SMART Policy Podcast
Podcast by the UT SMART Initiative. Host Jeremy Kourvelas speaks with experts from across the recovery ecosystem - representing healthcare, prevention, law enforcement and more - about local, state and federal drug policy to find out what is and isn't working to make this fight against addiction a little easier.
SMART Policy Podcast
How Law Enforcement Is Rethinking Mental Health And Addiction
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You're listening to the Smart Policy Podcast, a production of the University of Tennessee's Institute for Public Service. If anyone has gotten a true bird's eye view of the drug problem in the United States, it's someone like Special Agent Carl Kulder of the U.S. Drug Enforcement Administration. From starting in Philadelphia when crack cocaine was the top concern, to overseeing the region containing West Virginia and DC when the opioid crisis progressed from prescription pills to heroin and fentanyl, finally directing the entire Department of Internal Affairs at the DEA, Special Agent Carl Kulder has seen the whole drug trade up close and personally. In this conversation, he reflects on some of the changes and challenges experienced by law enforcement over the past 30 years.
SPEAKER_01Hey, we can't arrest our way out of this problem. What do we do? We have to team up with community. We're not programmed to deal with these things. You know, homelessness, mental health, substance use.
SPEAKER_00Now retired from the DEA, he works as a consultant, providing education and training to faith communities.
SPEAKER_01Guess what? Who's the first person somebody's gonna go to when they're suffering?
SPEAKER_00They're gonna go to their minister. And law enforcement organizations on evidence-based practices relating to addiction and mental health intervention.
SPEAKER_01If you're a detective and all you've seen is homicides for the last three years, what what do you think is going on in the mind there?
SPEAKER_00A big focus of his work centers around improving such resources for law enforcement and first responders.
SPEAKER_01When you have an officer who's addicted to alcohol, and everybody knows they have a drinking problem, but nobody says anything. There's all kinds of employee assistance programs that have to be utilized up front as opposed to after the damage is done.
SPEAKER_00Agent Koulder has a lot of fascinating insights covering everything from the southern border to rural communities, from youth education to telehealth. His structural and systemic perspectives on what's happening with law enforcement are particularly interesting.
SPEAKER_01So those users are now saying, Well, I don't want to deal with this fentanyl, I'll go back to methamphetamine. Well, the cartels know what we desire in terms of uh drug trafficking. Now, in in places like Tennessee and Florida, you're now seeing more of the old way of making methamphetamine, and you have the mom and pop labs coming back just to be safe. And so now the Mexicans shift gears and the Colombians shift gears right along with us, okay, and with with the demand.
SPEAKER_00That's that's actually really fascinating. I hadn't hadn't heard yet uh people turning to more homegrown meth to to avoid fentanyl contamination just because it's such a huge issue.
SPEAKER_01We're we're we're seeing that now, you know. That's fascinating. Yeah. But because of the laws, you know, with pseudo-ephedrine, you know, over-the-counter medications like that for production of methamphetamine, you know, that there's more tighter regulations, right? Tighter regulations on that. But but it it it still happens, we still see it. Oh, that's interesting.
SPEAKER_00Uh, a quick, a quick aside, you were talking about the cartels know what we want, and that that reminded me of uh uh Mexican president Lopez Obrador. He said that Americans need to focus more on reducing demand. I I think there is something to be said about needing to reduce demand, but there's been a lot of talk about how the United States should handle what is clearly a lack of action, and some are some are even talking about special military operations and things like that. I I there's there's a wide range of things that people are talking about at the federal and and local levels. I imagine in Texas there's quite a quite a raging debate too. But I was just wondering if if I could get your perspective on on because this has been a pretty heated and contentious issue.
