Police Officers' Stigmatizing Attitudes Toward People Who Use Drugs: Implications for Support of Deflection

Police Officers' Stigmatizing Attitudes Toward People Who Use Drugs: Implications for Support of Deflection | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Police Officers' Stigmatizing Attitudes Toward People Who Use Drugs: Implications for Support of Deflection Jessica Reichert, Kaitlin Martins, Bruce Taylor, Brandon del Pozo, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6596810/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 04 Feb, 2026 Read the published version in Harm Reduction Journal → Version 1 posted 10 You are reading this latest preprint version Abstract Police deflection programs represent a promising public health strategy for addressing substance use disorders (SUDs) and diverting people who use drugs (PWUD) from the criminal legal system. These programs offer support for individuals frequently encountered by law enforcement by connecting them with treatment and resources. This study investigated the relationship between police officers' stigma towards PWUD and their support for the principles of deflection programs. We surveyed 248 officers from Illinois police departments, measuring stigma using established constructs of blame, distrust, fear, and shame. We examined the association between these stigmatizing attitudes and officer support for key deflection principles: access to treatment, utilization of medications for SUDs, and the potential for resource-saving solutions for law enforcement. Our findings revealed mixed findings, which suggest a complex relationship. While officers holding more stigmatizing views of fear and shame were less likely to endorse addressing addiction-related crime through treatment and support, officers exhibiting blame and certain aspects of distrust were more likely to support deflection. These nuanced results underscore the critical need for further research into the multifaceted relationship between stigmatizing attitudes of police officers and their willingness to embrace deflection strategies. Understanding these dynamics can aid in effectively implementing and optimizing deflection programs, which have been shown to enhance public safety and improve public health outcomes. Introduction Drug Use and Police Response In 2023, it was estimated that there were nearly 108,000 drug overdose deaths in the United States, and of those, a vast majority, over 75%, were due to opioids (Centers for Disease Control and Prevention, 2024). In the past, drug enforcement policies supporting harsh penalties for non-violent drug possession and use, including police drug seizures, arrests, and incarceration (Ray et al., 2023; Wagner et al., 2015), did not reduce drug usage or criminal activity and increased fatal and non-fatal overdose risk (Caulkins et al., 2021; Zhang et al., 2022) and disproportionately affected Americans of color (Chandler et al., 2009; Cooper, 2015; del Pozo et al., 2021-a; Earp et al., 2021). Therefore, a growing consensus has emerged among researchers and policymakers regarding the need for collaboration between public safety and public health to improve outcomes for people who use drugs (PWUD) (Conner et al., 2022; Crépault et al., 2023; Enos, 2021; Johnson et al., 2022; Sisto, 2024). Many U.S. police departments have responded by establishing deflection programs to refer community members to treatment or other services without arrest (Charlier & Reichert, 2020; Diriba & Whitlock, 2022; Martinez, n.d.) that can improve public health and public safety outcomes (Blais et al., 2022; Labriola et al., 2023; Lindquist-Grantz et al., 2021). Police officers’ stigmatizing views toward PWUD may influence their attitudes toward deflection and interactions with, and responses to, PWUD, thereby impacting the success of police-led deflection programs (Dickson-Gomez et al., 2022; Kruis et al., 2021; Pokrajac et al., 2016). The Current Study The current study examines the impact of officer stigma and their views on deflection principles. Stigma refers to people’s negative labeling and devaluation based on their identification with an undesired social category (Stangl et al., 2019), often attributed to PWUD (Corrigan et al., 2017). Stigma may cause people to distance themselves and discriminate against PWUD (Stone et al., 2021; Kruis et al., 2020). The negative impacts of stigma toward PWUD are well documented, affecting treatment outcomes, risky behavior (e.g., needle sharing), and fatal overdose (Ahern et al., 2007; Baker et al., 2020; Corrigan et al., 2006; Fadanelli et al., 2020; Keyes et al., 2010; Livingston et al., 2022; Lloyd, 2012; Muncan et al., 2020). Since police are a vital component to the success of deflection programs as the primary referral source, examining stigma may impact program success and outcomes (Barberi & Taxman, 2019; Labriola et al., 2023). We found only one prior study partially exploring officers' stigma toward PWUD and deflection principles (Kruis et al., 2021). As deflection programs expand nationwide, understanding officer perspectives is crucial to developing strategies to mitigate stigmatizing views and garner support for these promising initiatives. Background on Deflection and Police Stigma Deflection Programs Deflection programs are pre-booking, voluntary, and predominately assist PWUD (Enos, 2021; Reichert et al., 2022). There are six deflection pathways to identify participants, including self-referrals at police stations, active outreach by officers or co-response teams, post-overdose interventions, officer-initiated prevention and intervention during routine activities, and community response teams (Charlier & Reichert, 2020). The Angel program, originating in Gloucester, Massachusetts, exemplifies the self-referral pathway (Labriola et al., 2023; Reichert et al., 2017; Schiff et al., 2016), while Quick Response Teams employ post-overdose responses (Bagley et al., 2019; Bailey et al., 2023; Canada & Formica, 2022; Firesheets et al., 2022), and Law Enforcement Assisted Diversion (LEAD) utilizes the officer prevention pathway; all of these programs have expanded to multiple states across the U.S. (Clifasefi et al., 2017; Collins et al., 2019; Gilbert et al., 2022; Malm et al., 2020; Schaible at al., 2022). Research has found that deflection programs reduced citations, arrests, jail bookings, court involvement, and prison admissions (Callister & Braaten, 2016; Collins et al., 2019; Gilbert et al., 2022; Labriola et al., 2023; Nyland et al., 2024). Deflection programs have improved participants’ quality of life, psychosocial outcomes (Barile et al., 2022; Perillo & Heath, 2024), and engagement in SUD treatment (Gilbert et al., 2022; Malm et al., 2020). In addition, deflection has lessened participants’ substance use and drug overdoses (Barile et al., 2022; Blais et al., 2022; Labriola et al., 2023; Malm et al., 2020; Nyland et al., 2024; Perillo & Heath, 2024; Schaible et al., 2022; Xuan et al., 2023) and reduced the use of emergency medical services (Barile et al., 2022). Finally, deflection programs have been found to have a cost-benefit through a reduction in criminal justice costs (Collins et al., 2019; Gilbert et al., 2022; Malm et al., 2020; Schaible et al., 2020) and healthcare costs (e.g., emergency department visits) (Gilbert et al., 2022; Heslin et al., 2016). However, the extent to which police departments adopt or have officers willing to engage in deflection practices may vary depending on factors such as stigma, the nature of the offense, the characteristics of the suspect, and the type of drug involved (Ross & Taylor, 2022). Police Stigmatizing Attitudes Toward PWUD Police often harbor stigmatizing perceptions of PWUD (Beletsky et al., 2005; del Pozo et al., 2021-b; Kruis et al., 2020; Reichert et al., 2023) including attributing adverse outcomes to personal failings and blaming PWUD for their circumstances (Beletsky et al., 2005; Kruis et al., 2020). Officers have distrusted, felt threatened by, and desired separation from them (del Pozo et al., 2021-b; Kruis et al., 2020). Officer attitudes may be influenced by addiction frameworks, officer characteristics, and beliefs about substance users (Kruis et al., 2020; Murphy & Russell, 2021). Police officers’ views on addiction as a moral failure or disease impact their support for treatment-oriented drug policies (Murphy & Russell, 2021). Characteristics such as officer age, education, experience level, and experiences can impact officers' views of PWUD (Becker, 2020; Jorgensen, 2018; Kruis et al., 2020; Reichert et al., 2025). Impact of Police Stigma on Deflection Officer stigma attitudes can influence the desire to help PWUD (Formica et al., 2018; Yang et al., 2017). Officers with stigma attitudes are less likely to support the use of naloxone to reverse overdose (Kruis & Merlo, 2021) and medication for opioid use disorder treatment (Kruis et al., 2021). According to Livingston et al. (2022), criminalizing individuals with SUDs exacerbates stigma and further marginalizes this population. A scoping review found that stigma and criminal legal involvement reduced SUD treatment participation (Lin et al., 2024). Bystanders of an overdose, often PWUD, hesitate to call 911 and downplay their need for overdose assistance because of perceived stigma by police and fear of harassment or arrest (Atkins et al., 2024; Bohnert et al., 2011; Wagner et al., 2016). Methods Sample Our sample consisted of 248 officers from Illinois police departments recruited through the Chiefs of Police. Officer participation varied widely by police department, ranging from 55.6% to less than 1% (0.03%) (Mean = 24.4%), a common finding in police surveys (Nix et al., 2019). Our overall response rate marginally exceeded prior studies examining officer views regarding SUDs (Kruis & Merlo, 2021; Kruis et al., 2020; Kruis et al., 2021). The size of the departments ranged from 2 to 298 full-time sworn officers, with a mean of 9.95. The majority of officers in the sample were White, held a bachelor’s degree or higher, and had worked in policing for eight or more years (Table 1). A majority of our sample consisted of males, which is commensurate with the proportion of male officers employed in the state in 2020 (78.8%) (Illinois State Police, n.d.-b). We recruited 48 police departments through stratified random sampling, of which 41.7% ( n = 20) agreed to participate. Table 1 Demographic Characteristics of Respondents Characteristic n % Gender Female 31 12.5 Male 209 84.3 Other/ prefer not to say 8 3.2 Race/ethnicity Asian 2 0.8 Black 13 5.2 Latinx 10 4.0 White 205 82.7 Other or multiple race/ethnicity 16 6.5 Unknown 2 0.8 Highest level of education High school 5 2.0 Some college 35 14.1 Associate degree 30 12.1 Bachelor’s degree 150 60.5 Master’s degree or higher 28 11.3 Rank Captain/equivalent or above 16 6.5 Lieutenant 10 4.0 Sergeant 42 16.9 Detective 46 18.6 Police officer 126 50.8 Non-sworn employee 7 2.8 Unknown 1 0.4 Years in policing 0-3 years (new) 24 9.7 4-7 years (early career) 32 12.9 8-15 years (mid-career) 52 21.0 16-25 years (veteran) 100 40.3 More than 25 years 40 16.1 Primary assignment Administration 22 8.9 Community affairs/outreach 14 5.6 Detective (investigatory) 45 18.1 Narcotics 11 4.4 Patrol 137 55.2 Other/unknown 19 7.7 Overdose responses 0-5 31 12.5 6-10 39 15.7 11-25 58 23.4 26-50 45 18.1 >50 75 30.2 Someone you care about is/was addicted to opioids. Yes 72 29.0 No 146 58.9 Do not know 30 12.1 Someone you care about died of opioid overdose Yes 34 13.7 No 214 86.3 Note : The sample size was 248. Due to rounding, percentages may not equal 100%. Race and gender were self-identified. Measure of Police Officers’ Stigma We developed 64 survey items on officers’ stigma and deflection principles by drawing on prior literature and survey research on stigma. We used 11 items to measure stigma toward PWUD (independent variables). The items are consistent with the literature on the subject (Yang et al., 2017) and adapted from prior stigma survey studies (Kennedy-Hendricks et al., 2017; Stone et al., 2021; Yang et al., 2019). Our survey items were consistent with established social stigma categories of blame (5 items), distrust (4 items), fear (i.e., dangerousness, 1 item), and shame (i.e., social