Public Health / Public Safety Collaborations

Voiceover

00:00

This is The Beat—a podcast series that keeps you in the know about the latest community policing topics 

facing our nation.

Nazmia Comrie

00:08

Hello and welcome. My name is Nazmia Comrie, and on behalf of the COPS Office, I would like to 

introduce Acting Director of National Drug Control Policy Michael Botticelli and Vermont State Police 

Colonel Tom L'Esperance. Acting Director Botticelli previously served as Deputy Director of the Office of 

National Drug Control Policy, a position he held since November 2012. He has more than two decades of 

experience supporting Americans who have been affected by substance abuse disorders and has been a 

state and federal leader on overdose prevention and public health and public safety collaborations.

Colonel L’Esperance, Director of the Vermont State Police since 2009, oversees the field force, criminal, 

and support services divisions. L’Esperance has spent nearly two decades targeting the flow of drugs in 

the Green Mountain State and more recently has led the way in Vermont in implementing a naloxone 

program that allows police to intervene when an individual is experiencing an opiate overdose. This will 

be a two part podcast to discuss public health / public safety collaborations and law enforcement use of 

naloxone.

Acting Director Botticelli, what is the Office of National Drug Control Policy? I’d think many of our 

listeners have heard of ONDCP but might not understand its overall role is in federal drug policy and its 

mission. What are some of ONDCP’s priority issues this year?

Acting Director Michael Botticelli

01:32

Thank you, Nazmia. The Office of National Drug Control Policy is a component of the Executive Office of 

the President. We have many functions, but our prime function, by statute, is to annually publish the 

administration’s national drug control strategy, which lays out the administration’s approach to drug 

policy. We do that in coordination with our federal agencies and have many action items that speak to 

how we’re going to reduce drug use and its consequence in the United States. Clearly, we rely on our 

state and local partners to help us execute that, and I think today’s discussion is a good example of that.

In 2010, as the administration was coming in, we quickly learned the magnitude of the prescription drug 

misuse problem that many communities across the country are experiencing. And in 2011, we released 

our federal agency’s plan to reduce prescription drug abuse in the United States and in the communities 

as well as dealing with the dramatic increase in opiate overdose deaths that we have seen across the 

country. We have a long history with the COPS Office including former Director Kerlikowske’s role as the 

Deputy Director and also as a former police chief; he understood and the office understood that law 

enforcement has a key role to play, not only as it relates to larger public health and public safety 
collaboration but specifically in first responders and the role that they can play in reducing overdose 

deaths. So we know that overdose happened at the rural, suburban, and urban levels, and clearly we 

have a public health and law enforcement infrastructure there to deal with it. So I really want to thank 

the current Director, Ron Davis, for his support as well as Colonel L'Esperance and the Vermont State 

Police. This has really been emblematic of the role of our office in looking at this balanced approach with 

public safety and public health working hand in hand. And clearly, the naloxone distribution by law 

enforcement is a really stellar example of how different parts of the community can work together to 

really reduce the magnitude of the drug use problem that we have.

Comrie

03:51

Thank you. Acting Director, quite a bit of attention has been paid recently to the uptick in heroin 

overdose deaths. While they attract headlines, I understand that there are drugs that are much more 

widely abused in this country. Can you elaborate on this?

Botticelli

04:05

Recent data according to the CDC, which is in 2012, has shown that about 16,000 drug poisoning deaths 

involved opioid analgesics or opioid pain medication like oxytocin and hydrocodone and heroin. We’ve 

been cautiously optimistic. In the first time in 13 years, we actually saw a decrease in the number of 

opiate overdose deaths associated with prescription pain killers. What’s disconcerting to us and what’s 

of significant concern has been a recent spike over the past few years in heroin-related overdose deaths. 

So while we know the heroin deaths still don’t approximate the number of opiate overdose deaths, it 

really is a significant concern. But to put that in context, we know that people, recent initiates to heroin, 

about four-fifths of them began using opiates by misusing prescription pain medication. So we clearly 

know that we have to deal with the misuse of pain medication as it relates to dealing with the heroin 

issue. And we know that it appears that only a fairly small percentage of people who are misusing pain 

medication actually transition to heroin. So we know we have an opportunity here for a wide variety of 

interventions, not just in terms of reducing overdose deaths, but really intervening in people’s 

progression from misusing pain medication to heroin.

