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Works Cited

The content of SHIELD trainings is based on the best available science. The following is a list of studies cited across SHIELD curricula.


The Action Lab at the Center for Health Policy and Law. (2019, July 12). Fentanyl-laced Drugs. Changing the Narrative. 

Act Missouri. (2016). Myths & Facts About Naloxone (Narcan). Act Missouri.


Agnoli, A., Xing, G., Tancredi, D. J., Magnan, E., Jerant, A., & Fenton, J. J. (2021). Association of dose tapering with overdose or mental health crisis among patients prescribed long-term opioids. The Journal of the American Medical Association, 326(5), 411-419.

Ajmera, R. (2021, December 14). Stress Symptoms: Physical Effects of Stress and How to Treat. Healthline.

Alves, J. (2024, March). Stimulants 101. Grayken Center for Addiction, Boston, MA. 


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Avois, L., Robinson, N., Saudan, C., Baume, N., Mangin, P., & Saugy, M. (2006). Central nervous system stimulants and sport practice. British Journal of Sports Medicine, 40(1), i16–i20. 

Ball, J., & Ross, A. (1991). Follow-up study of 105 patients who left treatment. In The Effectiveness of Methadone Maintenance Treatment: Patients, Programs, Services, and Outcome (pp. 176-187). Springer New York, NY.

Beletsky, L., Macalino, G., & Burris, S. (2005). Attitudes of police officers towards syringe access, occupational needle-sticks, and drug use: a qualitative study of one city police department in the United States. International Journal of Drug Policy, 16(4), 267-274.

Beletsky, L., & Davis, C. S. (2017). Today’s fentanyl crisis: Prohibition’s Iron Law, revisited. International Journal of Drug Policy, 46, 156–159.

Beletsky, L., Ryan, E. J., & Parmet, W. E. (2018, January 28). Involuntary treatment for substance use disorder: A misguided response to the opioid crisis. Harvard Health.

Binswanger, I., Stern, M., Deyo, R., Heagerty, P., Cheadle, A., Elmore, J., & Koepsell, T. (2007). Release from prison—a high risk of death for former inmates. New England Journal of Medicine, 356(2), 157-165. 

Binswanger, I. A., Blatchford, P. J., Mueller, S. R., & Stern, M. F. (2013). Mortality after prison release: opioid overdose and other causes of death, risk factors, and time trends from 1999 to 2009. Annals of Internal Medicine, 159(9), 592-600. 

Bredenberg, E., Tietbohl, C., Dafoe, A., Thurman, L., & Calcaterra, S. (2023). Identifying factors that contribute to burnout and resilience among hospital-based addiction medicine providers: A qualitative study. Journal of Substance Abuse Treatment, 144, 108924. 

Bronson, J., Stroop, J., Zimmer, S., & Berzofsky, M. (2017). Drug use, dependence, and abuse among state prisoners and jail inmates, 2007–2009. United States Department of Justice, Office of Juvenile Justice and Delinquency Prevention. 

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Caulkins, J. P., Gould, A., Pardo, B., Reuter, P., & Stein, B. D. (2021). Opioids and the criminal justice system: new challenges posed by the modern opioid epidemic. Annual Review of Criminology, 4, 353-375.

Carroll, G. G., Wasserman, D. D., Shah, A. A., Salzman, M. S., Baston, K. E., Rohrbach, R. A., Jones, I. L., & Haroz, R. (2021). Buprenorphine Field Initiation of ReScue Treatment by Emergency Medical Services (Bupe FIRST EMS): A Case Series. Prehospital Emergency Care, 25(2), 289–293.

Centers for Disease Control and Prevention. (2019, March 22). Syringe Services Programs (SSPs) Infographic. CDC. 

Centers for Disease Control and Prevention. (2022, February 23). Polysubstance Use Facts. Centers for Disease Control and Prevention.

Centers for Disease Control and Prevention. (2023, January 11). Summary of Information on The Safety and Effectiveness of Syringe Services Programs (SSPs). CDC.

