police practices and criminal justice responses to substance use and mental health disorders that could serve as models for the future.
TREATING SUBSTANCE ABUSE IN JAIL
When Craig Apple became sheriff of Albany County in 2015, he quickly recognized how the region’s law enforcement and drug policies had amounted to a “revolving door” of substance users going from arrest to incarceration and eventually back to the streets without treatment, only to resume a life of drug use. In response, Sheriff Apple started a voluntary diversion program to move individuals into treatment while remaining in jail, and to offer a full range of post-jail support services. In partnership with the Addictions Care Center of Albany, the program assesses and evaluates drug users remanded to a county jail, and offers addiction therapies including medication-assisted treatment (MAT) and peer-based counseling. Upon release, individuals are directed to the appropriate levels of treatment and care and supported in their effort to re-integrate into society. Sheriff Apple also started a shelter in the facility to treat homeless drug users—all part of what he calls a more “humane” approach to policing and substance use.
As of 2019, more than 300 individuals have enrolled in the program and the recidivism rate in Albany County has dropped to around 11 percent from as high as 44 percent. The model shows such promise that that every county in New York State has received information about it, along with funding to implement a pilot project.
IN BUFFALO, A PARTNERSHIP BETWEEN POLICE AND ADDITION PROFESSIONALS
In response to the escalating opioid epidemic and drug overdoses, law enforcement and local Buffalo provider Endeavor Health Services put together the Police Behavioral Intervention Team, with the goal of diverting users from ending up in the emergency room, or going through the criminal justice system. Comprising law enforcement and clinicians with substance use and mental health experience, the teams respond to emergency calls and screen, assess and stabilize individuals in crisis and link them with appropriate treatment as well as follow-up services.
In the first year of operation, there were 30 emergency room diversions and 375 individuals received follow-up and linkage to appropriate treatment, support and services. Endeavor CEO Elizabeth Mauro says the program also makes policing more effective, helps de-stigmatize mental illness and addiction for officers, and reduces trauma and stress for first responders. After starting up in Cheektowaga, a first-ring suburb of Buffalo, the program recently expanded into the city and is also ramping up teams in two other nearby suburbs.
Both programs are formulated on the belief that expanding access to treatment not only helps substance users but can also reduce drug arrests and incarceration—and in turn realign law enforcement responsibilities. During a time of bitter national debate about criminal justice reform, these practical and promising approaches need significant state and federal support to assess their viability at scale.