Comrie

05:31

Thank you. Acting Director Botticelli and Colonel L’Esperance, the opiate epidemic has led to some law 

enforcement agencies beginning to equip officers with naloxone, an overdose reversal drug. It seems 

like most officers respond positively to having this tool that can help them save lives. Has that been the 

trend you are seeing?

Botticelli

05:50

So I’ll start and then let the colonel talk about his experience. We know that overdose deaths have had 

devastating impact on families and communities across the country. And we have clearly heard that 
from not only public health officials but law enforcement folks who are seeing their own community 

members’ children and sometimes their own children overdose and die. And I think that we—I hear 

from law enforcement all the time about the role that they can play in reducing the magnitude of the 

opiate overdose deaths that we have here. And just to give you some perspective in terms of kind of 

where we started and how this has changed: in 2011, we trained the first police force in the country—

Quincy, Massachusetts, a very small town south of Boston that was hit hard by the opioid epidemic—

and trained and equipped all the officers in Quincy to use naloxone. And since 2011, in this very small 

town south of Boston, they have been able to reverse over 300 deaths in this very small town. So we 

think about the opportunities. And since that time, and the number is growing daily, but at latest count, 

there have been over 300 state and local law enforcement agencies that have begun to use naloxone. 

And one of the things we have been doing at the Federal Government, with the Federal Government, 

with the COPS program, and the Department of Justice and included that expertise of people like 

Colonel L'Esperance, was we just released a tool kit that helps local law enforcement really understand 

how to implement a naloxone program and what some of the challenges might be and how they 

overcome those. So we have really been heartened by the number of state and local law enforcement 

agencies that have taken this on and the change in state law. We now have about 32 states including the 

District of Columbia who have passed some level of legislation around overdose prevention, as well as 

what we’re calling good Samaritan laws. These are laws that allow people to not get arrested for 

possession issues when they’re calling to report an overdose. So we’re really heartened by how this has 

been taken up by state and local law enforcement agencies nationwide.

Colonel Tom L'Esperance

08:03

And I guess I can echo some of the acting director’s comments. We followed the road map that was laid 

in Quincy and using some of the protocols they had in place, we were able to kick off our program. As 

I’ve said publicly before, this was the easiest decision that I’ve made as the Director of the State Police. I 

addressed a group of colonels from across the country last year in New Orleans to discuss the program 

we’re putting in place. And by a show of hands, there were very few if any other state agencies that 

were involved in this program. And I can say with pleasure that I just left Orlando over the weekend and 

I asked the same question and a number of state police agencies are now involved: Rhode Island State 

Police, New York, Massachusetts, to name a few. And the Tennessee Highway Patrol colonel who sits 

next to me during these meetings was asking me about our program and how to get a program going in 

his state because there is a legislative push to introduce this program to law enforcement in Tennessee. 

At the same time, I was receiving the emails from your office about the tool kit. So I was able to push the 

tool kit out through conversation and another conversation with the New Hampshire state police 

colonel about his program. Again, this tool kit that the ONDCP put together will pave the way for those 

agencies who are—number one—considering the program and those that are mandated to do

something with naloxone. So the trend is moving from east to west which, in law enforcement, most 

crimes move west to east—the methamphetamine crisis of the east coast, we couldn’t get a hold of it 

until after we saw some best practices that were taking place out west and in the Midwest. This heroin 

epidemic and the naloxone program is headed east to west so police agencies will benefit from the work 

that was conducted by towns like Quincy and other agencies across the east coast.
Comrie

09:55

That’s wonderful. Thank you.

While a majority of drug overdoses are caused by opioids, not every drug overdose is reversible by 

naloxone. As communities think about bringing public health and public safety strategies into greater 

alignment for their overall well-being, are there other things law enforcement can do to help their 

communities address substance use disorders in general and overdose? What partnerships should law 

enforcement be making to address the public health concern that can become a public safety concern?