SPEAKER_01Yeah, well, you know, there's different points of view on this, you know, for one, you can't go into another country and control that country, you know, um, they have a responsibility as well. So, with um, for example, the drug enforcement administration, we do our best. We're in over 90 countries uh in abroad, and so when you see that and you have that reach, you're trying to uh assist host countries and nations in how they control it themselves. With that, you have corruption, you have all these things that you know even uh foreign governments are dealing with, right? Uh the violence associated with that, um, with the cartels and and the militia. So, so those are all the things that you worry about abroad, having good relationships, you know, there's an up and down with uh the Mexican government. So, and the trafficking patterns are changing, you know, from Colombia, Mexico, and now Africa and all these other countries uh where you're now uh having to shift gears and pay attention to. When we look at ourselves here in the United States, what do we do? How do we provide programs for those who are in recovery and have substance use disorders? How do we educate young people that, you know, hey, a pill may not be the real pill, it may be fentanyl. Okay, so so education, uh, you know, just awareness and talking about it here in our country, getting organizations involved, you know, law enforcement for uh years now. I could say in the last decade or so, uh law enforcement has changed. Law enforcement now, hey, we can't arrest our way out of this problem. What do we do? We have to team up with community, we have to do these things. And then on the other side, you have the issues in policing where uh, you know, we haven't done a good job in terms of civil rights. So so all these things come into play. And you know, you go into DEA headquarters and you see uh the the walls, and and you might want to take a visit to because of the DEA museums there and and that sort of thing, but they have walls of of uh those who have uh died from overdoses through throughout headquarters. So so education. I do a lot of that work with faith-based organizations because guess what? Who's the first person somebody's gonna go to when they're suffering? They're gonna go to their minister. Yeah, the parents are gonna go there, the loved ones are all gonna go to their priest to say that they have a loved one who's suffering, especially in a place like Tennessee, yeah. Yeah, yeah. So so how do we educate our ministers, our priests, to you know what, you can't save the world by counseling. You have to know where your services are in your community, all right? There, there's there's more than one piece to this.
SPEAKER_00Yeah, I believe it's been called uh the everything problem.
SPEAKER_01Yeah, the everything problem, and and you know, how do we how do we deal with it?
SPEAKER_00Well, this coalition building and education that you're talking about, this has been a significant part of your more recent work.
SPEAKER_01Well, um, my consulting is uh very diverse, you know, because uh one piece is to assist companies in their effort to get their data analytics into government law enforcement. Uh and I have several contracts with uh Fortune 500 companies who are doing business with the government, they have uh technologies that are valuable to federal law enforcement and state and local law enforcement. So I I try to facilitate those guess contacts and collaborations with agency and business, and and so that is one part of it. The this the second part of it is um community engagement. Initially, it was the Episcopal Church. Um, I'm a member of the Episcopal Church, and I question what we were doing as uh an Episcopal church in Virginia to help those who are suffering from substance use disorder, and that mushroomed into regional programs. And Bishop Curry at the national level decided that hey, we need to do something nationally, and that was uh uh a great thing, and then I started getting contacts from other uh churches uh in conjunction with that. But the the other thing that we also started doing, and this is where law enforcement comes in, because now there's also mental health associated with substance use disorder. And so, how do we deal with that in law enforcement? Okay, because we're not programmed to deal with these things, you know, homelessness, mental health, substance use, and then um not only are we dealing with the epidemic, you have the stress with first responders dealing with COVID and substance use disorder. And they also have to take care of themselves, yeah. So that's another message. So so we we we have a long way to go. We're still moving, we're doing well as a country to to at least have identified our issues.
SPEAKER_00There are efforts to increase mental health first aid programs, not only to reach out to law enforcement themselves, but but to provide more training to the officers to be able to respond. There have been efforts to have mixed unit response teams, alternative response teams that that partner with social workers, psychologists, things like that. Uh, do you think this is a good direction?
SPEAKER_01Oh, that's absolutely that's huge because you know, relationships solve problems. Okay, so so if you have a a a good community relationship with mental health, first responders, faith-based organizations, and volunteers, all these things to help, you know, go in outreach.
SPEAKER_00So, what do you think we've been getting right and what do you think we've been getting wrong?
SPEAKER_01You know, controlling our borders, you know, we we have to find a way to do do a better job of that. Uh when you look at the um border crossings, how many trucks and cars cross the border every day? You know, it's like uh uh a parking lot, you know, and then uh traffickers they they get smarter, they dig tunnels, you're you know, you we've seen all these things, and then you know, establishing better relationships with countries that we don't have good good relationships with. It causes them a problem too in terms of overdose and addiction. So, how do we educate young people? And and uh I'm I'm really concerned about our young people understanding, hey, one experiment could cost you your life.
SPEAKER_00Like we've been talking about, there's mental health, there's homelessness, uh, there's a lot of economic factors here. What do you think has been playing a role in the background in terms of uh stimulating our demand?
SPEAKER_01Well, services, you know. Um uh, you know, what I what I saw in in West Virginia, which is a sad thing, we have to decentralize service areas, okay, because they're all in the big cities, so to speak.
SPEAKER_00Right.
