A qualitative comparison of 3 law enforcement deflection programs for people who use drugs (PWUD) in Wisconsin

Due to the high cost of imprisonment and high rates of recidivism, there are a growing number of programs working to divert individuals involved in non-violent drug offenses away from arrest, jail and prison. Deflection programs are those that refer people who use drugs (PWUD) to harm reduction or drug treatment in lieu of arrest while diversion programs refer PWUD post-arrest in lieu of pressing charges. While the prevalence of these programs has increased significantly in recent years, results of these programs have been mixed, and much remains unknown regarding how these programs vary in structure and implementation. We used a multiple case study design and conducted semi-structured interviews with staff ( n = 11) from three county-wide police diversion/deflection programs in rural areas of Wisconsin including law enforcement personnel (chiefs and officers) and non-police specialists working to provide drug treatment, case management or medical services to PWUD as part of the deflection program. The oldest program had been in existence for 4 years while the other two had been in existence for 2 years prior to interview. Interview participants were asked to describe their current role and the police diversion/deflection program and to assess the successfulness and effectiveness of the diversion/deflection program. Staff from all counties described creating their programs by borrowing referral pathways, staffing structure and workflows from other departments and adapting them to their local needs. Interviews also revealed key implementation factors that led to the success or failure of the program including the social capital and degree of leadership support for the program, outreach specialists and other civilian staffing, resource availability, and incentives and disincentives to referring PWUD to the program. Results from this study show several factors that facilitate implementation of diversion and deflection programs Law enforcement is a critical component in overdose prevention and can play a vital role in emergency and behavioral health needs in rural areas.