Centers for Disease Control and Prevention. (2023, February 24). Stimulant Guide. Centers for Disease Control and Prevention. 


Centers for Disease Control and Prevention. (2023, March 14). Occupationally-Acquired Infections in Healthcare Settings. Centers for Disease Control and Prevention. 


Centers for Disease Control and Prevention. (2023, April 21). Lifesaving Naloxone. Centers for Disease Control and Prevention. 


Centers for Disease Control and Prevention. (2023, August 8). Understanding the Opioid Overdose Epidemic. Centers for Disease Control and Prevention.

Chen, Q., Sterner, G., Segel, J., & Feng, Z. (2022). Trends in opioid-related crime incidents and comparison with opioid overdose outcomes in the United States. International Journal of Drug Policy, 101, 103555.

Chikwem, C. (2017). The relationship of job stress to job performance in police officers. [Doctoral Dissertation]. Walden University College of Social and Behavioral Sciences.

Christopher, P., Anderson, B., & Stein, M. (2018). Civil commitment experiences among opioid users. Drug and Alcohol Dependence, 193, 137-141.

Cicero, T., Elliz, M., & Chilcoat, H. (2018). Understanding the use of diverted buprenorphine. Drug and Alcohol Dependence, 193, 117-123.


Cidambi, I. (2017, July 17). Drug and Alcohol Abuse in the Legal Profession. Psychology Today.

Cleveland Clinic. (2022, March 27). Epinephrine (Adrenaline): What It Is, Function, Deficiency & Side Effects. Cleveland Clinic.

Coffin, P., Behar, E., Rowe, C., Santos, G.-M., Coffa, D., Bald, M., & Vittinghoff, E. (2016). Nonrandomized intervention study of naloxone coprescription for primary care patients receiving long-term opioid therapy for pain. Annals of Internal Medicine, 165(4), 245-252.

Commonwealth of Massachusetts. (2008, November 19). 7840 Sale of Drug Paraphernalia.

Commonwealth of Massachusetts. (2019, June 21). Mass. General Laws c.94C § 34A.

Dahan, A., Franko, T. S., Carroll, J. W., Craig, D. S., Crow, C., Galinkin, J. L., Garrity, J. C., Peterson, J., & Rausch, D. B. (2024). Fact vs. fiction: naloxone in the treatment of opioid-induced respiratory depression in the current era of synthetic opioids. Frontiers in Public Health, 12, 1346109.

Dean, W., Talbot, S., & Dean, A. (2019). Reframing clinician distress: moral injury not burnout. Federal Practitioner, 36(9), 400.

Dwyer, K., Walley, A., Langlois, B., Mitchell, P., Nelson, K., Cromwell, J., & Bernstein, E. (2015). Opioid education and nasal naloxone rescue kits in the emergency department. Western Journal of Emergency Medicine, 16(3), 381.

Eddie, D., & Kelly, J. (2021, May 3). People recover from addiction. They also go on to do good things. STAT News.


Evans, E. A., Zhu, Y., Yoo, C., Huang, D., & Hser, Y. I. (2019). Criminal justice outcomes over 5 years after randomization to buprenorphine‐naloxone or methadone treatment for opioid use disorder. Addiction, 114(8), 1396-1404.

Evans, E., Wilson, D., & Friedmann, P. (2022). Recidivism and mortality after in-jail buprenorphine treatment for opioid use disorder. Drug and Alcohol Dependence, 231.


Fearn, N. E., Vaughn, M. G., Nelson, E. J., Salas-Wright, C. P., DeLisi, M., & Qian, Z. (2016). Trends and correlates of substance use disorders among probationers and parolees in the United States 2002–2014. Drug and Alcohol Dependence, 167, 128-139.


Feldman, R., & Weston, B. W. (2022). Accidental occupational exposure to a large volume of liquid fentanyl on a compromised skin barrier with no resultant effect. Prehospital and Disaster Medicine, 37(4), 550-552. doi:10.1017/S1049023X22000905


Fisher, R., O'Donnell, D., Ray, B., & Rusyniak, D. (2016). Police officers can safely and effectively administer intranasal naloxone. Prehospital Emergency Care, 20(6), 675-680.  