SPEAKER_01And now you have rural towns and cities that are suffering, and those people have to travel different places to get services. We had um the panhandle of Westford Martinsburg, they were traveling to Baltimore for services, and so when you have to travel that distance, you go and you get your methadone, you get your services, you get all those things, and guess what? You have to travel back home. So, what's going on on your way back home? Drugs, right? We have to ensure that these services are everywhere.
SPEAKER_00Like, I think the median distance uh to uh uh medications for opioid use disorder clinic is something like 50 miles, right? And telehealth has played a huge role in this. The pandemic came and opened up a lot of prescribing uh capabilities, right? But now the DEA I believe is making recommendations and and they're taking some open feedback now. They were going to shut down a lot of that, they were gonna make recommendations shutting down the ability to prescribe without an in-person visit on the first one, right?
SPEAKER_01Right, exactly. Yeah, yeah.
SPEAKER_00But now they reconsidered and uh they're taking open feedback, and a lot of addiction medicine physicians are are and providers are saying, no, hold up, this is this is saving lives. Let's take a minute and think about this. What do you think is happening there?
SPEAKER_01Well, you you have to look at when when you're talking about Suboxone, uh HHS, they really deal with that because they put out the regulations to the doctors that the doctors have to um abide by. But everybody thinks it's solely DEA. Oh, I see. Well, DEA has to really ensure that they're abiding by those regulations, and they it's it's like they're the middleman here.
SPEAKER_00Oh, and they're so they're getting all the finger pointing, even though they're just saying, right.
SPEAKER_01So so so you know, you have to understand these these things, and and so the DEA is just uh there to um ensure that the process works well.
SPEAKER_00Drug enforcement, not drug legislation, agents.
SPEAKER_01Right. Exactly. You know, and and and that's that's that's what we're seeing in in a lot of uh cities uh around the country. There their um law enforcement gets that bad rap because they have to put out the fire that's created by these programs that aren't working well. Okay. And and so, you know, hey, that's why we need more training, because a lot of it is not just drugs, it's mental health.
SPEAKER_00Yeah, and if there's no services in those small towns like you're talking about, and the only way to respond is to have a cop put them in jail for a little bit. Uh, this is why we hear again and again and again from county mayors that, yeah, my county's largest mental health institution is our jail.
SPEAKER_01Right. And and see, and and the other thing is larger cities have the capacity to have 24-hour programs. Well, the smaller rural towns, you know, after five o'clock, everything shuts down. So where's the service? Law enforcement, first respond, the fire department, and the emergency room.
SPEAKER_00Those are the services. Emergency rooms are just getting slammed with us, yeah.
SPEAKER_01Right. And you know, um, before I became a DEA agent, I was uh I worked in a um basically not a halfway house, but a um a rehabilitation center. Okay, so I got to see that side of it. That was a 24-hour, 365-day of the year program. We were also a thermal shelter in the winter, having doors open to people, and then you have a number of transient people who come into these communities and they're told, hey, go to um such and such city because they have the services. So now that city gets an influx of people coming into the community who need services, and the services aren't available if they come in at midnight.
SPEAKER_00And I'm thinking now about opioid abatement settlement money, thinking about these small towns, a lot of them, you know, sometimes there are whole counties that are only getting you know some tens of thousands of dollars. There's there's a town in Tennessee that's only getting $18 over 18 years. Well, what are they gonna do that? You can't hire a psychiatrist with that.
SPEAKER_01No, you you see, so uh these people have to travel to Knoxville or whatever, you know. So, how do we bring services to the people? What uh recommendations do you have for us? Oh man, I mean, you know, uh hey, and and and here's the thing you um create more jobs, but now you have to have people who want to live in these places, you know, but you're creating income because now you have services in these places.
SPEAKER_00There's concerns about how these providers might get paid. Uh, do you think we're talking about that element of it enough?
SPEAKER_01Yeah, well, that's that's uh another thing, you know, Medicare, Medicaid, um, how how that's being used in the process, you know, all these benefits, and and it the the sad thing that nobody really pays attention to is how incomes have been affected by by this, okay? Because you you uh this has no face. Substance use has no face. Okay, it doesn't ask you um whether you were rich at one time or you had a substantial income, it has destroyed families, it has destroyed the income of families.
SPEAKER_00I I personally do think economics is inextrably linked with addiction.
SPEAKER_01It is.
SPEAKER_00Everybody needs help now, yeah.
