Boston Medical Center and Boston University School of Medicine, Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, 801 Massachusetts Ave, 2nd Floor, Boston, MA 02118, United States.
Northeastern University School of Law and Bouvé College of Health Sciences, 416 Huntington Ave, Boston, MA 02115, United States; Health in Justice Action Lab, Northeastern University, 416 Huntington Ave, Boston, MA 02115, United States.
Int J Drug Policy. 2022 Feb;100:103483. doi: 10.1016/j.drugpo.2021.103483. Epub 2021 Oct 23.
Post-overdose outreach programs engage survivors in harm reduction and treatment to prevent future overdoses. In Massachusetts, these emerging programs commonly deploy teams comprised of police and public health professionals based on 911 call information. Some teams use name/address data to conduct arrest warrant checks prior to outreach visits. We used mixed methods to understand approaches to outreach related to warrant checking, from the perspectives of police and public health outreach agencies and staff.
We analyzed a 2019 statewide survey of post-overdose outreach programs in Massachusetts to classify approaches to warrant checking and identify program and community factors associated with particular approaches. Ethnographic analysis of qualitative interviews conducted with outreach staff helped further contextualize outreach program practices related to warrants.
A majority (57% - 79/138) of post-overdose outreach programs in Massachusetts conducted warrant checks prior to outreach. Among programs that checked warrants, we formulated a taxonomy of approaches to handling warrants: 1) performing outreach without addressing warrants (19.6% - 27/138), 2) delaying outreach until warrants are cleared (15.9% - 22/138), 3) arresting the survivor (11/138 - 8.0%), 4) taking a situational approach (10/138 - 7.2%), 5) not performing outreach (9/138 - 6.5%). Program characteristics and staff training did not vary across approaches. From police and public health outreach staff interviews (n = 38), we elicited four major themes: a) diverse motivations precede warrant checking, b) police officers feel tension between dual roles, c) warrants alter approaches to outreach, and d) teams leverage warrants in relationships. Findings from both analyses converged to demonstrate unintended consequences of warrant checking.
Checking warrants prior to post-overdose outreach visits can result in arrest, delayed outreach, and barriers to obtaining services for overdose survivors, which can undermine the goal of these programs to engage overdose survivors. With the public health imperative of engaging overdose survivors, programs should consider limiting warrant checking and police participation in field activities.
中毒后救援计划通过减少伤害和治疗来接触幸存者,以防止未来再次中毒。在马萨诸塞州,这些新兴的项目通常根据 911 报警电话信息,部署由警察和公共卫生专业人员组成的小组。一些小组在进行外展访问前使用姓名/地址数据进行逮捕令检查。我们使用混合方法从警察和公共卫生外展机构和工作人员的角度了解与搜查令相关的外展方法。
我们分析了 2019 年马萨诸塞州中毒后外展计划的全州调查,对搜查令的方法进行分类,并确定与特定方法相关的项目和社区因素。对与搜查令相关的外展计划实践进行了定性访谈的人种学分析,进一步说明了外展计划的情况。
马萨诸塞州的中毒后外展计划中有一半以上(57% - 79/138)在进行外展前进行了搜查令检查。在进行搜查令检查的计划中,我们制定了处理搜查令的方法分类法:1)不处理搜查令进行外展(19.6% - 27/138),2)等待搜查令被清除后再进行外展(15.9% - 22/138),3)逮捕幸存者(11/138 - 8.0%),4)采取权宜之计(10/138 - 7.2%),5)不进行外展(9/138 - 6.5%)。计划特点和工作人员培训在不同的方法中没有差异。从警察和公共卫生外展工作人员访谈(n = 38)中,我们得出了四个主要主题:1)搜查令之前存在各种动机,2)警察感到双重角色之间的紧张关系,3)搜查令改变了外展方法,4)团队利用搜查令建立关系。这两种分析的结果都表明了搜查令的意外后果。
在进行中毒后外展访问之前检查搜查令可能会导致逮捕、延迟外展以及给中毒幸存者获得服务的机会造成障碍,从而破坏这些计划让中毒幸存者参与的目标。考虑到让中毒幸存者参与的公共卫生当务之急,计划应考虑限制搜查令和警察参与实地活动。