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Blog Post | May 7, 2019

Taking the LEAD: A Q&A with North Carolina’s Harm Reduction Coalition

SAFE is working with the North Carolina Harm Reduction Coalition (NCHRC) to support the implementation of Pre-Arrest Diversion (PAD) programs. We have shared why we support PAD, but there is a specific model that is working well in North Carolina  – Law Enforcement Assisted Diversion (LEAD).

This innovative program allows law enforcement officers to redirect low-level offenders engaged in drug activity to community-based services, instead of jail and prosecution. Today, the North Carolina Harm Reduction Coalition’s LEAD Coordinator Melissia Larson joins us to talk more about this model of PAD, harm reduction and the progress North Carolina is seeing throughout the state.


What makes the LEAD model unique and why are they being implemented in North Carolina?

Law enforcement is looking for new innovative ways to address the intersection of substance use and the criminal justice system. We hear time and time again that traditional law enforcement efforts simply have not been effective. At the same time, NC law enforcement agencies have been partnering with the North Carolina Harm Reduction Coalition (NCHRC) for numerous years on a variety of harm reduction related efforts, such as naloxone distribution and training for officers.

Assisting departments in their implementation of naloxone programming opened the door to introduce law enforcement to the concept of harm reduction. With the LEAD model operating in a harm reduction framework, it has been a good diversion model for officers to support given both their desire for new ways and understanding of harm reduction strategies.

What changes have you seen in communities as a result of law enforcement implementing PAD programs?

The support for LEAD programs from the stakeholders, community members, and participants has been inspiring. There is a rallying together that happens. Because this is a collaborative program, stakeholders have come to the table to offer an array of services. LEAD brings partners together who have typically worked in a silo.

Changing the police/community dynamic regarding drug-related offenses, after decades of enforcing the war on drugs, will not happen overnight. Communities with police agencies rooted in more heavy enforcement strategies are slower to warm to LEAD programs based on trust and previous negative experiences.

What steps do you usually take to begin working with law enforcement to implement a pre-arrest diversion?

North Carolina’s Fayetteville LEAD team

Exploring LEAD site implementation can be an exciting time when we see stakeholders come together for a common interest of effecting change within the criminal justice system and improving health outcomes. Initial steps include ensuring the key stakeholders for success are on board and then assessing the availability of services within the community. Not all sites have the multitude of services ideal for implementation; it just means we have to be more creative in helping connect people to services.

As a pre-arrest program, it is imperative that harm reduction services are available to include peer support and outreach services such as community distribution of naloxone and access to syringe exchange services. We also work with each community to develop a post-overdose response protocol if one does not already exist. The next phase of implementation involves creating a memorandum of understanding, policies, and training for law enforcement.

What challenges does the North Carolina Harm Reduction Coalition (NCHRC) face in implementing LEAD programs?

NC has been very fortunate in the number of communities interested in exploring LEAD but funding continues to be a challenge. Many team members in LEAD programs are existing staff members of partnering agencies which reduces the overall staffing budget. Funding for the case manager and peer support/outreach component are a struggle for most agencies exploring LEAD implementation.

For existing programs, transportation in rural areas and short-term clients such as housing deposits continue to be a need along with ensuring program sustainability. Each of our sites has continued to foster strong relationships with community-based services and treatment providers to identify funding streams for this population.

Can you share some statistics or facts highlighting the success of LEAD programs?

Jessie Garner, NCHRC Outreach Specialist talks about importance of outreach in the community.

LEAD sites have been actively monitoring participant criminal justice involvement whether it is field contact with officers or new criminal activity. Preliminary data in several sites are showing at least an 80% reduction in criminal justice interaction among participants. The majority of participants are involved in harm reduction services. Linking them to a variety of substance use treatment services is a critical component of programming and many participants are taking advantage of these opportunities.

But it is in the stories from participants and officers where the biggest change is found. When a participant beams over having their own money to pay their apartment rent after a 7-year stint living in a motel not conducive to recovery, you know the impact on lives is real. The engagement of both case management and peer support can really wrap services around an individual.

Another success we find is the buy-in from officers. While the LEAD program is a pre-arrest diversion program, the majority of referrals by officers are social referrals -typically 80%. (note: Social referrals come into the program through social contact with police, rather than by arrest diversion.)  This cultural shift of decriminalizing drug offenses in favor of connecting people to a case manager who can facilitate linkage to care is new to the field of policing.

Additionally, in traditional policing, officers normally do not have the benefit of knowing the impact of conversations or actions they take when engaging with citizens. LEAD changes that. Officers can attend the case staffings or communicate with the case manager to find out how a participant is doing. Because LEAD is not a coercive or punitive program and officers have been trained to understand the dynamics and complexity of substance use, officer attitudes towards how a participant progress is one of understanding.


Melissia Larson is the Law Enforcement Assisted Diversion Coordinator (LEAD-C) for the North Carolina Harm Reduction Coalition (NCHRC). NCHRC is a statewide grassroots organization dedicated to the implementation of harm reduction interventions, public health strategies, drug policy transformation, and justice reform in North Carolina and throughout the American South. NCHRC engages in grassroots advocacy, resource and policy development, coalition building, and direct services for people impacted by drug use, incarceration, sex work, overdose, gender, HIV and hepatitis and first responders.