This publication describes a number of deflection programs that have arisen as non-law enforcement responses to the opioid crises.
The programs highlighted in this publication by the Bureau of Justice Assistance (BJA)
Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) exemplify deflection initiatives that enable fire and EMS personnel to go beyond naloxone administration and reliance on emergency departments and to actively link individuals to treatment and services. Deflection programs offer a promising alternative to traditional justice system responses and demonstrate that a collaborative approach involving community-based organizations can create pathways to treatment and recovery. In 2013, in response to an alarming increase in the number of overdose deaths, driven by the use of synthetic opioids, law enforcement agencies and other first responders began to collaborate with community-based treatment and service providers to rapidly engage individuals with opioid use disorders (OUDs). Following a brief decrease in the number of drug overdose deaths from 2017 to 2018, the highest number of overdose fatalities in a 12-month period was recorded between 2019 and 2020, an increase of 38.4 percent from the same time frame the year prior. The number of overdose fatalities appears to have been exacerbated by the COVID-19 pandemic, highlighting the need to redouble intervention efforts. The programs discussed include first responder/non-law enforcement deflection (FRD) programs; the Self-Referral Pathway; the Naloxone Plus Pathway; the Officer Prevention Pathway; and the Support Team Assisted Response (STAR) program. EMS specialization in medication-assisted treatment (MAT) is also discussed.