Massachusetts Is Trying a Radical But Shockingly Simple New Response to the Opioid Crisis

We’re winding through a residential neighborhood in Framingham, Massachusetts, when the radio beeps. From the back seat of officer Jose Goncalves’ police cruiser, Danielle Larsen stops typing and listens. “Well-being check,” a dispatcher says, reading off an address; it’s outside Goncalves’ coverage area. “The occupant called to say her boyfriend is not waking up. Concerned about drugs in there. Going to get the fire rolling.” Goncalves keeps driving in silence.

Three minutes later, the officer makes an abrupt U-turn and pulls over. Through the front window of the cruiser, we see a man in his mid-30s, wearing jeans and a ball cap, head down near a curbside trash can, nodding out. Goncalves picks up his radio, says, “Going over to a male hunched over right by Gallagher Park,” and jumps out the door.

Larsen stays put, barely looking up from her laptop as Goncalves approaches the man. Goncalves asks for his ID and reads his license number into the radio—no outstanding warrants. The two stand on the sidewalk, an arm’s distance apart, their faces neutral. Then, the man adjusts his hat, pulls up his jeans, and heads down the sidewalk. “He’s on his way,” Goncalves says into the radio. “Clear.”

Goncalves climbs back in his cruiser and shifts into drive. No one says a word.

The exchange feels unremarkable, and that, Larsen argues, is what’s so remarkable about it. She isn’t Goncalves’ partner but a “co-responder”—a clinical social worker embedded in the police department to offer help to people rather than tossing them in jail. Until recently, that man, or anyone suspected of using drugs, might have ended up in cuffs. But now, Larsen trusts that officers will take a different approach—so much so that in April, when I accompanied Larsen on a Friday evening shift, she didn’t feel the need to jump out or really even monitor Goncalves’ interaction. “Rather than treating him like he was a criminal nodding off on the side of the road, on a main street, he had a conversation,” Larsen tells me later. “Basically assessed for safety and moved him along.”

While there are more and more stories about progressive policing efforts across the country and a purported drawdown in the war on drugs, society overwhelmingly treats people who use drugs as criminals who deserve punishment, not as patients with a chronic disease. National data shows that arrests for drug law violations continue to climb. At the same time, there are few signs the crisis is abating. In 2017, more than 70,200 Americans died of overdoses (the apparent peak of drug deaths), and, between 2010 and 2018, deaths from opioid-related overdoses more than tripled in Massachusetts. “Nobody was calling the police to save their friend that was overdosing because they didn’t want to get caught,” Larsen says.

“That’s why people were dying,” she adds.

Massachusetts has been hit hard, particularly by the rise of fentanyl—but it’s now also at the forefront of testing new ways to respond.

Recent law-enforcement initiatives underscore how police are trying to do the right thing, but also how they’re scrambling to fill a void. “God, how broken is our system that this is our response?” says Dr. Sarah Wakeman, medical director of the Mass General Substance Use Disorder Initiative. “Imagine if, at the height of the HIV epidemic, our response was to send police officers out with an outreach worker. We’re in the midst of a public health crisis, we have treatments that we know work, and so why is this our response?”