Botticelli

10:24

One of the—if there’s any silver lining to the prescription drug and the heroin overdose issue—it’s really 

the tremendous amount of work and collaboration that’s been happening with public health and public 

safety folks. We know that just reversing an overdose death is not a comprehensive response to this 

issue. And I think that there are great examples of the work that’s happening at the community level 

about how public safety and public health are partnering together for a comprehensive approach.

First and foremost, we know we need to focus on prevention in reducing substance use. We know that 

law enforcement are some of the most well-known and well-respected people in their communities and 

engaging law enforcement into broader community prevention efforts are particularly important. Our 

office actually supports and funds the drug-free community support program that convenes all 

community stakeholders, and law enforcement are actually required to be a part of that because we 

know they play a pivotal role. We also want to make sure people have access to good treatment and 

recovery support programs. And we’re really seeing the solidification of relationships between local law 

enforcement and treatment programs. I often hear from local law enforcement who understand that we 

can’t arrest our way out of the problem, and they want those kinds of partnerships. They want 

alternatives. They want to make sure that we’re getting and they’re getting people into treatment. So I 

think it’s really important to get to know the treatment resources and the treatment community in their 

local jurisdictions because it really can help them to look at alternative approaches. And we also know, 

and I hear this time and time again, that we really have to look at stopping the revolving door between 

arrest, incarceration, and re-arrest, particularly for people with histories of substance use, and helping 

to support innovative evidence-based criminal justice reforms that move people away from the criminal 

justice system. So things like drug court and good re-entry programs—having our law enforcement and 

public safety officials involved in those and supportive of those kind initiatives—will really go a long way 

in reducing the burden and the public health and public safety impact of drug use.

L’Esperance

12:41

And I’d follow up with, it’s well publicized that the governor of Vermont spent his entire State of the 

State address speaking to the heroin epidemic that we’re facing here in Vermont. In speaking about the 

war on drugs if you will. I used to take that personal because I thought that law enforcement was at the 

tip of the spear on the war on drugs. But I quickly realized as he was speaking that his comments 
actually hold all of us accountable, meaning law enforcement, prevention, treatment, and it forced us to 

the table in some respects. We did have some good relationships that were brewing along the way, but 

his conversation and conversations thereafter put us all at the table with equal voice. I don’t think that 

there’s anybody that’s really trying to get their arms around this issue, that’s really trying to reach real 

deep into the well for money or deeper into the well—we all collectively realize that this three-legged 

stool that’s been developed, prevention, law enforcement, and treatment, have to work in concert—

otherwise, we’re going to continue to slip behind. So whether it’s the naloxone program or just other 

conversations that are taking place between law enforcement and treatment folks, it puts us in the 

same conversation. I think at the end of this, we can use these relationships to attack other issues that 

face our community.

Botticelli

13:52

I just want to echo what the colonel said and I think the naloxone distribution programs have really 

jump-started those conversations—and the opioid epidemic that we have—have really jump-started 

those conversations. I love the way that the colonel framed this in terms of a three-legged stool, 

because I think he’s absolutely right that if we’re going to have a comprehensive response looking at 

things like prevention and treatment, we need law enforcement, law enforcement needs public health, 

and each of us have a role to play in diminishing the impact of this issue. And so I think it has really kind 

of jump-started a tremendous amount of interaction at the state and local level.

Comrie

14:31

Thank you Acting Director Botticelli and Colonel L’Esperance for providing us with your expertise and 

time. I look forward to continuing this conversation in the second part of this podcast series.

Voiceover: The Beat Exit

14:40

The Beat was brought to you by the United States Department of Justice COPS Office. The COPS Office 

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Voiceover: Disclaimer

14:56

The opinions contained herein are those of the authors and do not necessarily represent the official 

position or polices of the U.S. Department of Justice. References to specific agencies, companies, 

products, or services should not be considered an endorsement by the authors or the U.S. Department 

of Justice. Rather, the references are illustrations to supplement discussion of the issues.