Ferreira, S., Couto, B., Sousa, M., Vieira, R., Sousa, N., Pico-Perez, M., & Morgado, P. (2021). Stress influences the effect of obsessive-compulsive symptoms on emotion regulation. Frontiers in Psychiatry, 11, 594541.    


Garg, A., Solas, D. W., Takahashi, L. H., & Cassella, J. V. (2010). Forced degradation of fentanyl: Identification and analysis of impurities and degradants. Journal of Pharmaceutical and Biomedical Analysis, 53(3), 325–334.


Environmental Protection Agency. (2018, May 22). Fact Sheet for OSCs: Fentanyl and Fentanyl Analogs. Environmental Protection Agency.

Gilmartin, K. M. (2002). Emotional Survival for Law Enforcement: A Guide for Officers and Their Families. E-S Press.

Green, T., Clarke, J., Brinkley-Rubinstein, L., Marshall, B., Alexander-Scott, N., Boss, R., & Rich, J. (2018). Postincarceration fatal overdoses after implementing medications for addiction treatment in a statewide correctional system. The Journal of the American Medical Association Psychiatry, 75(4), 405-407.

Harvard T. H. Chan School of Public Health. (2014, November 18). Police face higher risk of sudden cardiac death during stressful duties [Press release]. Harvard T. H. Chan School of Public Health.

Heimer, R., Black, A. C., Lin, H., Grau, L. E., Fiellin, D. A., Howell, B. A., ... & Becker, W. C. (2024). Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17. Drug and Alcohol Dependence, 254, 111040.

Help For Our Heroes. (2021, July 15). The Blue Line: Substance Abuse Among Police Officers. Help For Our Heroes Treatment Program.


Hern, H. G., Lara, V., Goldstein, D., Kalmin, M., Kidane, S., Shoptaw, S., Tzvieli, O., & Herring, A. A. (2023). Prehospital Buprenorphine Treatment for Opioid Use Disorder by Paramedics: First Year Results of the EMS Buprenorphine Use Pilot. Prehospital Emergency Care, 27(3), 334–342.

Huebner, B. (2006). Drug Abuse, Treatment, and Probationer Recidivism. Office of Justice Programs. 

Indiana State Department of Health. (2019, May 16). Naloxone Myths Debunked. 

International Centre for the Prevention of Crime. (2015, June 1). Prevention of Drug-Related Crime Report. United Nations Office on Drugs and Crime.

Ives, M. (2023, October 12). California Bans 'Excited Delirium' as a Cause of Death. The New York Times.

Jain, A., Christopher, P., & Appelbaum, P. (2018). Civil commitment for opioid and other substance use disorders: does it work? Psychiatric Services, 69(4), 374-376.

Johnson, C., & Foley, R. (2023, April 3). Medical examiners group steps away from 'excited delirium'. AP News. 


Johnson, C. (2023, October 12). A doctors group calls its 'excited delirium' paper outdated and withdraws its approval. AP News.

Klostermann, K. C., & Fals-Stewart, W. (2006). Intimate partner violence and alcohol use: Exploring the role of drinking in partner violence and its implications for intervention. Aggression and Violent Behavior, 11(6), 587-597.

Koenig, H. G., & Al Zaben, F. (2021). Moral injury: An increasingly recognized and widespread syndrome. Journal of Religion and Health, 60, 2989-3011.

Kop, N., Euwema, M., & Schaufeli, W. (1999). Burnout, job stress and violent behaviour among Dutch police officers. Work & Stress, 13(4), 326-340.

Krawczyk, N., Picher, C. E., Feder, K. A., & Saloner, B. (2017). Only one in twenty justice-referred adults in specialty treatment for opioid use receive methadone or buprenorphine. Health Affairs, 36(12), 2046-2053.

Krill, P. R., Johnson, R., & Albert, L. (2016). The prevalence of substance use and other mental health concerns among American attorneys. Journal of Addiction Medicine, 10(1), 46.

