While public health experts struggle to pinpoint the exact cause, overdose fatalities have been falling across the United States since autumn 2023. A Guardian analysis highlights that this decline, though uneven, includes states like West Virginia, long considered the epicentre of the opioid epidemic. One under-explored factor contributing to this positive trend is the growing adoption of specialised crisis intervention training (CIT) for law enforcement officers.
From Mental Health to the Overdose Epidemic
Originally developed in the late 1980s to help police recognise and humanely manage mental health crises, CIT programmes have evolved. They are now increasingly utilised to address the nation's substance use disorder pandemic. The training equips officers to identify when someone is in crisis due to addiction, communicate with empathy, and actively connect individuals to treatment resources instead of defaulting to arrest.
"As more police officers recognise that substance use disorders are a pandemic, more have become interested in crisis intervention training," explained Yolandah Mwikisa, crisis response unit supervisor for the Wheeling Police Department in West Virginia. She notes officers are motivated by a desire to improve their effectiveness, avoid litigation, and genuinely understand the people they encounter.
The "Warm Handoff": A Critical Shift in Practice
The philosophy behind this approach is backed by experts. Richard Frank, a senior fellow at the Brookings Institution who helped coordinate the Obama administration's opioid response, emphasises that intention must be matched by concerted effort. He points to the importance of a "warm handoff"—where officers personally deliver an individual to a treatment facility—rather than merely providing a phone number and hoping for the best.
Supervisor Mwikisa strongly agrees with this principle, stating that prioritising the needs of those struggling is paramount. "People aren't going to want to tell their story twice," she said. To ease the transition, her team will call ahead to a treatment centre, ensuring the person receives continuity of care without having to relive traumatic details.
Accountability Versus Help: A False Dichotomy
Mwikisa, who has witnessed a tangible change in officer behaviour since the training's implementation, argues that getting people into treatment and recovery—even if not permanent—reduces criminal motivation and the risk of fatal overdose. Conversely, incarceration often increases both dangers.
Addressing sceptics who believe illegal acts should always lead to jail time, Mwikisa offers a compelling perspective: "Holding people accountable and getting them help are not opposites. The real failure is when we do neither." Early research comparing jurisdictions with and without CIT programmes appears to support this view, showing an association between the training and a decline in overdose fatalities.
As the United States continues to grapple with the complex legacy of the opioid crisis, the expansion of crisis intervention training represents a pragmatic, compassionate shift in how frontline services respond to one of the nation's most pressing public health challenges.