distance, 1 item) (Kruis & Merlo, 2021; Kruis et al., 2020; Kruis et al., 2021; Kruis et al., 2022; Lloyd, 2012). In our survey items, we used the term opioid ‘addiction’ rather than opioid ‘use disorder,’ which is the clinical diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013) because it was likely a more commonly understood term for officers. Respondents rated their agreement with each statement on a 6-point Likert scale (1 = Strongly disagree, 2 = Disagree, 3 = Somewhat disagree, 4 = Somewhat agree, 5 = Agree, and 6 = Strongly agree). A higher score on our stigma scale indicated more negative attitudes towards stigma. Three items on the scale were reverse-coded to minimize response bias and improve the quality of survey results. This adjustment changed the direction of their responses, as noted in Table 5. We used multiple survey items (subscales) to measure blame and distrust. We use Cronbach’s α to assess the reliability (i.e., internal consistency) of the blame and distrust subscales. Using 0.7 as the minimum threshold for acceptable internal consistency, the results indicate that the subscales of blame demonstrated acceptable internal consistency, whereas the distrust subscales did not (Table 2). Consequently, we calculated the mean of the five original blame items to create a composite score but analyzed the distrust construct as four separate items. Table 2 Subscales of Stigma Factors Subscale Number of items N M SD Cronbach’s α Distrust 4 177 11.86 2.370 .398 Blame 5 213 15.80 4.039 .743 Note . The sample size was 248. Three items were reverse coded, so stronger agreement on a 6-point Likert Scale of 1 (strongly disagree) to 6 (strongly agree) indicated more negative responses indicating stigma. Measures of Support of Deflection Principles We used three items to measure the principles of deflection, which we labeled “opportunities,” “medications,” and “solutions” (Table 3). Our measures align with the guiding principles for deflection established by the Police and Treatment and Community Collaborative (PTACC) (2018), an alliance that provides leadership for the field of deflection (PTACC, 2023). In addition, they align with surveys of officer attitudes toward deflection (Kruis et al., 2021; Rouhani et al., 2019). Our measures had a Cronbach’s α of 0.646, slightly below the acceptable threshold of 0.70; therefore, we examined them as three separate dependent variables. The first dependent variable, opportunities, measured the agreement with the statement, ‘The best way to reduce addiction-related crime is to meet a suspect’s needs with opportunities for treatment, education, and employment.’ This statement aligns with three of PTACC’s deflection principles: Principle 3: Deflection participants need an ‘individualized process’ which ‘may include a variety of treatment approaches and recovery support options’ (PTACC, 2018, para. 7); Principle 5: Deflection participants ‘need access to an array of community-based treatment and service options’ (PTACC, 2018, para. 9); and Principle 6: deflection programs should ‘reduce barriers for access to services and recovery supports’ (PTACC, 2018, para.10). Referrals to SUD treatment and services are central to deflection practices (Blais et al., 2022; Lindquist-Grantz et al., 2021; Martinez, n.d.). The second dependent variable (medications) assessed the desirability of connecting subjects who appear to have an opioid addiction with medications of methadone, buprenorphine, and naltrexone used to treat opioid use disorder (Schuckit, 2016). This aligns with Principle 6: Deflection programs should reduce barriers, including ‘expand the accessibility of Medication Assisted Treatment’ (PTACC, 2018, para. 10). Many police departments have reported employing deflection in response to the opioid crisis to address opioid use (Boston Medical Center, 2023; Police Executive Research Forum, 2016). The post-overdose response is one of the six deflection pathways to identify potential program participants (Bagley et al., 2019; Bailey et al., 2023; Firesheets et al., 2022). In a national survey of deflection programs, the primary treatment referral—nearly three-fourths of programs—was to medication-assisted treatment (Ross & Taylor, 2022). The third dependent variable, solutions, measured the desirability of saving a police department’s resources by finding solutions for individuals who repeatedly interact with the police. This aligns with deflection Principle 10: ‘outcomes and client satisfaction measures for each stakeholder group, including law enforcement’ (PTACC, 2018, para. 13). Prior studies have documented officer support for deflection programs (del Pozo et al., 2021-b; Labriola et al., 2023; Pike et al., 2021; Reichert et al., 2017). In qualitative interviews, officers have expressed how deflection can benefit officers or their departments (Green et al., 2013; Labriola et al., 2023). Furthermore, deflection may reduce future arrests and repeat encounters (Barile et al., 2022; Callister & Braaten, 2016; Labriola et al., 2023; Perrone et al., 2022), thereby limiting the time officers spend on calls (Fisher et al., 2024; Kisely et al., 2010). Table 3 Dependent Variables Measuring of Support for Deflection Principles Deflection principle Survey item Likert scale Opportunities The best way to reduce addiction-related crime is to meet a suspect’s needs with opportunities for treatment, education, and employment. 1 = Strongly disagree to 6 = Strongly agree Medications Connecting subjects who appear to have an opioid addiction with medications used to treat opioid use disorder is… 1 = Very undesirable to 6 = Very Desirable Solutions Saving a police department’s resources by finding solutions for people who repeatedly deal with police is… 1 = Very undesirable to 6 = Very Desirable Procedures We employed stratified random sampling to recruit Illinois police departments, ensuring variation in the types of police departments represented in the sample. We included only municipal police departments and excluded other types of police departments due to considerable variance in their core roles (e.g., county sheriffs, university police, and forest preserve police). We created five strata for police departments based on rurality and department size (Table 4). Rural/small police departments had less than 15 full-time sworn officers; rural/large police departments had 15 or more officers; urban/small police departments had 1-100 officers; urban/medium police departments had 101-249 officers; and urban/large police departments had more than 250 officers. The police department's rurality was based on data from the U.S. Census Bureau (n.d.), and officer headcounts were provided by the Illinois State Police (n.d.-a). Table 4 Police Department Survey Participation by Strata Police department strata Departments in the state Police departments recruited Police departments in the study Police departments not in the study Response rate by department Officer sample % n Rural, small 85 20 5 15 25.0 14 Rural, large 11 5 0 5 0.0 0 Urban, small 340 8 5 3 62.5 33 Urban, medium 19 10 6 4 60.0 98 Urban, large 8 5 4 1 80.0 54 Unknown strata -- -- -- -- 49 Total 463 48 20 28 41.7 248 Note : The police departments “not in the study” included those who did not respond to recruitment efforts or declined to participate. The rural/urban designation was based on 2010 U.S. Census Bureau data and on the county of the police department. The department size was based on the number of full-time sworn officers from the Illinois State Police. We emailed the chiefs of police departments selected to participate to explain the purpose of the study and request their participation. If the chiefs did not respond to our initial email, we followed up by email and/or phone four times. For departments that agreed to participate, we emailed a study description and a link to the consent form and online survey. We used Qualtrics, a web-based software, to administer the survey and collect responses. Analytic Strategy For the regression analyses, the independent variables included the composite score of blame and four distrust items, one item on fear, and one item on shame. In comparison, the dependent variables consisted of the three items (opportunities, medications, and solutions) measuring officers’ support for deflection principles. The models include officer demographics, related experience, and department organizational features as the control variables. We conducted ordinal logistic regression to investigate the impact of stigma measures on support for deflection principles regarding opportunities, medications, and solutions (Table 3). The blame measure was combined to create an average composite score, and the items measuring distrust, shame, and fear were used in the regression models. We analyzed the data using IBM SPSS Statistics 27. The Institutional Review Boards of the Illinois Criminal Justice Information Authority and Lifespan evaluated the study and determined it to be exempt. Results Table 5 presents the officers' responses to the survey items. Our prior publications utilize this dataset and provide additional discussion of officer survey responses (del Pozo et al., 2023 b; Reichert et al., 2023; Reichert et al., 2025). Table 5 Police Officer Responses to Stigma Items Survey measures and items Strongly disagree Disagree Somewhat disagree Somewhat agree Agree Strongly agree M n % n % n % n % n % n % Blame 1. People with an opioid addiction are usually responsible for their condition. 3 1.4 12 5.6 35 16.4 89 41.8 53 24.9 21 9.9 4.1 2. People addicted to opioids because they lack the willpower to stop before it’s too late. 17 8.0 49 23.0 53 24.9 63 29.6 21 9.9 10 4.7 3.24 3. People who are addicted to opioids choose to act in ways that make their own condition worse. 2 0.9 10 4.7 36 16.9 80 37.6 62 29.1 23 10.8 4.22 4. People who become addicted to opioids can’t be blamed for condition. (RC) 1 0.5 7 3.3 21 9.9 66 31.0 84 39.4 34 16.0 4.54 5. When a young person is addicted to opioids, you have to wonder if they had good parents. 25 11.7 53 24.9 53 24.9 52 24.4 22 10.3 8 3.8 3.08 Distrust 6. If I knew someone was in recovery for addiction to opioids, I would be fine with them marrying into my family. (RC) 4 2.3 10 5.6 42 23.7 64 36.2 57 32.2 0 0.0 3.9 7. People who are addicted to opioids won’t hesitate to lie. 0 0.0 5 2.3 23 10.8 47 22.1 79 37.1 59 27.7 4.77 8. When a person with an opioid addiction is in your life, you need to be on guard for what they might do. 0 0.0 2 0.9 14 6.6 58 27.2 91 42.7 48 22.5 4.79 9. A police officer in treatment for addiction to opioids could one day return to full duty. (RC) 11 5.2 73 34.3 66 31.0 39 18.3 19 8.9 5 2.3 2.99 Fear 10. I would worry about a person in treatment for opioid addiction taking care of my family’s children for a few hours. 2 0.9 6 2.8 10 4.7 23 10.8 67 31.5 105 49.3 5.17 Shame 11. I wouldn’t want to let my colleagues know if a relative of mine was addicted to opioids. 