Lamoureux, I., Schutt, P., & Rasmussen, K. (2017). Petitioning for Involuntary Commitment for Chemical Dependency by Medical Services. The Journal of the American Academy of Psychiatry and the Law, 45(3), 332-338.

Lane, M. E. (2013). The transdermal delivery of fentanyl. European Journal of Pharmaceutics and Biopharmaceutics, 84(3), 449–455.

LawAtlas. (2019, August 1). Syringe Service Program Laws. The Policy Surveillance Program.

Lawrence, D. S., Gourdet, C., Banks, D., Planty, M. G., Woods, D., & Jackson, B. A. (2019). Prosecutor priorities, challenges, and solutions. RAND Corporation.

Lexipol. (2023, November 3). Understanding Excited Delirium: 4 Takeaways for Law Enforcement Officers. Lexipol. 

Lorentz, J., Hill, L., & Samimi, B. (2000). Occupational needlestick injuries in a metropolitan police force. American Journal of Preventive Medicine, 18(2), 146 150.

MacDonald, M., Law, M., Kaldor, J., Hales, J., & Dore, G. J. (2003). Effectiveness of needle and syringe programmes for preventing HIV transmission. International Journal of Drug Policy, 14(5-6), 353-357.

Macmadu, A., Yolken, A., Frueh, L., Toussaint, J., Newman, R., Jacka, B., Collina, A., & Marshall, B. (2022). Characteristics of events in which police responded to overdoses: an examination of incident reports in Rhode Island. Harm Reduction Journal, 19(1), 116.

Manzoni, P., & Eisner, M. (2006). Violence between the police and the public: Influences of work-related stress, job satisfaction, burnout, and situational factors. Criminal Justice and Behavior, 33(5), 613-645.

Massachusetts Department of Public Health. (2017). An Assessment of Fatal and Nonfatal Opioid Overdoses in Massachusetts (2011 – 2015). In Section III.e Persons Released from Incarceration in Prisons and Jails (p. 50). Massachusetts Department of Public Health.

Massachusetts Department of Public Health. (2017, August). Data Brief: An Assessment of Opioid-Related Overdoses in Massachusetts 2011-2015.

Massachusetts Department of Public Health. (2019, February 28). Section 35 Commission Treatment Statistics from BSAS Programs.

Mayo Clinic. (2021, June 5). Job burnout: How to spot it and take action. Mayo Clinic.


Missouri College of Emergency Physicians. (2024). Hospital-Initiated Substance Use Programming: Engaging Patients In Care Coordination [EPICC]. Missouri College of Emergency Physicians.


Missouri Department of Health and Senior Services. Drug Overdose Dashboard - Fatal Overdoses. Missouri Department of Health and Senior Services.

Moss, M., Warrick, B., Nelson, L., McKay, C., Dubé, P.-A., Gosselin, S., Palmer, R., & Stolbach, A. (2018). ACMT and AACT position statement: preventing occupational fentanyl and fentanyl analog exposure to emergency responders. Clinical Toxicology, 56(4), 297-300. 

National Alliance on Mental Illness. Building Resilience. NAMI.

National Council on Alcoholism and Drug Dependence, Inc. (2011, June 13). The Role of Alcohol in Crime Victimization. Montana State University. 

National Harm Reduction Coalition. (2020, July 7). Harm Reduction Principles. National Harm Reduction Coalition.

The National Institute for Occupational Safety and Health (NIOSH). (2022, August 30). Protecting Law Enforcement Officers from Sharps Injuries. Centers for Disease Control and Prevention.

National Institute of Mental Health. (2024, March). Substance Use and Co-Occurring Mental Disorders. National Institute of Mental Health.

National Institute on Drug Abuse. (2020, June 1). Criminal Justice DrugFacts. National Institute on Drug Abuse.

National Institute on Drug Abuse. (2020, June 16). Summary of Misuse of Prescription Drugs. National Institute on Drug Abuse.

National Institute on Drug Abuse. (2020, July 10). Drug Misuse and Addiction. National Institute on Drug Abuse. 

