Focus on Training
Addressing the Opioid Epidemic
By William J.C. Matthews, M.P.A.
“We don't rise to the level of our expectations; we fall to the level of our training.”
The opioid epidemic continues to present an immense public health threat. The devastating effects it leads to, including loss of life and the economic and socioeconomic impact on communities, requires a refocus on training. Law enforcement, medical personnel, communities and schools, and social services are strained by this crisis, and dedicated trainings could help alleviate the burden on communities struggling to respond. Providing training designed to not only educate on the opioid epidemic but also promote a community response in addressing it is crucial to confronting this public health threat.
This opioid crisis has had devastating consequences on communities throughout the United States. In 2020, the Centers for Disease Control and Prevention reported 93,000 opioid overdose deaths, a significant increase from 70,630 in 2019.2 A recent book examining the effects of opiate abuse explored the loss of community and the idea that the connections holding neighborhoods together have withered, contributing to isolation and feeding addiction. For vicinities impacted by opiate abuse, the author concluded that community is an “antidote” for heroin abuse and broader prescription opioid abuse.3
The COVID-19 pandemic brought on social distancing concerns, further isolation, loss of community, and a rise of opiate abuse and deaths. In-person and virtual trainings as well as check-ins can promote community and accountability while providing the most current information on opiate abuse and drug trends.
Mr. Matthews, a retired DEA assistant special agent in charge with experience in complex investigations, international operations, security and personnel recovery, and training, is a managing director at a private consulting firm.
Need for Training
With the DEA’s rapid creation of tactical diversion squads throughout the United States, the number of newly assigned special agents and other personnel with a limited background on pharmaceutical diversion created a need for specialized training.4
Special agents required training on investigating DEA registrants (those authorized by law to possess, prescribe, or dispense drugs) who violated the Controlled Substances Act (CSA).5 Their state and local counterparts needed training on pharmaceutical controlled substances. Specifically, state and local officers learned how pharmaceutical information from traffic stops, search warrants, and public tips could build on a current “pill mill” case.6
Prosecutors benefited from actionable training on investigative and prosecution strategies. Social services, schools, and community leaders needed education on current trends in pharmaceutical abuse and points of contact in their community for resources. From legal, pharmacological, and investigative standpoints, training can catapult stagnant cases and provide information for medical and community personnel desperate for knowledge and action.
Often, criminal diversion investigations have complex legal and constantly evolving investigative components. From case initiations to sentencings, success in these investigations involves extensive documentation, data, and graphic summaries to support the findings. These skills require continuous, specialized trainings.
Criminal diversion investigations often have fraud and financial elements, which require multiagency coordination and an understanding of violations beyond the scope of the CSA. These investigations can sometimes span over several years and may involve additional years in the prosecution phase.
Providing joint training for prosecutors and investigators across agencies can alleviate some of the burden of resources, strategy, and investigative approaches. Early, consistent, and meaningful trainings will promote cohesiveness early on and allow for greater prosecution success rates. Nothing is more frustrating than to watch cases linger because of a lack of applicable training on both the investigative and prosecution phases.
The DEA established the Diversion Specialized Training Unit (DSTU) in 2018 to address the need for diversion training. During its first two years of existence, the DSTU trained approximately 1,300 DEA personnel and prosecutors. As its training cornerstone, the unit takes a team approach — special agents, diversion investigators, intelligence research analysts, task force officers, and prosecutors learn together.
From investigative strategies, to search warrant affidavits, to presenting the case to a prosecutor, these trainings provide actionable information designed to help initiate, advance, and successfully conclude civil and criminal diversion investigations. Over a dozen courses developed by the DSTU address the many facets of the opioid crisis, including interviewing vulnerable victims, working with the medical community, and coordinating with social services.
“This opioid crisis has had devastating consequences on communities throughout the United States.”
During the pandemic, the DSTU incorporated a virtual format and trained federal prosecutors in 33 federal judicial districts throughout the United States on prosecuting diversion cases. The in-person and virtual trainings provided not only actionable information and case examples but also community among law enforcement and prosecutors to exchange experiences, tools, and motivation for attacking the problem. These trainings were also a call to arms for the trainees to return and educate the communities they came from.
The DSTU was designed to complement the DEA and other agencies’ approaches to the opioid crisis. Both the DEA and the U.S. Department of Health and Human Services (HHS) have implemented such strategies.
In 2015, the DEA introduced its 360 Strategy, which employs a three-pronged approach to respond to the heroin and prescription opioid pill crisis.
- Coordinated law enforcement actions against drug cartels and heroin traffickers in specific communities
- Diversion control enforcement actions against DEA registrants operating outside the law and long-term engagement with pharmaceutical drug manufacturers, wholesalers, pharmacies, and practitioners
- Community outreach through local partnerships that empower communities to take back neighborhoods affected by enforcement actions and prevent the same problems from arising again7
In 2017, the HHS initiated a five-point strategy aimed at the most effective methods of addressing the opioid misuse disorder.
- More effective addiction, prevention, and treatment services
- More reliable data
- Enhanced pain management
- Improved targeting of overdose-reversing drugs
- Better research8
Both the DEA’s 360 Strategy and HHS’ five-point strategy offer a community response in addressing the opioid epidemic, and focused trainings will elevate these important initiatives.
“Over a dozen courses … address the many facets of the opioid crisis, including interviewing vulnerable victims, working with the medical community, and coordinating with social services.”
Training that reaches not just law enforcement personnel but also community members is crucial to addressing the opioid crisis and creating a community that can develop, share, and strategize. The outreach education to the neighborhoods we live in, along with consistent trainings on the evolving trends surrounding opioid abuse, will increase awareness on this epidemic and equip all members of society in tackling this devastating crisis.
Mr. Matthews can be reached at firstname.lastname@example.org.
1 “Archilochus,” AZ Quotes, accessed March 14, 2022, https://www.azquotes.com/quote/654940.
2 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Drug Overdose Deaths Remain High, last reviewed February 22, 2022, https://www.cdc.gov/drugoverdose/deaths/index.html.
3 Sam Quinones, Dreamland: The True Tale of America’s Opiate Epidemic (New York, NY: Bloomsbury Publishing, 2015).
4 Diversion refers to “legitimately made controlled substances being diverted from their lawful purpose into illicit drug traffic.” U.S. Department of Justice, Drug Enforcement Administration, Diversion Control Division, accessed March 16, 2022, https://www.deadiversion.usdoj.gov/prog_dscrpt/index.html.
5 U.S. Department of Justice, Drug Enforcement Administration, The Controlled Substances Act, accessed March 16, 2022, https://www.dea.gov/drug-information/csa.
6 For additional information, see Pia Malbran, “What’s a Pill Mill?” CBS News, May 31, 2007, https://www.cbsnews.com/news/whats-a-pill-mill/.
7 U.S. Department of Justice, Drug Enforcement Administration, DEA 360 Strategy, January 2019, https://www.dea.gov/sites/default/files/2019-04/360_Fact_Sheet_2019_FinalCOMPLIANT_0.pdf.
8 U.S. Department of Health and Human Services, Office of Family Assistance, 5-Point Strategy to Combat the Opioid Crisis, accessed March 16, 2022, https://peerta.acf.hhs.gov/content/5-point-strategy-combat-opioid-crisis.