Posted by & filed under Noah's Notes.

Last month I reviewed the recommendations of the Prevention and Harm Reduction task force of the US Attorney’s Maine Opiate Collaborative.  This month I will share the recommendations of the Law Enforcement task force of the collaborative, which was made up of representatives of law enforcement agencies spanning the state.

And let me preface this by saying that in my interactions discussing this issue with law enforcement people, I have been struck by how knowledgeable, compassionate and innovative they are in working to address this challenge in an effective manner.  The recommendations are as follows:

  1. Train all existing and new law enforcement personnel on the science of substance use disorders. This is fundamental to an effective approach and, I think, shows tremendous insight on the part of the task force.  By the way, the same could be said for medical personnel and for policy makers.  The task force goes into some detail on how to accomplish this objective.
  2. Identify, investigate and prosecute the most dangerous drug traffickers. Hard to argue this point, and while we recognize the disease of substance use disorder, those who take advantage of the current prevalence of that disease to market drugs illegally ought to be held criminally responsible.  The task force recommends statewide intelligence sharing, implementation of software designed to meet some of this need, record sharing, information sharing, outreach from drug intelligence officers to local law enforcement and improved collaboration as strategies for advancing this goal.
  3. Support and encourage effective law enforcement pre-charge diversion programs. This refers to the need for a treatment and recovery resource in each prosecutorial district so that people arrested on drug charges could be referred for treatment of their substance use disorder.  They also recommend tracking data so that the effectiveness of these interventions can be monitored.
  4. Increase statewide access to effective problem solving courts. This includes the recommendation to seek state and federal funding to support facilities, case managers, judges, prosecutors, and treatment providers.
  5. Provide treatment for county jail inmates with substance use disorders and provide case management services for re-entry into the community. This is critical in order to stop the cycle of addiction, arrest, detoxification, release and relapse.  In addition, the 48 hours after release from jail is the time of highest risk for fatal drug overdose.  If a person with substance use disorder is established in a treatment program and, most importantly, if the treatment can continue seamlessly as they transition out of jail, we can break that cycle and help people enter long term recovery.

Next month, the recommendations of the Treatment and Recovery Task Force.


Noah Nesin, MD

Dr. Nesin, Vice President of Medical Affairs for PCHC, is a family doctor with 30 years of experience.

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