19 8.9 62 29.1 54 25.4 37 17.4 33 15.5 8 3.8 3.13 Note. The sample size of items was 213, except item 1 of the Blame measure was 177, as respondents did not answer every question. RC indicates reverse coding on items 1, 6, and 9. M is the mean based on the Likert Scale responses to the items. The regression analyses suggest that officers' stigma did not uniformly influence support for deflection principles but showed mixed effects. Officers who expressed higher levels of fear and shame-related stigma demonstrated reduced support for providing opportunities to PWUD. Greater fear about PWUD caring for children was linked to significantly lower odds of supporting opportunities for them; each unit increase in fear corresponded to 42.7% lower odds of support (OR = 0.583). Similarly, a one-unit increase on the shame scale, which involved not wanting colleagues to know about a relative's drug use, corresponded to a 31.1% decrease in the odds of higher support for opportunities (OR = 0.689). Conversely, specific stigma dimensions were positively associated with support for deflection principles. Officers who attributed more blame to PWUD showed increased support for both opportunities (OR = 3.028) and medications (OR = 1.976) for PWUD. Agreement with the distrust item, reluctance to accept a person in recovery as a family member, was positively associated with medication support (OR = 1.631). Finally, officer agreement with the distrust item (hesitancy about officers treated for addiction returning to work) was positively associated with support for solutions to assist PWUD (OR = 1.412). Among the control variables, only education level demonstrated a significant positive association with support for solutions for PWUD. Table 6 Ordinal Logistic Regression: Effect of Officer Blame, Distrust, Fear, and Shame on Referrals to Assist People Who Use Drugs Officer views on referrals Stigma items Medications Solutions Opportunities B S.E. O.R. p B S.E. O.R. p B S.E. O.R. p Blame 0.681 0.303 1.976 0.024 * 0.441 0.273 1.554 0.107 1.108 0.314 3.028 0.000 *** Distrust: marrying into family RC 0.489 0.207 1.631 0.018* 0.217 0.132 1.242 0.149 0.347 0.210 1.415 0.097 Distrust: lie -0.007 0.213 0.993 0.971 -0.161 0.189 0.851 0.393 -0.217 0.209 0.805 0.300 Distrust: on guard 0.018 0.264 1.018 0.942 -0.344 0.242 0.709 0.154 -0.404 0.272 0.668 0.137 Distrust: officer return RC 0.217 0.177 1.242 0.219 0.345 0.159 1.412 0.029* 0.266 0.189 1.305 0.158 Fear -0.347 0.195 0.707 0.074 0.025 0.196 1.025 0.869 -0.539 0.199 0.583 0.006** Shame -0.131 0.134 0.877 0.330 0.08 0.126 1.083 0.522 -0.372 0.142 0.689 0.008** Note . The sample size is 130. RC = reverse coded. Due to space constraints, the table does not display the results for control variables, including urban or rural location, department size, officer's race, sex, rank, years of experience in policing, education level, and officers' professional and personal experiences with overdoses. Full results, including these control variables, are available upon request. * p < .05. ** p < .01 *** p < .001. Discussion We examined the relationship between the level of officer stigma and their support for deflection principles. This research addresses a critical gap in the literature, as previous studies have primarily focused on the extent of or reasons for, police stigma toward PWUD (Kruis et al., 2020 ; Livingston et al., 2012; Reichert et al., 2025 ) without extensively examining how these attitudes relate to support for deflection initiatives (Kruis et al., 2021 ). Deflection is a promising practice, so officer support, or lack thereof, is valuable to explore. Our study revealed a complex relationship between officers' stigmatizing views of PWUD and their support for deflection principles, challenging the initial expectation that higher levels of stigma would correspond with less support for these principles. Stigma and Decreased Support for Deflection Principles Fear and shame-related stigma were associated with decreased support for the deflection principle of opportunities for PWUD. This is similar to a prior study that found officers with a fear of PWUD were less favorable toward medication-assisted treatment (Kruis et al., 2021 ). Training can alter police officers' cognitive beliefs and perceptions of PWUD for police officers (Canales et al., 2025 ; Hansson & Markström, 2014 ). To reduce fear toward PWUD, training should feature individuals with lived experience, as it provides opportunities for positive social engagement between police and PWUD and can reduce stigma (Batson et al., 2002 ; Clinton & Pollini, 2021 ; Coleman & Cotton, 2014 ; Lavoie et al., 2022 ). However, studying the impact of training on officer behaviors presents significant challenges, as it is difficult to isolate the effects of training (Worden et al., 2024 ). Stigma and Increased Support for Deflection Principles In contrast, higher levels of stigma (blame and specific aspects of distrust) toward PWUD were positively correlated with support for deflection principles. Prior research has found that individuals may support actions that seem to contradict their personal attitudes due to various factors, including social pressures, perceived expectations of others, and their sense of control over their behaviors (Fazio & Roskos-Ewoldsen, 2005 ; Haddock et al., 2020 ). The positive associations could be explained by officers recognizing the practical benefits of these approaches in their professional roles, even if they hold personal stigmatizing views. Alternatively, it may reflect a nuanced understanding of addiction that incorporates both stigmatizing attitudes and a recognition of the need for treatment and support. Prior studies have found that supervisors can significantly influence officers' views (Engel, 2003 ), including their support for deflection initiatives (del Pozo et al., 2021-b ). Furthermore, champions in the police department, such as the police chief, are crucial to the success of deflection (Barberi & Taxman, 2019 ; Labriola et al., 2023 ; Marotta et al., 2023 ; Reichert et al., 2017 ; Rouhani et al., 2019 ). Police directives also significantly impact officer attitudes (Mummolo, 2018 ; Terrill & Paoline, 2013 ). Individual officers may not endorse deflection principles but follow department protocols (Labriola et al., 2023 ; Taylor, 2024 ), suggesting a top-down approach to deflection support. Finally, police often encounter the same PWUD repeatedly due to drug use-related criminal activity (Ti et al., 2013 ; Zhang et al., 2022 ) and calls for drug overdoses (Butler et al., 2022 ; Huey & Ricciardelli, 2015 ; Zakimi et al., 2022 ). Therefore, deflection may be in the self-interest of officers in reducing police contact and work (del Pozo et al., 2021). Stigma’s Impact on Actions This study examined the principles of stigma and deflection, rather than officer decision-making in the field, but underscored the need for further investigation. Research suggests that stigma is linked to avoidance and lower willingness to assist PWUD (Corrigan et al., 2009 ; Yang et al., 2017 ). Formica et al. ( 2018 ) found that police stigma was a barrier to implementing programs to assist PWUD in accessing drug treatment. However, Fazio and Roskos-Ewoldsen ( 2005 ) noted that attitudes do not always predict behavior, as individual, professional, and contextual factors can mediate this relationship. Future research could explore attitudes and professional behavior, as well as the implications for deflection initiatives. Study Limitations The study surveyed police officers recruited via their departments' Chiefs of Police, and participation rates varied significantly across departments. Relying on self-reported data introduced potential social desirability bias, as officers may underreport stigmatizing attitudes or opposition to deflection principles. Additionally, the Illinois-based sample limits the generalizability of the findings to other regions. The study design precludes causal inferences between officer stigma and behaviors supporting deflection principles. Conclusion This study examined the relationship between officers' stigmatizing views of people who use drugs (PWUD) and their support for principles of deflection programs. The study found that stigmatizing views related to fear and shame of PWUD may negatively influence officers' support for these programs. However, officers' stigmatizing views of blame and distrust did not predict reduced support for deflection principles. The findings highlight the complex interplay between officers' attitudes, experiences, and professional practices. Addressing unwarranted fear and shame of PWUD among law enforcement personnel could enhance support for deflection principles. Future research should investigate methods to mitigate stigmatizing views of officers and enhance their support for deflection principles and programs. Ultimately, this study contributes to the growing body of literature on police views of PWUD and tenets of deflection and emphasizes the need for continued efforts to align police practices with public health approaches to addiction. Declarations Author Contribution J.R., K.M., B.T., B.D., contributed to the conception and design of the work.J.R. and B.D. contributed to the the acquisition of the data.J.R., K.M., B.D., and J.W. analyzed and interpreted the data.J.R., K.M., and J.W. helped draft the work and revise it.All authors have approved the submitted version.All authors have agreed both to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. Data Availability Deidentified data files may be available upon request. References Ahern, J., Stuber, J., & Galea, S. (2007). Stigma, discrimination, and the health of illicit drug users. Drug and Alcohol Dependence, 88 (3), 188–196. https://doi.org/10.1016/j.drugalcdep.2006.10.014 American Psychiatric Association. (2013). 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The International Journal of Drug Policy, 65 , 78-85. Ross, J., & Taylor, B.G. (2022). Designed to do good: Key findings on the development and operation of first responder deflection programs. Journal of Public Health Management and Practice, 28 (6), (Suppl. 6), S295-S301. https://doi.org/10.1097/PHH.0000000000001578 Schaible, L., Hughes, L., Grant, L., Pichardo, D., Otterbein, S., Tyner, M., & Prout, L. (2022). Colorado Law Enforcement Assisted Diversion (LEAD) pilot programs: Final evaluation report . [Report]. The Criminal Justice Research Initiative, University of Colorado Denver. https://bha.colorado.gov/sites/bha/files/documents/Colorado%20Law%20Enforcement%20Assisted%20Diversion%20%28LEAD%29%20Pilot%20Programs-%20Final%20Evaluation%20Report%20_PDF%20version.pdf Schiff, D. M., Drainoni, M. L., Bair-Merritt, M., Weinstein, Z., & Rosenbloom, D. (2016). A police-led addiction treatment referral program in Massachusetts. The New England Journal of Medicine , 375 (25), 2502-2503. https://doi.org/10.1056/NEJMc1611640 Schuckit, M. A. (2016). Treatment of opioid-use disorders. The New England Journal of Medicine. 375 (4), 357–368. https://doi.org/10.1056/NEJMra1604339 Sisto, R. (2024). Substance use and public health: Solutions beyond policing . Center for Policing Equity. https://policingequity.org/resources/blog/substance-use-and-public-health-solutions-beyond-policing Stangl, A. L., Earnshaw, V. A., Logie, C. H., van Brakel, W., Simbayi, L. C., Barré, I., & Dovidio, J. F. (2019). The health stigma and discrimination framework: A global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas. BMC Medicine , 17 (1), 31. https://doi.org/10.1186/s12916-019-1271-3 Stone, E. M., Kennedy-Hendricks, A., Barry, C. L., Bachhuber, M. A., & McGinty, E. E. (2021). The role of stigma in U.S. primary care physicians’ treatment of opioid use disorder. Drug and Alcohol Dependence , 221 , 108627. https://doi.org/10.1016/j.drugalcdep.2021.108627 Taylor, J. (2024). Stakeholder perspectives on the implementation of police-led deflection programs . RAND Corporation, [Unpublished manuscript] Terrill, W., & Paoline, E. A., III. (2013). Examining less lethal force policy and the force: Continuum results from a national use-of-force study. Police Quarterly, 16 (1), 38-65. https://doi.org/10.1177/1098611112451262 Ti, L., Wood, E., Shannon, K., Feng, C., & Kerr, T. (2013). Police confrontations among street-involved youth in a Canadian setting. The International Journal of Drug Policy , 24 (1), 46–51. https://doi.org/10.1016/j.drugpo.2012.06.008 Wagner, K. D., Bovet, L. J., Haynes, B., Joshua, A., & Davidson, P. J. (2016). Training law enforcement to respond to opioid overdose with naloxone: Impact on knowledge, attitudes, and interactions with community members. Drug and Alcohol Dependence , 165 , 22–28. https://doi.org/10.1016/j.drugalcdep.2016.05.008 Wagner, K. D., Liu, L., Davidson, P. J., Cuevas-Mota, J., Armenta, R. F., & Garfein, R. S. (2015). Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention. Drug and Alcohol Dependence , 153 , 215-220. https://doi.org/10.1016/j.drugalcdep.2015.05.026 Worden, R. E., Najdowski, C. J., McLean, S. J., Worden, K. M., Corsaro, N., Cochran, H., & Engel, R. S. (2024). Implicit bias training for police: Evaluating impacts on enforcement disparities. Law and Human Behavior, 48 (5-6), 338–355. https://doi.org/10.1037/lhb0000568 Xuan, Z, Yan, S, Formica, S. W., Green, T. C., Beletsky, L., Rosenbloom, D., Bagley, S. M., Kimmel, S. D., Carroll, J. J., Lambert, A. M., & Walley, A. Y. (2023). Association of implementation of postoverdose outreach programs with subsequent opioid overdose deaths among Massachusetts municipalities. JAMA Psychiatry, 80 (5), 468–477. https://doi.org/10.1001/jamapsychiatry.2023.0109 Yang, L. H., Grivel, M. M., Anderson, B., Bailey, G. L., Opler, M., Wong, L. Y., & Stein, M. D. (2019). A new brief opioid stigma scale to assess perceived public attitudes and internalized stigma: Evidence for construct validity. Journal of Substance Abuse Treatment , 99 , 44–51. https://doi.org/10.1016/j.jsat.2019.01.005 Yang, L. H., Wong, L. Y., Grivel, M. M., & Hasin, D. S. (2017). Stigma and substance use disorders: An international phenomenon. Current Opinion in Psychiatry, 30 (5), 378–388. https://doi.org/10.1097/YCO.0000000000000351 Zakimi, N., Greer, A., & Butler, A. (2022). Too many hats? The role of police officers in drug enforcement and the community. Policing , 16(4), 615–629. https://doi.org/10.1093/police/paab082 Zhang, A., Balles, J. A., Nyland, J. E., Nguyen, T. H., White, V. M., & Zgierska, A. E. (2022). The relationship between police contacts for drug use-related crime and future arrests, incarceration, and overdoses: A retrospective observational study highlighting the need to break the vicious cycle. Harm Reduction Journal , 19 (1), 67. https://doi.org/10.1186/s12954-022-00652-2 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6596810","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":462722780,"identity":"a4f4e66a-6121-482b-a09c-0d3722ad98dc","order_by":0,"name":"Jessica Reichert","email":"data:image/png;base64,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","orcid":"","institution":"Illinois Criminal Justice Information Authority","correspondingAuthor":true,"prefix":"","firstName":"Jessica","middleName":"","lastName":"Reichert","suffix":""},{"id":462722781,"identity":"977333d9-f316-48db-904e-f1595c2dccf4","order_by":1,"name":"Kaitlin Martins","email":"","orcid":"","institution":"Rhode Island Hospital","correspondingAuthor":false,"prefix":"","firstName":"Kaitlin","middleName":"","lastName":"Martins","suffix":""},{"id":462722782,"identity":"9f9b5623-1e3e-4ab8-ab41-a626c1081ac0","order_by":2,"name":"Bruce Taylor","email":"","orcid":"","institution":"National Opinion Research Center","correspondingAuthor":false,"prefix":"","firstName":"Bruce","middleName":"","lastName":"Taylor","suffix":""},{"id":462722783,"identity":"73aa62c3-b0e1-4e1e-b0cc-9c3efda8459e","order_by":3,"name":"Brandon del Pozo","email":"","orcid":"","institution":"Rhode Island Hospital","correspondingAuthor":false,"prefix":"","firstName":"Brandon","middleName":"del","lastName":"Pozo","suffix":""},{"id":462722784,"identity":"54ce0f17-73fd-449a-9481-268f6428f045","order_by":4,"name":"Jing Wang","email":"","orcid":"","institution":"Illinois Criminal Justice Information Authority","correspondingAuthor":false,"prefix":"","firstName":"Jing","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2025-05-05 18:53:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6596810/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6596810/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12954-026-01406-0","type":"published","date":"2026-02-04T15:58:03+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":102234459,"identity":"5bc69f51-3f62-4b03-9b95-441176a1b081","added_by":"auto","created_at":"2026-02-09 16:12:01","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1053267,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6596810/v1/af773aec-d698-4fb8-b739-72d48926902c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Police Officers' Stigmatizing Attitudes Toward People Who Use Drugs: Implications for Support of Deflection","fulltext":[{"header":"Introduction","content":"\u003cp\u003e\u003cstrong\u003eDrug Use and Police Response\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn 2023, it was estimated that there were nearly 108,000 drug overdose deaths in the United States, and of those, a vast majority, over 75%, were due to opioids (Centers for Disease Control and Prevention, 2024). In the past, drug enforcement policies supporting harsh penalties for non-violent drug possession and use, including police drug seizures, arrests, and incarceration (Ray et al., 2023;\u0026nbsp;Wagner et al., 2015),\u0026nbsp;did not reduce drug usage or criminal activity and increased fatal and non-fatal overdose risk (Caulkins et al., 2021; Zhang et al., 2022) and disproportionately affected Americans of color (Chandler et al., 2009; Cooper, 2015; del Pozo et al., 2021-a; Earp et al., 2021). Therefore, a growing consensus has emerged among researchers and policymakers regarding the need for collaboration between public safety and public health to improve outcomes for people who use drugs (PWUD) (Conner et al., 2022; Cr\u0026eacute;pault et al., 2023; Enos, 2021; Johnson et al., 2022; Sisto, 2024). Many U.S. police departments have responded by establishing deflection programs to refer community members to treatment or other services without arrest (Charlier \u0026amp; Reichert, 2020; Diriba \u0026amp; Whitlock, 2022; Martinez, n.d.) that can improve public health and public safety outcomes (Blais et al., 2022; Labriola et al., 2023; Lindquist-Grantz et al., 2021). Police officers\u0026rsquo; stigmatizing views toward PWUD may influence their attitudes toward deflection and interactions with, and responses to, PWUD, thereby impacting the success of police-led deflection programs (Dickson-Gomez et al., 2022; Kruis et al., 2021; Pokrajac et al., 2016).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Current Study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe current study examines the impact of officer stigma and their views on deflection principles. Stigma refers to people\u0026rsquo;s negative labeling and devaluation based on their identification with an undesired social category (Stangl et al., 2019), often attributed to PWUD (Corrigan et al., 2017). Stigma may cause people to distance themselves and discriminate against PWUD (Stone et al., 2021; Kruis et al., 2020). The negative impacts of stigma toward PWUD are well documented, affecting treatment outcomes, risky behavior (e.g., needle sharing), and fatal overdose (Ahern et al., 2007; Baker et al., 2020; Corrigan et al., 2006; Fadanelli et al., 2020; Keyes et al., 2010; Livingston et al., 2022; Lloyd, 2012; Muncan et al., 2020). Since police are a vital component to the success of deflection programs as the primary referral source, examining stigma may impact program success and outcomes (Barberi \u0026amp; Taxman, 2019; Labriola et al., 2023). We found only one prior study partially exploring officers\u0026apos; stigma toward PWUD and deflection principles (Kruis et al., 2021). As deflection programs expand nationwide, understanding officer perspectives is crucial to developing strategies to mitigate stigmatizing views and garner support for these promising initiatives.\u003c/p\u003e"},{"header":"Background on Deflection and Police Stigma","content":"\u003cp\u003e\u003cstrong\u003eDeflection Programs\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDeflection programs are pre-booking, voluntary, and predominately assist PWUD (Enos, 2021; Reichert et al., 2022).\u0026nbsp;There are six deflection pathways to identify participants, including self-referrals at police stations, active outreach by officers or co-response teams, post-overdose interventions, officer-initiated prevention and intervention during routine activities, and community response teams (Charlier \u0026amp; Reichert, 2020). The Angel program, originating in Gloucester, Massachusetts, exemplifies the self-referral pathway (Labriola et al., 2023; Reichert et al., 2017; Schiff et al., 2016), while Quick Response Teams employ post-overdose responses (Bagley et al., 2019; Bailey et al., 2023; Canada \u0026amp; Formica, 2022; Firesheets et al., 2022), and Law Enforcement Assisted Diversion (LEAD) utilizes the officer prevention pathway; all of these programs have expanded to multiple states across the U.S. (Clifasefi et al., 2017; Collins et al., 2019; Gilbert et al., 2022; Malm et al., 2020; Schaible at al., 2022).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResearch has found that deflection programs reduced citations, arrests, jail bookings, court involvement, and prison admissions (Callister \u0026amp; Braaten, 2016; Collins et al., 2019; Gilbert et al., 2022; Labriola et al., 2023; Nyland et al., 2024). Deflection programs have improved participants\u0026rsquo; quality of life, psychosocial outcomes (Barile et al., 2022; Perillo \u0026amp; Heath, 2024), and engagement in SUD treatment (Gilbert et al., 2022; Malm et al., 2020). In addition, deflection has lessened participants\u0026rsquo; substance use and drug overdoses (Barile et al., 2022; Blais et al., 2022; Labriola et al., 2023; Malm et al., 2020; Nyland et al., 2024; Perillo \u0026amp; Heath, 2024; Schaible et al., 2022; Xuan et al., 2023) and reduced the use of emergency medical services (Barile et al., 2022). Finally, deflection programs have been found to have a cost-benefit through a reduction in criminal justice costs (Collins et al., 2019; Gilbert et al., 2022; Malm et al., 2020; Schaible et al., 2020) and healthcare costs (e.g., emergency department visits) (Gilbert et al., 2022; Heslin et al., 2016). However, the extent to which police departments adopt or have officers willing to engage in deflection practices may vary depending on factors such as stigma, the nature of the offense, the characteristics of the suspect, and the type of drug involved (Ross \u0026amp; Taylor, 2022).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePolice Stigmatizing Attitudes Toward PWUD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePolice often harbor stigmatizing perceptions of PWUD (Beletsky et al., 2005; del Pozo et al., 2021-b; Kruis et al., 2020; Reichert et al., 2023) including attributing adverse outcomes to personal failings and blaming PWUD for their circumstances (Beletsky et al., 2005; Kruis et al., 2020). Officers have distrusted, felt threatened by, and desired separation from them (del Pozo et al., 2021-b; Kruis et al., 2020). Officer attitudes may be influenced by addiction frameworks, officer characteristics, and beliefs about substance users (Kruis et al., 2020; Murphy \u0026amp; Russell, 2021).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ePolice officers\u0026rsquo; views on addiction as a moral failure or disease impact their support for treatment-oriented drug policies (Murphy \u0026amp; Russell, 2021). Characteristics such as officer age, education, experience level, and experiences can impact officers\u0026apos; views of PWUD (Becker, 2020; Jorgensen, 2018; Kruis et al., 2020; Reichert et al., 2025).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImpact of Police Stigma on Deflection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOfficer stigma attitudes can influence the desire to help PWUD (Formica et al., 2018; Yang et al., 2017). Officers with stigma attitudes are less likely to support the use of naloxone to reverse overdose (Kruis \u0026amp; Merlo, 2021) and medication for opioid use disorder treatment (Kruis et al., 2021). According to Livingston et al. (2022), criminalizing individuals with SUDs exacerbates stigma and further marginalizes this population. A scoping review found that stigma and criminal legal involvement reduced SUD treatment participation (Lin et al., 2024). Bystanders of an overdose, often PWUD, hesitate to call 911 and downplay their need for overdose assistance because of perceived stigma by police and fear of harassment or arrest (Atkins et al., 2024; Bohnert et al., 2011; Wagner et al., 2016).\u0026nbsp;\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eSample\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur sample consisted of 248 officers from Illinois police departments recruited through the Chiefs of Police. Officer participation varied widely by police department, ranging from 55.6% to less than 1% (0.03%) (Mean = 24.4%), a common finding in police surveys (Nix et al., 2019). Our overall response rate marginally exceeded prior studies examining officer views regarding SUDs (Kruis \u0026amp; Merlo, 2021; Kruis et al., 2020; Kruis et al., 2021). The size of the departments ranged from 2 to 298 full-time sworn officers, with a mean of 9.95. The majority of officers in the sample were White, held a bachelor\u0026rsquo;s degree or higher, and had worked in policing for eight or more years (Table 1). A majority of our sample consisted of males, which is commensurate with the proportion of male officers employed in the state in 2020 (78.8%) (Illinois State Police, n.d.