Beliefs of US chiefs of police about substance use disorder, fentanyl exposure, overdose response, and use of discretion: results from a national survey.

backgroundTo inform the feasibility and acceptability of evidence-informed police practices related to substance use, addiction, and overdose, we sought to better understand how US police chiefs perceive substance use and related policing practices.

methodsA national sample of randomly selected US police chiefs (N = 276) completed a 37-item survey about substance use and policing. Nine items assessed chiefs' perceptions of: officers' discretion in making arrests, effectiveness of overdose responses, risks of fentanyl exposure, de-escalation practices, harmful drugs in their community, and illicitly-obtained buprenorphine. Data were analyzed with descriptive statistics and exploratory ordinal logistic regressions.

resultsMost chiefs (72.5%) agreed that arrest for any nonviolent misdemeanor was at the discretion of their officers, and they overwhelmingly (94.9%) trusted their officers to make the right arrest decision. The majority of chiefs (87.7%) felt their officers could effectively respond to an opioid overdose, and 83.7% reported their officers carried naloxone on patrol. Chiefs in the Northeast were significantly less likely to be confident in their officers' ability to respond to a methamphetamine overdose than chiefs in the West. Most (90.0%) were receptive to implementing methamphetamine de-escalation strategies (i.e., techniques to resolve crises short of force). Almost all chiefs (91.2%) agreed with the inaccurate statement that fentanyl exposure at a drug overdose scene could harm officers.

conclusionsPolice chiefs express interest in several types of evidence-based public health approaches to policing. Critically, there is a need to curtail fentanyl misinformation and to improve officer knowledge about medications for treating opioid use disorder.