SPEAKER_01You know, and and I I go I go even deeper now that I've been in, you know, consulting. We have to get our young people into STEM programs. We have to enhance our knowledge in STEM, national security, uh, cybersecurity. We have to get ourselves up to standards now. We're depending on others to perform these things for us. We we need to be that premier nation who has it and has all the tools.
SPEAKER_00In closing, is there anything you'd like to add?
SPEAKER_01No, I'd like to thank you. And you know, just by happenstance we happen to meet, and uh maybe we can uh do this again, focus on other topics. And um, but at the end of the day, you know, we're we're public servants. We we want to make sure people are safe and and healthy. I think uh that's the number one goal. I've met tremendous people in law enforcement and throughout my my career, you know, even as a police chief. And it's one of those professions where it's a broad brush effect. And and and we have to realize that, but at the same time, understanding that it's a uh a broad brush because what happens in in Philadelphia, you know, trickles down into Virginia or whatever, you know, in terms of policing. And so we've had a few bad incidents that as we climb and try to fix things, these things happen and it just pulls law enforcement down again, you know, and so and and that's that's a sad thing because there are so many hardworking first responders and uh people in in in law enforcement that are doing great things, you know, and and it's overshadowed by the one or two things, you know. So so I I just wanna leave with that. Take care of your first responders as well. Um they're they're people just like anybody else, they don't have the Superman logo on their chest, they think they do at times, you know. Um, and um that leads to uh stress, yeah, law enforcement. We have the same problems that everybody else has, you know, family, uh, you know, relationships, all these other things that that we have. Um, and you know, we have elderly parents that we have to take care of. We have female uh and male um officers who have to take care of their families, you know, just like everybody else. Um, and and they see bad things every day. So where are the programs for uh our first responders, our firemen? And and one of the great things that they have at the Huntington Police Department, or we had there, is a compass program. And that program was geared towards the health and wellness of first responders, and in particular the the um Huntington Police Department and Huntington Fire Department, and and you know, just um uh uh a place to go for learning how to prepare a healthy meal, learning how to uh take care of your body, having physicians on staff, you know, um mental health care, checkup, chiropractic stuff, you know, uh these are the things when you're sitting in the car all day, if you're a detective and you know all you've seen is homicides for for the last three years, what what do you think is going on in the mind there? Yeah, you know, these are things, and it's no excuse for what happens, but when when you have an officer who's addicted to alcohol, all right, and everybody knows they have a drinking problem, but nobody says anything. Uh so so it's up to management to understand these things. There's all kinds of employee assistance programs that have to be utilized up front as opposed to after the damage is done.
SPEAKER_00Yeah.
SPEAKER_01And we see that all the time, that you know, hey, these programs aren't a get out of jail free car or or a save my job program, right? You know, we have to identify these issues, and then our veterans, okay. Um we we talk about our veterans, 20 25 a day committing suicide. Uh these these are the issues, and guess what? How many reservists are in law enforcement? Quite a lot, I'd imagine. Quite a lot, and and uh a lot of them go through traumatic situations when they're on duty with the military, and then they come home and there's no decompression, they go right back in into their law enforcement job. But there's great people in law enforcement. Let's let's let's not let's not take that away. There's people there are uh there's law enforcement working day and night to get a job done. And and and you know, we just suffer from some of the the bad things that happen.
SPEAKER_00Suffering alongside all the rest of us. Very well said. Uh Carl, it was a true pleasure talking to you. Uh, like you said, a happenstance, uh uh a family connection uh led to a really, really wonderful conversation. And uh uh just by pure pure coincidence. Uh so you you just gotta love that kind of thing.
SPEAKER_01Yeah, it it's amazing. Thank you. And uh what you do is important too, because you you open the ears and and and the eyes to a problem or issues, and and that's that's that's good. And and it it's really unbiased, and and and I I like that part of it, you know, we have to look at the facts. There's not one problem that has one thing responsible for it.
SPEAKER_00Right.
SPEAKER_01Okay, and and so, you know, we we we have to look at ourselves and and and really come up with solutions.
SPEAKER_00Uh well, Special Agent Carl Colder, it was a true pleasure talking to you, and we'll definitely be having you back on the Smart Policy Podcast. Okay, thank you. For more episodes on in-depth discussions on Tennessee policies related to substance use disorder by a range of local experts. Please subscribe to us wherever you get podcasts and visit our website at smart.tenessee.edu. I'm Jeremy Corvellis. Thank you for listening and see you next month.