The little-known program contributing to a decline in overdose deaths in the US

Overdoses have been declining nationally since the fall of 2023, and public health experts have been unable to agree as to why. The decline has been uneven across states, and West Virginia, long known as the epicenter of the opioid crisis, is also among the states that have most reduced overdose fatalities, as noted in a recent Guardian analysis.One little explored factor is the increased adoption of crisis intervention training (CIT) for law enforcement. Early research that compares jurisdictions that have CIT programs to those that do not show that this intervention is associated with a decline in overdose fatalities.Invented in the late 1980s, CIT was intended to help officers recognize mental health conditions and help those struggling access resources and treatment, rather than jailing them. In the wake of the overdose epidemic, these programs have become increasingly popular among law enforcement.“As more police officers recognize that substance use disorders are a pandemic, more have become interested in crisis intervention training,” said Yolandah Mwikisa, the crisis response unit supervisor for the Wheeling, West Virginia, police department.“More of them want to do their jobs better. They want to avoid lawsuits. They really want to understand what people are going through,” Mwikisa said.CIT teaches officers how to recognize when someone is struggling with substance use and in a state of crisis, how to speak to them empathetically and calmly, and encourage them to seek treatment. Mwikasa said that getting people to treatment and into recovery reduces their motivation to commit crimes and can help them live longer without overdosing, even if their recovery is not permanent. Sending them to jail, on the other hand, increases the risk of fatal overdose and of continued substance use.Richard Frank, a senior fellow at the Brookings Institution who helped coordinate the Obama administration’s opioid response, said that getting people into treatment rather than jail wasn’t just about intention, it’s about effort. For example, he noted the importance of a “warm handoff”, meaning you deliver someone to a treatment facility directly, rather than simply giving them a phone number.Mwikisa agreed that prioritizing the needs of those struggling with substance use is paramount.“People aren’t going to want to tell their story twice,” she said, so rather than expecting them to show up to a treatment facility and confess the painful details they have already given to the CIT team, she will call ahead to make the transition as easy as possible.In her years working as a CIT coordinator, Mwikisa says she has seen the difference in how officers behave. She remembers shortly after moving for a CIT job, she was pulled over for speeding.“The treatment I got was brutal. Maybe more brutal than you’d expect,” she recalled.But the training changes the way officers behave. Still, there are skeptics – people who think that anyone who does something illegal should go to jail.“Holding people accountable and getting them help are not opposites,” Mwikisa said. “The real failure is when we do neither.”