-b). We recruited 48 police departments through stratified random sampling, of which 41.7% (\u003cem\u003en\u003c/em\u003e = 20) agreed to participate.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003e\u003cem\u003eDemographic Characteristics of Respondents\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e84.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Other/ prefer not to say\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eRace/ethnicity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Asian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Black\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Latinx\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;White\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e82.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Other or multiple race/ethnicity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Unknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eHighest level of education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;High school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Some college\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e14.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Associate degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e12.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Bachelor\u0026rsquo;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e60.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Master\u0026rsquo;s degree or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e11.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eRank\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Captain/equivalent or above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Lieutenant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Sergeant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Detective\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e18.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Police officer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e50.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Non-sworn employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Unknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eYears in policing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;0-3 years (new)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;4-7 years (early career)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;8-15 years (mid-career)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e21.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;16-25 years (veteran)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e40.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;More than 25 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e16.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003ePrimary assignment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Administration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Community affairs/outreach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e5.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Detective (investigatory)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e18.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Narcotics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Patrol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e55.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Other/unknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eOverdose responses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;0-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;6-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e15.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;11-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e23.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;26-50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e18.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026gt;50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e30.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eSomeone you care about is/was addicted to opioids.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e29.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e58.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Do not know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e12.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eSomeone you care about died of opioid overdose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e13.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026nbsp;No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e214\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e86.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e: The sample size was 248. Due to rounding, percentages may not equal 100%. Race and gender were self-identified.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003cem\u003eMeasure of Police Officers\u0026rsquo; Stigma\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe developed 64 survey items on officers\u0026rsquo; stigma and deflection principles by drawing on prior literature and survey research on stigma. We used 11 items to measure stigma toward PWUD (independent variables). The items are consistent with the literature on the subject (Yang et al., 2017) and adapted from prior stigma survey studies (Kennedy-Hendricks et al., 2017; Stone et al., 2021; Yang et al., 2019). Our survey items were consistent with established social stigma categories of blame (5 items), distrust (4 items), fear (i.e., dangerousness, 1 item), and shame (i.e., social distance, 1 item) (Kruis \u0026amp; Merlo, 2021; Kruis et al., 2020; Kruis et al., 2021; Kruis et al., 2022; Lloyd, 2012). In our survey items, we used the term opioid \u0026lsquo;addiction\u0026rsquo; rather than opioid \u0026lsquo;use disorder,\u0026rsquo; which is the clinical diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013) because it was likely a more commonly understood term for officers. Respondents rated their agreement with each statement on a 6-point Likert scale (1 = Strongly disagree, 2 = Disagree, 3 = Somewhat disagree, 4 = Somewhat agree, 5 = Agree, and 6 = Strongly agree). A higher score on our stigma scale indicated more negative attitudes towards stigma. Three items on the scale were reverse-coded to minimize response bias and improve the quality of survey results. This adjustment changed the direction of their responses, as noted in Table 5.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe used multiple survey items (subscales) to measure blame and distrust. We use Cronbach\u0026rsquo;s \u0026alpha; to assess the reliability (i.e., internal consistency) of the blame and distrust subscales. Using 0.7 as the minimum threshold for acceptable internal consistency, the results indicate that the subscales of blame demonstrated acceptable internal consistency, whereas the distrust subscales did not (Table 2). Consequently, we calculated the mean of the five original blame items to create a composite score but analyzed the distrust construct as four separate items.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003e\u003cem\u003eSubscales of Stigma Factors\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eSubscale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNumber of items\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cem\u003eSD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eCronbach\u0026rsquo;s \u0026alpha;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eDistrust\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e177\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e11.86\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e2.370\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e.398\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eBlame\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e15.80\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e4.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e.743\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e. The sample size was 248. Three items were reverse coded, so stronger agreement on a 6-point Likert Scale of 1 (strongly disagree) to 6 (strongly agree) indicated more negative responses indicating stigma.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eMeasures of Support of Deflection Principles\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe used three items to measure the principles of deflection, which we labeled \u0026ldquo;opportunities,\u0026rdquo; \u0026ldquo;medications,\u0026rdquo; and \u0026ldquo;solutions\u0026rdquo; (Table 3). Our measures align with the guiding principles for deflection established by the Police and Treatment and Community Collaborative (PTACC) (2018), an alliance that provides leadership for the field of deflection (PTACC, 2023). In addition, they align with surveys of officer attitudes toward deflection (Kruis et al., 2021; Rouhani et al., 2019). Our measures had a Cronbach\u0026rsquo;s \u0026alpha; of 0.646, slightly below the acceptable threshold of 0.70; therefore, we examined them as three separate dependent variables.\u003c/p\u003e\n\u003cp\u003eThe first dependent variable, opportunities, measured the agreement with the statement, \u0026lsquo;The best way to reduce addiction-related crime is to meet a suspect\u0026rsquo;s needs with opportunities for treatment, education, and employment.\u0026rsquo; This statement aligns with three of PTACC\u0026rsquo;s deflection principles: Principle 3: Deflection participants need an \u0026lsquo;individualized process\u0026rsquo; which \u0026lsquo;may include a variety of treatment approaches and recovery support options\u0026rsquo; (PTACC, 2018, para. 7); Principle 5: Deflection participants \u0026lsquo;need access to an array of community-based treatment and service options\u0026rsquo; (PTACC, 2018, para. 9); and Principle 6: deflection programs should \u0026lsquo;reduce barriers for access to services and recovery supports\u0026rsquo; (PTACC, 2018, para.10). Referrals to SUD treatment and services are central to deflection practices (Blais et al., 2022; Lindquist-Grantz et al., 2021; Martinez, n.d.).\u003c/p\u003e\n\u003cp\u003eThe second dependent variable (medications) assessed the desirability of connecting subjects who appear to have an opioid addiction with medications of methadone, buprenorphine, and naltrexone used to treat opioid use disorder (Schuckit, 2016). This aligns with Principle 6: Deflection programs should reduce barriers, including \u0026lsquo;expand the accessibility of Medication Assisted Treatment\u0026rsquo; (PTACC, 2018, para. 10). Many police departments have reported employing deflection in response to the opioid crisis to address opioid use (Boston Medical Center, 2023; Police Executive Research Forum, 2016). The post-overdose response is one of the six deflection pathways to identify potential program participants (Bagley et al., 2019; Bailey et al., 2023; Firesheets et al., 2022). In a national survey of deflection programs, the primary treatment referral\u0026mdash;nearly three-fourths of programs\u0026mdash;was to medication-assisted treatment (Ross \u0026amp; Taylor, 2022).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe third dependent variable, solutions, measured the desirability of saving a police department\u0026rsquo;s resources by finding solutions for individuals who repeatedly interact with the police. This aligns with deflection Principle 10: \u0026lsquo;outcomes and client satisfaction measures for each stakeholder group, including law enforcement\u0026rsquo; (PTACC, 2018, para. 13). Prior studies have documented officer support for deflection programs (del Pozo et al., 2021-b; Labriola et al., 2023; Pike et al., 2021; Reichert et al., 2017). In qualitative interviews, officers have expressed how deflection can benefit officers or their departments (Green et al., 2013; Labriola et al., 2023). Furthermore, deflection may reduce future arrests and repeat encounters (Barile et al., 2022; Callister \u0026amp; Braaten, 2016; Labriola et al., 2023; Perrone et al., 2022), thereby limiting the time officers spend on calls (Fisher et al., 2024; Kisely et al., 2010).