Newswise — PROVIDENCE, R.I. [Brown University] —For years, the police have relied on seizing illegal drugs as a fundamental tactic to disrupt drug markets and eliminate drugs from localities. However, a recent study reveals an unintended consequence when opioids are confiscated: a rise in overdoses, including lethal ones.
The study discovered a correlation between police drug seizures and a surge in fatal overdoses within the nearby vicinity in the three weeks after law enforcement actions. This phenomenon could be attributed to individuals with substance use disorder resorting to more dangerous measures in their attempts to replenish their drug supply. Published in the American Journal of Public Health, the study raises concerns about policies that could be exacerbating overdoses in the midst of an ongoing epidemic that is negatively impacting the nation's life expectancy.
According to Bradley Ray, the lead researcher of the study and a senior researcher at the nonprofit research institute RTI International, the findings offer proof that endeavors aimed at disrupting drug markets can inadvertently result in harm to the public.
Ray expressed concern over the idea that regular drug enforcement efforts could worsen the harms associated with drug use. He emphasized the need to prioritize strategies that reduce the sources of overdose risk in order to address this issue.
The study was co-authored by Brandon del Pozo, who holds positions as an assistant professor (research) at both Brown University's Warren Alpert Medical School and School of Public Health. Del Pozo brings extensive experience to the study, having served in the New York City Police Department for 19 years and later as the chief of police of Burlington, Vermont, where he oversaw the city's efforts to combat the opioid crisis. Del Pozo emphasized that the study shed light on the unintended and secondary effects of law enforcement drug seizures, often referred to as "collateral consequences."
Del Pozo emphasized the importance of adopting comprehensive policing strategies to effectively reduce overdose deaths. He stated that it is crucial to consider all the outcomes of police work, not just the immediate impact of incapacitating drug dealers. This includes recognizing how drug seizures disrupt drug sales within a community and understanding how these disruptions influence patterns of drug use, which in turn impact the health and safety of individuals. The study provides evidence that the seizure of opioids leads to an increased risk of overdose.
In order to conduct the study, the research team utilized two years' worth of administrative data from Marion County, Indiana. The data allowed them to compare various types of drug seizures with subsequent changes in fatal overdoses, nonfatal overdose calls for emergency medical services, and the administration of naloxone within the surrounding area. This approach enabled them to analyze the correlation between different types of drug seizures and their impact on overdose-related outcomes.
The study revealed significant findings indicating that opioid-related drug seizures by the police were linked to increased overdoses within specific timeframes and distances. Within seven, 14, and 21 days, the presence of opioid-related seizures by law enforcement was associated with a notable rise in overdoses within 100, 250, and 500 meters of the seizure location. Particularly striking was the observation that the number of fatal overdoses was twice as high as anticipated within seven days and 500 meters following an opioid-related incident involving drug seizures by the police.
The researchers put forward a hypothesis to explain the surge in overdose incidents, suggesting that individuals who use opioids typically try to find an alternative drug supply after losing access to their previous source. This replacement supply may have an unknown potency, making it riskier for consumption. Additionally, during the transition period between losing the familiar supply and acquiring a new one, individuals using opioids may experience a reduction in their tolerance to the drugs. Accidental ingestion of a dose that exceeds their lowered tolerance level can result in fatal consequences.
Ray highlighted one of the inherent risks associated with the illicit drug market, which is the lack of certainty regarding what constitutes a safe dosage. When individuals who use drugs are no longer able to obtain their regular supply, they are compelled to seek out an unfamiliar source, introducing a level of uncertainty regarding the composition and potency of the drugs they acquire. This uncertainty significantly increases the risk of overdoses, as the individuals may unknowingly consume substances with higher potency or different compositions than what they are accustomed to.
The researchers pointed out that fentanyl, an extremely potent opioid commonly mixed with other substances like heroin or cocaine, is a major contributor to the increasing fatality count in opioid- and stimulant-related overdose deaths. Fentanyl has become prevalent in the illicit opioid market and has contaminated a significant portion of the drug supply. Even in small doses, fentanyl is highly lethal, further exacerbating the risks associated with drug use and contributing to the rising number of overdose fatalities.
Del Pozo stated that due to the widespread presence of fentanyl in the drug market, individuals who engage in drug use have an extremely limited room for error when it comes to dosage miscalculations.
According to del Pozo, the results of the study can provide valuable insights for developing a more impactful law enforcement strategy to combat overdoses. For instance, he emphasized the significance of incorporating targeted harm reduction measures alongside drug seizures in specific regions. These measures may include outreach services, facilitating access to treatment, expanding naloxone distribution, and implementing programs that enable the testing of illicit drugs to detect the presence of fentanyl.
Del Pozo expressed that if drug seizures by law enforcement are to remain a component of the strategic response to the nation's overdose crisis, it is crucial to acknowledge that, at least in the short term, such seizures contribute to an increase in overdoses. He stated that saving lives should be a fundamental objective of drug enforcement, but the current approach seems to have the opposite effect.
In addition to del Pozo, the study involved contributions from various other researchers, including Steven J. Korzeniewski, Grant Victor, Philip Huynh, and Bethany J. Hedden from Wayne State University. George Mohler from Boston College and Jennifer J. Carroll from the Warren Alpert Medical School at Brown University and North Carolina State University also participated in the study.
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