Pichardo, G. (2023, September 24). What Causes an Adrenaline Rush? The Impact of Epinephrine and Certain Situations. WebMD. 


Prevent + Ed. Opioid Overdose. Prevent + Ed.

Raychaudhuri, D., & Sloan, K. (2022, April 13). Prosecutors wanted: District attorneys struggle to recruit and retain lawyers. Reuters.

Oliva, E. M., Bowe, T., Manhapra, A., Kertesz, S., Hah, J. M., Henderson, P., ... & Trafton, J. A. (2020). Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation. British Medical Journal, 368. 

Opioid Resource Connector. (2020). Engaging Patients in Care Coordination (EPICC). Brandeis Opioid Resource Connector.

Organ, J. M., Jaffe, D. B., & Bender, K. M. (2016). Suffering in silence: The survey of law student well-being and the reluctance of law students to seek help for substance use and mental health concerns. Journal of Legal Education, 66(1), 116-156. 

Oser, C. B., Biebel, E. P., Pullen, E., & Harp, K. L. (2013). Causes, consequences, and prevention of burnout among substance abuse treatment counselors: A rural versus urban comparison. Journal of Psychoactive Drugs, 45(1), 17-27. 

Park, I., Choo, T., & Na, C. (2022). Burnout in the DA's office: Correlates and coping strategies among male and female prosecutors. International Journal of Law, Crime and Justice, 69, 100533.

Payne, E. R., Stancliff, S., Rowe, K., Christie, J. A., & Dailey, M. W. (2024). Comparison of administration of 8-milligram and 4-milligram intranasal naloxone by law enforcement during response to suspected opioid overdose — New York, March 2022–August 2023. MMWR. Morbidity and

Mortality Weekly Report, 73(5), 110–113.


Pietrangelo, A. (2023). The Effects of Stress on Your Body. Healthline.

Reichert, J., & Gleicher, L. (2019, June 17). Probation Clients’ Barriers to Access and Use of Opioid Use Disorder Medications. Illinois Criminal Justice Information Authority.


Reitstetter, R., & Losser, T. The Synthetic Opioid Fentanyl Is Degraded By Temperature And Ultraviolet Irradiation In The Environment [Poster]. Environmental Protection Agency.

Retreat Behavioral Health. (2023, May 1). Drug Use Among Police Officers, Alcoholism Among Police Officers. Retreat Behavioral Health.

Samuels, E. (2014). Emergency department naloxone distribution: a Rhode Island department of health, recovery community, and emergency department partnership to reduce opioid overdose deaths. Rhode Island Medical Journal, 97(10), 38.

Saunders, J., Kotzias, V., & Ramchand, R. (2019). Contemporary police stress: The impact of the evolving socio-political context. Criminology, Criminal Justice, Law & Society, 20(1).

Schenk, S., Eisenbarth, H., & Dixon, L. (2020). Treating opioid use disorders in the criminal justice system with pharmacotherapy. Forensic Science International: Mind and Law, 1, 100009. 

Sirkin, J., Sawyer, J., Augenbraun, S., Rasky, R., & Freij, M. (2023, February 1). Lawyer Well-Being in Massachusetts. NORC at the University of Chicago.

Sherry, A. (2023, December 1). Colorado strikes “excited delirium” from all law enforcement diagnosis, training documents. Colorado Public Radio.

Smith, B. (2014, May 13). Resilience seminar offered to Families. U.S. Army.

Stanley, T. H. (2014). The Fentanyl Story. The Journal of Pain, 15(12), 1215–1226.


Strömmer, E. M. F., Leith, W., Zeegers, M. P., & Freeman, M. D. (2020). The role of restraint in fatal excited delirium: A research synthesis and pooled analysis. Forensic Science, Medicine, and Pathology, 16(4), 680–692. 

Substance Abuse and Mental Health Services Administration. (1999). Treatment for Stimulant Use Disorders: Updated 2021 (Treatment Improvement Protocol (TIP) Series, No. 33). Substance Abuse and Mental Health Services Administration.