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003e\u003cem\u003eDependent Variables Measuring of Support for Deflection Principles\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"630\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eDeflection principle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eSurvey item\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eLikert scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eOpportunities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eThe best way to reduce addiction-related crime is to meet a suspect\u0026rsquo;s needs with opportunities for treatment, education, and employment.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e1 = Strongly disagree to 6 = Strongly agree\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eMedications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eConnecting subjects who appear to have an opioid addiction with medications used to treat opioid use disorder is\u0026hellip;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e1 = Very undesirable to 6 = Very Desirable\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eSolutions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eSaving a police department\u0026rsquo;s resources by finding solutions for people who repeatedly deal with police is\u0026hellip;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e1 = Very undesirable to 6 = Very Desirable\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eProcedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe employed stratified random sampling to recruit Illinois police departments, ensuring variation in the types of police departments represented in the sample. We included only municipal police departments and excluded other types of police departments due to considerable variance in their core roles (e.g., county sheriffs, university police, and forest preserve police). We created five strata for police departments based on rurality and department size (Table 4). Rural/small police departments had less than 15 full-time sworn officers; rural/large police departments had 15 or more officers; urban/small police departments had 1-100 officers; urban/medium police departments had 101-249 officers; and urban/large police departments had more than 250 officers. The police department\u0026apos;s rurality was based on data from the U.S. Census Bureau (n.d.), and officer headcounts were provided by the Illinois State Police (n.d.-a).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u0026nbsp;\u003c/strong\u003e\u003cem\u003ePolice Department Survey Participation by Strata\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"592\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003ePolice department strata\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eDepartments in the state\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePolice departments recruited\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePolice departments in the study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePolice departments not in the study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eResponse rate by department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eOfficer sample\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eRural, small\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e25.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eRural, large\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eUrban, small\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e340\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e62.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eUrban, medium\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eUrban, large\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e80.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eUnknown strata\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e463\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e41.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e248\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e: The police departments \u0026ldquo;not in the study\u0026rdquo; included those who did not respond to recruitment efforts or declined to participate. The rural/urban designation was based on 2010 U.S. Census Bureau data and on the county of the police department. The department size was based on the number of full-time sworn officers from the Illinois State Police.\u003c/p\u003e\n\u003cp\u003eWe emailed the chiefs of police departments selected to participate to explain the purpose of the study and request their participation. If the chiefs did not respond to our initial email, we followed up by email and/or phone four times. For departments that agreed to participate, we emailed a study description and a link to the consent form and online survey. We used Qualtrics, a web-based software, to administer the survey and collect responses.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAnalytic Strategy\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor the regression analyses, the independent variables included the composite score of blame and four distrust items, one item on fear, and one item on shame. In comparison, the dependent variables consisted of the three items (opportunities, medications, and solutions) measuring officers\u0026rsquo; support for deflection principles. The models include officer demographics, related experience, and department organizational features as the control variables. We conducted ordinal logistic regression to investigate the impact of stigma measures on support for deflection principles regarding opportunities, medications, and solutions (Table 3). The blame measure was combined to create an average composite score, and the items measuring distrust, shame, and fear were used in the regression models. We analyzed the data using IBM SPSS Statistics 27. The Institutional Review Boards of the Illinois Criminal Justice Information Authority and Lifespan evaluated the study and determined it to be exempt.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable 5 presents the officers\u0026apos; responses to the survey items. Our prior publications utilize this dataset and provide additional discussion of officer survey responses (del Pozo et al., 2023 b; Reichert et al., 2023; Reichert et al., 2025).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u0026nbsp;\u003c/strong\u003e\u003cem\u003ePolice Officer Responses to Stigma Items\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"720\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eSurvey measures and items\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eStrongly disagree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eDisagree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eSomewhat disagree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eSomewhat agree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eAgree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eStrongly agree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlame\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1. People with an opioid addiction are usually responsible for their condition.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e5.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e16.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e41.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e24.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 41px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e2. People addicted to opioids because they lack the willpower to stop before it\u0026rsquo;s too late.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e8.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e23.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e24.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e29.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 41px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\n \u003cp\u003e4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e3.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e3. People who are addicted to opioids choose to act in ways that make their own condition worse.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e37.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e29.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 41px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e4.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e4. People who become addicted to opioids can\u0026rsquo;t be blamed for condition. (RC)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e31.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e39.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 41px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\n \u003cp\u003e16.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e4.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e5. When a young person is addicted to opioids, you have to wonder if they had good parents.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e11.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e24.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e24.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 41px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e3.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDistrust\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e6. If I knew someone was in recovery for addiction to opioids, I would be fine with them marrying into my family. (RC)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e5.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e23.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e36.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e32.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 41px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e7. People who are addicted to opioids won\u0026rsquo;t hesitate to lie.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e22.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e37.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 41px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\n \u003cp\u003e27.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e4.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e8. When a person with an opioid addiction is in your life, you need to be on guard for what they might do.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e27.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e42.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 41px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\n \u003cp\u003e22.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e4.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e9. A police officer in treatment for addiction to opioids could one day return to full duty. (RC)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e34.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e31.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e18.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 41px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e2.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFear\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e10. I would worry about a person in treatment for opioid addiction taking care of my family\u0026rsquo;s children for a few hours.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e31.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 41px;\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\n \u003cp\u003e49.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e5.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eShame\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e11. I wouldn\u0026rsquo;t want to let my colleagues know if a relative of mine was addicted to opioids.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e29.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e25.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e17.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e15.