Police discretion in encounters with people who use drugs: operationalizing the theory of planned behavior.

BACKGROUND: Policing shapes the health risks of people who use drugs (PWUD), but little is understood about interventions that can align officer practices with PWUD health. This study deploys the Theory of Planned Behavior (TPB) to understand what influences police intentions to make discretionary referrals to treatment and harm reduction resources rather than arrest on less serious charges. METHODS: On-line surveys integrating TPB constructs and adapting an instrument measuring police intentions to make mental health treatment referrals were completed by police employees in Indiana, Massachusetts, and Missouri. They also included items about stigma towards PWUD and attitudes and beliefs about opioid addiction, treatment, and recovery. FINDINGS: Across the sites, 259 respondents perceived control over their decision to arrest for misdemeanors (69%) and confiscate items such as syringes (56%). Beliefs about others' approval of referrals to treatment, its ability to reduce future arrests, and to increase trust in police were associated with stated practices of nonarrest for drug and possession and making referrals (p ≤ .001), and nonarrest for syringe possession (p ≤ .05). Stigma a towards PWUD was negatively associated with stated practices of nonarrest (p ≤ .05). Respondents identified supervisors as having the most influence over use of discretion, seriousness of the offense as the most influential value, and attitude of the suspect as the most important situational factor. The 17 Likert scale items analyzed had a Cronbach's alpha of 0.81. CONCLUSION: The TPB offers untapped potential to better understand and modify police practices. In designing interventions to improve the health outcomes of police encounters with PWUD, further research should validate instruments that measure the relationship between these variables and discretionary intentions, and that measure role-relevant police stigma towards PWUD.

Can touch this: training to correct police officer beliefs about overdose from incidental contact with fentanyl.

Misinformation about overdose risk from accidentally inhaling or touching fentanyl is widespread among police in the United States. This may aggravate already elevated burdens of officer stress and burnout, while chilling lifesaving overdose response. Police education has shown promise in reducing false beliefs about fentanyl. To better understand the potential of training interventions in correcting officer knowledge, we administered a 10-min online training with corrective messaging about occupational overdose risk from fentanyl contact to 204 police officers in Indiana. Overall, 129 officers (63%) completed baseline survey and 69 (34%) completed follow-up instrument. Using a 6-point Likert scale, we documented assent with the statement: "First responders who encounter fentanyl are at great risk of overdose by touching it or inhaling it." At baseline, 79.8% expressed agreement, while 20.2% disagreed. At follow-up, 39.1% agreed, while 60.9% disagreed (p < .001). Baseline responses varied in that those officers without a college degree and those on patrol were more likely to report false beliefs. A brief online training intervention holds promise for correcting false beliefs about the risk of fentanyl overdose under circumstances commonly encountered by police.