A new study highlights an unintended consequence of a popular tactic.
The seizure of illicit drugs by police has been a cornerstone strategy for disrupting markets and removing drugs from communities.
But there’s an unintended outcome when opioids are seized, a new study finds: increases in overdoses, including those that are fatal.
The study, published in the American Journal of Public Health, found that police drug seizures were associated with increases in fatal overdose in the surrounding geographic area in the three weeks following enforcement, possibly by leading people with substance use disorder to take greater risks when they tried to restore their supply. The findings raise questions about policies that might be exacerbating overdoses during a persistent epidemic that is contributing to reductions in the nation’s life expectancy.
“To be truly effective in reducing overdose deaths, policing strategies need to be comprehensive,” says study author Brandon del Pozo, PhD, an assistant professor of medicine (research) and former police chief. “That means taking into account all the outcomes of police work, not just the effect of incapacitating drug dealers, but also how seizing drugs disrupts sales in a community, and how those disrupted sales affect usage patterns, and how those usage patterns affect an individual’s health and safety. According to this study, we have evidence that seizing opioids increases exposure to overdose.”
The research team used two years of administrative data from Marion County, IN, to compare different types of drug seizures with subsequent changes in fatal overdoses, nonfatal overdose calls for emergency medical services, and naloxone administration in the surrounding area. They found that opioid-related seizures of drugs by police were significantly associated with increased overdoses nearby. Most notably, the number of fatal overdoses was two times higher than expected.
The researchers hypothesized that people who use opioids would generally seek out a new drug supply, which would have unknown potency. In addition, in the time it takes to find a new supply, they can lose some tolerance to the drugs.
Furthermore, the authors noted, fentanyl is driving fatalities in overdose deaths. Much of the drug supply is now contaminated by fentanyl, which is lethal even in small doses.
“The ubiquity of fentanyl in the drug supply affords people who use drugs almost no margin of error if they make a dosing mistake,” del Pozo says.
The study findings, he adds, can inform a more effective law enforcement strategy for preventing overdoses. For example, a drug seizure could be accompanied by targeted harm reduction approaches such as outreach services, links to treatment, increased naloxone distribution, and programs that test illicit drugs for the presence of fentanyl, he says.
“Part of the mission of drug enforcement is to save lives, and with the current approach, it’s doing the opposite,” del Pozo says.