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 41px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 43px;\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e The sample size of items was 213, except item 1 of the\u003cem\u003e\u0026nbsp;\u003c/em\u003eBlame measure was 177, as respondents did not answer every question. RC indicates reverse coding on items 1, 6, and 9. \u003cem\u003eM\u003c/em\u003e is the mean based on the Likert Scale responses to the items. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe regression analyses suggest that officers\u0026apos; stigma did not uniformly influence support for deflection principles but showed mixed effects. Officers who expressed higher levels of fear and shame-related stigma demonstrated reduced support for providing opportunities to PWUD. Greater fear about PWUD caring for children was linked to significantly lower odds of supporting opportunities for them; each unit increase in fear corresponded to 42.7% lower odds of support (OR = 0.583). Similarly, a one-unit increase on the shame scale, which involved not wanting colleagues to know about a relative\u0026apos;s drug use, corresponded to a 31.1% decrease in the odds of higher support for opportunities (OR = 0.689).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConversely, specific stigma dimensions were positively associated with support for deflection principles. Officers who attributed more blame to PWUD showed \u003cem\u003eincreased support\u003c/em\u003e for both opportunities (OR = 3.028) and medications (OR = 1.976) for PWUD. Agreement with the distrust item, reluctance to accept a person in recovery as a family member, was positively associated with medication support (OR = 1.631). Finally, officer agreement with the distrust item (hesitancy about officers treated for addiction returning to work) was positively associated with support for solutions to assist PWUD (OR = 1.412). Among the control variables, only education level demonstrated a significant positive association with support for solutions for PWUD.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6\u0026nbsp;\u003c/strong\u003e\u003cem\u003eOrdinal Logistic Regression: Effect of Officer Blame, Distrust, Fear, and Shame on Referrals to Assist People Who Use Drugs\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"702\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"12\" style=\"width: 582px;\"\u003e\n \u003cp\u003eOfficer views on referrals\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 120px;\"\u003e\n \u003cp\u003eStigma items\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 187px;\"\u003e\n \u003cp\u003eMedications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 192px;\"\u003e\n \u003cp\u003eSolutions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 203px;\"\u003e\n \u003cp\u003eOpportunities\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003eS.E.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003eO.R.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003eS.E.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003eO.R.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003eS.E.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003eO.R.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eBlame\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e0.681\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.303\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.976\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.024\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.441\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.273\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.554\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.314\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e3.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.000\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eDistrust: marrying into family RC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e0.489\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.631\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.018*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.415\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.097\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eDistrust: lie\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e-0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.993\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.971\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e-0.161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.851\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e-0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.805\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.300\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eDistrust: on guard\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.942\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e-0.344\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.709\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e-0.404\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.272\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.668\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.137\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eDistrust: officer return RC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.177\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.345\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.412\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.029*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.266\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.305\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.158\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eFear\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e-0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.195\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.707\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.074\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.869\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e-0.539\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.583\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.006**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eShame\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e-0.131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.877\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.330\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e1.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.522\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e-0.372\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.689\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.008**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e. The sample size is 130. RC = reverse coded. Due to space constraints, the table does not display the results for control variables, including urban or rural location, department size, officer\u0026apos;s race, sex, rank, years of experience in policing, education level, and officers\u0026apos; professional and personal experiences with overdoses. Full results, including these control variables, are available upon request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e*\u003c/sup\u003e\u003cem\u003ep\u003c/em\u003e \u0026lt; .05. \u003csup\u003e**\u003c/sup\u003e\u003cem\u003ep\u003c/em\u003e \u0026lt; .01 ***\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .001.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eWe examined the relationship between the level of officer stigma and their support for deflection principles. This research addresses a critical gap in the literature, as previous studies have primarily focused on the extent of or reasons for, police stigma toward PWUD (Kruis et al., \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Livingston et al., 2012; Reichert et al., \u003cspan citationid=\"CR98\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) without extensively examining how these attitudes relate to support for deflection initiatives (Kruis et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Deflection is a promising practice, so officer support, or lack thereof, is valuable to explore. Our study revealed a complex relationship between officers' stigmatizing views of PWUD and their support for deflection principles, challenging the initial expectation that higher levels of stigma would correspond with less support for these principles.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eStigma and Decreased Support for Deflection Principles\u003c/h2\u003e \u003cp\u003eFear and shame-related stigma were associated with decreased support for the deflection principle of opportunities for PWUD. This is similar to a prior study that found officers with a fear of PWUD were less favorable toward medication-assisted treatment (Kruis et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Training can alter police officers' cognitive beliefs and perceptions of PWUD for police officers (Canales et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Hansson \u0026amp; Markstr\u0026ouml;m, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). To reduce fear toward PWUD, training should feature individuals with lived experience, as it provides opportunities for positive social engagement between police and PWUD and can reduce stigma (Batson et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2002\u003c/span\u003e; Clinton \u0026amp; Pollini, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Coleman \u0026amp; Cotton, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Lavoie et al., \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). However, studying the impact of training on officer behaviors presents significant challenges, as it is difficult to isolate the effects of training (Worden et al., \u003cspan citationid=\"CR112\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eStigma and Increased Support for Deflection Principles\u003c/h2\u003e \u003cp\u003eIn contrast, higher levels of stigma (blame and specific aspects of distrust) toward PWUD were positively correlated with support for deflection principles. Prior research has found that individuals may support actions that seem to contradict their personal attitudes due to various factors, including social pressures, perceived expectations of others, and their sense of control over their behaviors (Fazio \u0026amp; Roskos-Ewoldsen, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2005\u003c/span\u003e; Haddock et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). The positive associations could be explained by officers recognizing the practical benefits of these approaches in their professional roles, even if they hold personal stigmatizing views. Alternatively, it may reflect a nuanced understanding of addiction that incorporates both stigmatizing attitudes and a recognition of the need for treatment and support.\u003c/p\u003e \u003cp\u003ePrior studies have found that supervisors can significantly influence officers' views (Engel, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2003\u003c/span\u003e), including their support for deflection initiatives (del Pozo et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2021-b\u003c/span\u003e). Furthermore, champions in the police department, such as the police chief, are crucial to the success of deflection (Barberi \u0026amp; Taxman, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Labriola et al., \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Marotta et al., \u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Reichert et al., \u003cspan citationid=\"CR95\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Rouhani et al., \u003cspan citationid=\"CR99\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Police directives also significantly impact officer attitudes (Mummolo, \u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Terrill \u0026amp; Paoline, \u003cspan citationid=\"CR108\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Individual officers may not endorse deflection principles but follow department protocols (Labriola et al., \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Taylor, \u003cspan citationid=\"CR107\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), suggesting a top-down approach to deflection support. Finally, police often encounter the same PWUD repeatedly due to drug use-related criminal activity (Ti et al., \u003cspan citationid=\"CR109\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Zhang et al., \u003cspan citationid=\"CR117\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) and calls for drug overdoses (Butler et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Huey \u0026amp; Ricciardelli, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Zakimi et al., \u003cspan citationid=\"CR116\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Therefore, deflection may be in the self-interest of officers in reducing police contact and work (del Pozo et al., 2021).