39 convictions. Over the years, the focus of diversion programs has been on individuals charged with drug-related offenses, particularly those exclusively about drugs. Central to diversion programs is “the understanding that a criminal conviction – misdemeanor or felony – triggers a cascade of collateral consequences that often severely hamper an individual’s ability to become a productive member of the community. While policies and practices minimizing the use of incarceration certainly may be sound options, the conviction itself precludes or restricts an individual’s pursuit of education, housing, and employment, and creates a platform for enhanced sanctions and consequences upon further justice system involvement.”58 Many scenarios describe how individuals escalate engagement with the criminal justice system if there is no intervention, showing that such a path can result in the deepening of a substance use disorder. Since recidivism is often tied to further substance use and related activities, reducing its probability through diversion programs has the effect of preventing continued substance use disorder. Finding alternatives to arrest, prosecution and correctional supervision is therefore a reasonable part of any strategy to reduce opioid use disorder. There are various points in the administration of justice where individuals can be diverted from further engagement with the criminal justice system. The major ones are (1) pre-arrest, (2) pre-trial and (3) post-adjudication. These intervention points are connected in what is termed the Sequential Intercept Model for providing a framework to link and coordinate a diversion strategy. “The Sequential Intercept Model provides a conceptual framework for communities to use when considering the interface between the criminal justice and mental health systems as they address concerns about criminalization of people with mental illness. The model envisions a series of points of interception at which an intervention can be made to prevent individuals from entering or penetrating deeper into the criminal justice system. Ideally, most people will be intercepted at early points, with decreasing numbers at each subsequent point. The interception points are law enforcement and emergency services; initial detention and initial hearings; jail, courts, forensic evaluations, and forensic commitments; reentry from jails, state prisons, and forensic hospitalization; and community corrections and community support. The model provides an organizing tool for a discussion of diversion and linkage alternatives and for systematically addressing criminalization. Using the model, a community can develop targeted strategies that evolve over time to increase diversion of people with mental illness from the criminal justice system and to link them with community treatment.”59 Police are increasingly “recognizing that increasing arrests of those with OUD will not improve individual and community outcomes, police have become a point of contact for those seeking help by facilitating immediate access to treatment.60 These deflection and diversion initiatives can help with barriers (e.g., lack of knowledge of available services, shame and stigma, cost and lack of insurance/Medicaid, lack of transportation, long treatment waiting lists) that prevent individuals from receiving treatment.”2 There are a variety of diversion programs, including models in which individuals referred to police – once it is discovered they have a substance use disorder – can instead be transported to a treatment facility. Substantial interest in and implementation of pre-trial diversion programs has developed over the past decade. After the police bring a case to the prosecutor, the prosecutor can elect to not file charges with the court and instead make a referral to a treatment program or, even after filing charges, the prosecutor can work to have the individual referred to treatment – in which case all charges are normally dropped. The National Institute of Justice, a coalition of the Center for Court Innovation, the RAND Corporation and the Association of Prosecuting Attorneys, in a multisite study, found that diversion programs in these jurisdictions appeared highly successful in reducing exposure to a conviction, in freeing up resources for criminal justice agencies and in reducing recidivism.61 A major focus of diversion programs that has been highly successful across the country is the creation of drug courts. A significant and thorough evaluation of these programs by the National Institute of Justice came to the following conclusions: “The impact evaluation found that adult drug courts significantly reduce participants’ drug use and criminal offending during and after program participation. Drug court participants reported less drug use (56 percent versus 76 percent) and were less likely to test positive for drug use (29 percent versus 46 percent) than the comparison probationers. Participants also reported less criminal activity (40 percent versus 53 percent) and had fewer rearrests (52 percent versus 62 percent, but not statistically significant difference) than the comparison probationers. Differences in employment, schooling, community service and other outcomes were not statistically significant.”62