Substance Abuse and Mental Health Services Administration. (2014, March 6). The NSDUH Report: Trends in Substance Use Disorders among Males Aged 18 to 49 on Probation or Parole. SAMHSA.

Substance Abuse and Mental Health Services Administration. (2017, April 17). Peers Supporting Recovery from Substance Use Disorders. SAMHSA.

Substance Abuse and Mental Health Services Administration. (2019). Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings. SAMHSA Publications.

Substance Abuse and Mental Health Services Administration. (2020, May 8). Guidance for Law Enforcement and First Responders Administering Naloxone. SAMHSA.


Substance Abuse and Mental Health Services Administration. (2022, December 6). Results from the 2021 National Survey on Drug Use and Health: Graphics from the Key Findings Report. SAMHSA. 

Szalavitz, M. (2021, September 12). Opioids and Cigarettes Are Both Harmful, but Opioids Have Valid Medical Uses. Scientific American.


Tang, S., Jones, C. M., Wisdom, A., Lin, H. C., Bacon, S., & Houry, D. (2021). Adverse childhood experiences and stimulant use disorders among adults in the United States. Psychiatry Research, 299, 113870. 

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Troilo, M. (2018, December 7). We know how to prevent opioid overdose deaths for people leaving prison. So why are prisons doing nothing? Prison Policy Initiative.

Tsai, J., & Gu, X. (2019). Utilization of addiction treatment among US adults with history of incarceration and substance use disorders. Addiction Science & Clinical Practice, 14, 1-9.

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U.S. Department of Veterans Affairs. (2016, June 28). Opioid Overdose Rescue with Naloxone Nasal Spray 4mg: Patient Guide. U.S. Department of Veterans Affairs.


University of Missouri, St. Louis - Missouri Institute of Mental Health. USML Addiction Science Team DOTS+MOBILE. UMSL-MIMH First Responder + Public Health Team. 


Vazda, A., Xia, W., & Engqvist, H. (2021). The use of heat to deliver fentanyl via pulmonary drug delivery. International Journal of Pharmaceutics: X, 3, 100096.


Velazquez, T., Remrey, L. (2022). Methamphetamine Use, Overdose Deaths, and Arrests Soared From 2015 to 2019. The Pew Charitable Trusts.


Violanti, J. (2018, May). PTSD among Police Officers: Impact on Critical Decision Making. Community Policing Dispatch, 11(5).

Wakeman, S. E., Larochelle, M. R., Ameli, O., Chaisson, C. E., McPheeters, J. T., Crown, W. H., ... & Sanghavi, D. M. (2020). Comparative effectiveness of different treatment pathways for opioid use disorder. The Journal of the American Medical Association Network Open, 3(2), e1920622-e1920622. doi:10.1001/jamanetworkopen.2019.20622

Walley, A. Y., Lodi, S., Li, Y., Bernson, D., Babakhanlou‐Chase, H., Land, T., & Larochelle, M. R. (2020). Association between mortality rates and medication and residential treatment after in‐patient medically managed opioid withdrawal: a cohort analysis. Addiction, 115(8), 1496-1508. doi: 10.1111/add.14964

Walley, A., Xuan, Z., Hackman, H., Quinn, E., Doe-Simkins, M., Sorensen-Alawad, A., Ruiz, S., & Ozonoff, A. (2013). Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis. British Medical Journal, 346.

Walley, A., Xuan, Z., Hackman, H., Quinn, E., Doe-Simkins, M., Sorensen-Alawad, A., Ruiz, S., & Ozonoff, A. (2013). Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis. British Medical Journal, 346.

Watson, P., Norman, S. B., Maguen, S., & Hamblen, J. (2022, October 26). Moral Injury in Health Care Workers. National Center for PTSD.


Werb, D., Kamarulzaman, A., Meacham, M. C., Rafful, C., Fischer, B., Strathdee, S. A., & Wood, E. (2016). The effectiveness of compulsory drug treatment: A systematic review. The International Journal of Drug Policy, 28, 1–9.

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