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eStigma\u0026rsquo;s Impact on Actions\u003c/h2\u003e \u003cp\u003eThis study examined the principles of stigma and deflection, rather than officer decision-making in the field, but underscored the need for further investigation. Research suggests that stigma is linked to avoidance and lower willingness to assist PWUD (Corrigan et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2009\u003c/span\u003e; Yang et al., \u003cspan citationid=\"CR115\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Formica et al. (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) found that police stigma was a barrier to implementing programs to assist PWUD in accessing drug treatment. However, Fazio and Roskos-Ewoldsen (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2005\u003c/span\u003e) noted that attitudes do not always predict behavior, as individual, professional, and contextual factors can mediate this relationship. Future research could explore attitudes and professional behavior, as well as the implications for deflection initiatives.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eStudy Limitations\u003c/h2\u003e \u003cp\u003eThe study surveyed police officers recruited via their departments' Chiefs of Police, and participation rates varied significantly across departments. Relying on self-reported data introduced potential social desirability bias, as officers may underreport stigmatizing attitudes or opposition to deflection principles. Additionally, the Illinois-based sample limits the generalizability of the findings to other regions. The study design precludes causal inferences between officer stigma and behaviors supporting deflection principles.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study examined the relationship between officers' stigmatizing views of people who use drugs (PWUD) and their support for principles of deflection programs. The study found that stigmatizing views related to fear and shame of PWUD may negatively influence officers' support for these programs. However, officers' stigmatizing views of blame and distrust did not predict reduced support for deflection principles. The findings highlight the complex interplay between officers' attitudes, experiences, and professional practices. Addressing unwarranted fear and shame of PWUD among law enforcement personnel could enhance support for deflection principles. Future research should investigate methods to mitigate stigmatizing views of officers and enhance their support for deflection principles and programs. Ultimately, this study contributes to the growing body of literature on police views of PWUD and tenets of deflection and emphasizes the need for continued efforts to align police practices with public health approaches to addiction.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eJ.R., K.M., B.T., B.D., contributed to the conception and design of the work.J.R. and B.D. contributed to the the acquisition of the data.J.R., K.M., B.D., and J.W. analyzed and interpreted the data.J.R., K.M., and J.W. helped draft the work and revise it.All authors have approved the submitted version.All authors have agreed both to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eDeidentified data files may be available upon request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAhern, J., Stuber, J., \u0026amp; Galea, S. 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Diversion programs for individuals who use substances: A review of the literature. \u003cem\u003eJournal of Drug Issues\u003c/em\u003e, \u003cem\u003e51\u003c/em\u003e(3), 483\u0026ndash;503. https://doi.org/10.1177/00220426211000330\u003c/li\u003e\n \u003cli\u003eLivingston, J., Bonn, M., Brown, P., Deveau, S., \u0026amp; Houston, A. M. (2022). Experiences of stigma and criminal in/justice among people who use substances. In G. Schomerous \u0026amp; P. W. Corrigan (Eds.), \u003cem\u003eThe stigma of substance use disorders\u003c/em\u003e. (1st ed., pp. 46-67). Cambridge University Press.\u003c/li\u003e\n \u003cli\u003eLloyd, C. (2012). The stigmatization of problem drug users: A narrative literature review. \u003cem\u003eDrugs: Education, Prevention and Policy, 20\u003c/em\u003e(2), 85\u0026ndash;95. https://doi.org/10.3109/09687637.2012.743506\u003c/li\u003e\n \u003cli\u003eMalm, A., Perrone, D., \u0026amp; Maga\u0026ntilde;a, E. (2020). \u003cem\u003eLaw Enforcement Assisted Diversion (LEAD) external evaluation: Report to the California State Legislature\u003c/em\u003e. [Report]. California State University Long Beach. https://www.bscc.ca.gov/wp-content/uploads/CSULB-LEAD-REPORT-TO-LEGISLATURE-1-15-2020.pdf\u003c/li\u003e\n \u003cli\u003eMarotta, P. L., Del Pozo, B., Baker, P., Abramovitz, D., Artamonova, I., Arredondo, J, McCreedy, K, Strathdee, S. A., Cepeda. J, \u0026amp; Beletsky, L. (2023). Unlocking deflection: The role of supervisor support in police officer willingness to refer people who inject drugs to harm reduction services. \u003cem\u003eThe International Journal of Drug Policy, 121\u003c/em\u003e, 104188. https://doi.org/10.1016/j.drugpo.2023.104188\u003c/li\u003e\n \u003cli\u003eMartinez, C. R. (n.d.) \u003cem\u003ePromising practices for pre-arrest diversion programs\u003c/em\u003e. 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Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention. \u003cem\u003eDrug and Alcohol Dependence\u003c/em\u003e, \u003cem\u003e153\u003c/em\u003e, 215-220. https://doi.org/10.1016/j.drugalcdep.2015.05.026\u003c/li\u003e\n \u003cli\u003eWorden, R. E., Najdowski, C. J., McLean, S. J., Worden, K. M., Corsaro, N., Cochran, H., \u0026amp; Engel, R. S. (2024). Implicit bias training for police: Evaluating impacts on enforcement disparities. \u003cem\u003eLaw and Human Behavior, 48\u003c/em\u003e(5-6), 338\u0026ndash;355. https://doi.org/10.1037/lhb0000568\u003c/li\u003e\n \u003cli\u003eXuan, Z, Yan, S, Formica, S. W., Green, T. C., Beletsky, L., Rosenbloom, D., Bagley, S. M., Kimmel, S. D., Carroll, J. J., Lambert, A. M., \u0026amp; Walley, A. Y. (2023). 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Stigma and substance use disorders: An international phenomenon. \u003cem\u003eCurrent Opinion in Psychiatry, 30\u003c/em\u003e(5), 378\u0026ndash;388. https://doi.org/10.1097/YCO.0000000000000351\u003c/li\u003e\n \u003cli\u003eZakimi, N., Greer, A., \u0026amp; Butler, A. (2022). Too many hats? The role of police officers in drug enforcement and the community. \u003cem\u003ePolicing\u003c/em\u003e, 16(4), 615\u0026ndash;629. \u003cu\u003ehttps://doi.org/10.1093/police/paab082\u003c/u\u003e\u003c/li\u003e\n \u003cli\u003eZhang, A., Balles, J. A., Nyland, J. E., Nguyen, T. H., White, V. M., \u0026amp; Zgierska, A. E. (2022). The relationship between police contacts for drug use-related crime and future arrests, incarceration, and overdoses: A retrospective observational study highlighting the need to break the vicious cycle. \u003cem\u003eHarm Reduction Journal\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e(1), 67. https://doi.org/10.1186/s12954-022-00652-2\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"harm-reduction-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"harj","sideBox":"Learn more about [Harm Reduction Journal](http://harmreductionjournal.biomedcentral.com/)","snPcode":"12954","submissionUrl":"https://submission.nature.com/new-submission/12954/3","title":"Harm Reduction Journal","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-6596810/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6596810/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePolice deflection programs represent a promising public health strategy for addressing substance use disorders (SUDs) and diverting people who use drugs (PWUD) from the criminal legal system. These programs offer support for individuals frequently encountered by law enforcement by connecting them with treatment and resources. This study investigated the relationship between police officers' stigma towards PWUD and their support for the principles of deflection programs. We surveyed 248 officers from Illinois police departments, measuring stigma using established constructs of blame, distrust, fear, and shame. We examined the association between these stigmatizing attitudes and officer support for key deflection principles: access to treatment, utilization of medications for SUDs, and the potential for resource-saving solutions for law enforcement. Our findings revealed mixed findings, which suggest a complex relationship. While officers holding more stigmatizing views of fear and shame were \u003cem\u003eless likely\u003c/em\u003e to endorse addressing addiction-related crime through treatment and support, officers exhibiting blame and certain aspects of distrust were \u003cem\u003emore likely\u003c/em\u003eto support deflection. These nuanced results underscore the critical need for further research into the multifaceted relationship between stigmatizing attitudes of police officers and their willingness to embrace deflection strategies. Understanding these dynamics can aid in effectively implementing and optimizing deflection programs, which have been shown to enhance public safety and improve public health outcomes.\u003c/p\u003e","manuscriptTitle":"Police Officers' Stigmatizing Attitudes Toward People Who Use Drugs: Implications for Support of Deflection","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-29 06:01:24","doi":"10.21203/rs.3.rs-6596810/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-10T10:29:39+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-09T18:52:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"280419491817207180220979816567112368374","date":"2025-09-08T13:24:06+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-12T21:38:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"338869217943296656405557133852856386093","date":"2025-06-03T02:52:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"144690189510981133195484837706308768786","date":"2025-05-27T20:53:00+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-27T09:00:30+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-06T04:10:43+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-06T04:10:05+00:00","index":"","fulltext":""},{"type":"submitted","content":"Harm Reduction Journal","date":"2025-05-05T18:42:18+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"harm-reduction-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"harj","sideBox":"Learn more about [Harm Reduction Journal](http://harmreductionjournal.biomedcentral.com/)","snPcode":"12954","submissionUrl":"https://submission.nature.com/new-submission/12954/3","title":"Harm Reduction Journal","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3cec42c9-71fe-4a51-9ed8-f19065a993e5","owner":[],"postedDate":"May 29th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-02-09T16:06:53+00:00","versionOfRecord":{"articleIdentity":"rs-6596810","link":"https://doi.org/10.1186/s12954-026-01406-0","journal":{"identity":"harm-reduction-journal","isVorOnly":false,"title":"Harm Reduction Journal"},"publishedOn":"2026-02-04 15:58:03","publishedOnDateReadable":"February 4th, 2026"},"versionCreatedAt":"2025-05-29 06:01:24","video":"","vorDoi":"10.1186/s12954-026-01406-0","vorDoiUrl":"https://doi.org/10.1186/s12954-026-01406-0","workflowStages":[]},"version":"v1","identity":"rs-6596810","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6596810","identity":"rs-6596810","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}