What Are Community Supervision Officers’ Knowledge and Views of Naloxone? An Exploratory Study

• Published date: 01 February 2025
• DOI: http://doi.org/10.1177/00938548241292247
• Author: Linsey A. Belisle,Tereza Trejbalová,Kimberly R. Kras
• Date: 01 February 2025
• Subject Matter: Articles

CRIMINAL JUSTICE AND BEHAVIOR, 2025, Vol. 52, No. 2, February 2025, 214 –232.

DOI: https://doi.org/10.1177/00938548241292247

Article reuse guidelines: sagepub.com/journals-permissions

© 2024 International Association for Correctional and Forensic Psychology

214

WHAT ARE COMMUNITY SUPERVISION

OFFICERS’ KNOWLEDGE AND

VIEWS OF NALOXONE?

An Exploratory Study

LINSEY A. BELISLE

Boise State University

TEREZA TREJBALOVÁ

KIMBERLY R. KRAS

San Diego State University

Naloxone is a critical component in fighting the opioid epidemic, particularly for justice-involved individuals who are at an

increased risk of drug-related deaths. However, numerous barriers to carrying the medication continue to exist for individuals

under community supervision. Little is known about community supervision officers’ perceptions and knowledge surround-

ing Naloxone, which is critical in understanding barriers to Naloxone possession for those on supervision. To address this

gap in the literature, this exploratory mixed-methods study gathered data through an online survey of community supervision

officers (n = 109). The findings suggest that while Naloxone is widely known among community supervision officers, there

is a need for more consistent training to improve knowledge, address stigmas/misconceptions, and further equip officers to

support overdose prevention through harm reduction. Future research on this topic is crucial to help address barriers to dis-

tributing and using Naloxone to reduce opioid overdose deaths among those on community supervision.

Keywords: probation; parole; substance use; harm reduction; stigma; health

AUTHORS’ NOTE: This research was supported in part by the JCOIN cooperative U2C DA 050097 (mPI,

Taxman and Rudes), funded by the National Institute on Drug Abuse (NIDA), National Institutes of Health

(NIH), through the NIH HEAL Initiative. The authors gratefully acknowledge the collaborative contributions

of NIDA. The contents of this publication are solely the responsibility of the authors and do not necessarily

represent the official views of NIDA, the NIH HEAL Initiative, or the participating sites. The authors would

like to thank the American Probation and Parole Association (APPA) leadership for supporting this research

and distributing the survey in the monthly e-newsletters. They would also like to thank graduate students, Cheri

Chowdhury and Magalli Morado Landaverde for their assistance in parts of the data management phases.

Correspondence concerning this article should be addressed to Linsey A. Belisle, School of Public Service,

Boise State University, 1910 University Drive, Boise, ID 83725. e-mail: linseybelisle@boisestate.edu

1292247CJBXXX10.1177/00938548241292247Criminal Justice and BehaviorBelisle et al. /

research-article2024

Belisle et al. / COMMUNITY SUPERVISION OFFICERS’ & NALOXONE 215

INTRODUCTION

Overdose fatalities, most of which are tied to opioid use, remain a leading cause of death

in the United States (Centers for Disease Control and Prevention [CDC], 2022a). From

1990 to 2020, over 550,000 individuals died from an opioid-related overdose (CDC, 2022b),

contributing to the United States having the highest rate of opioid-related deaths in the

world (Congressional Budget Office, 2022). Another rising concern surrounding overdose

fatalities is other substances (both opioids and nonopioids) being “cut” with fentanyl—a

highly potent drug—often without users’ knowledge (CDC, 2023a; Drug Enforcement

Administration [DEA], 2021). Justice-involved persons are at high risk of using opioids and

experiencing overdose fatalities (Binswanger et al., 2007; Bougler et al., 2022; Morrison

et al., 2024; Ranapurwala et al., 2018). To address the ongoing concern of opioid overdoses,

especially among at-risk populations such as justice-involved individuals, the U.S.

Department of Health and Human Services (DHHS, n.d.) emphasizes the use of evidence-

based overdose prevention strategies, including harm reduction practices.

Harm reduction minimizes the harms of a behavior when abstinence is not realistic or

feasible (Logan & Marlatt, 2010; Marlatt, 1996). Naloxone is an example of a harm reduc-

tion tool; Naloxone is a legal opioid antagonist medication that can reverse fatal opioid

overdoses (National Institute on Drug Abuse [NIDA], 2022). Given its ability to reverse

fatal opioid overdoses, Naloxone is a key component in fighting the opioid epidemic,

particularly for justice-involved persons who are at an increased risk of drug-related deaths

(Harm Reduction International, 2020). This positions community supervision officers

(probation/parole) at the front lines of intervention and harm reduction strategies.

In response to the opioid epidemic, steps have been taken to advance community super-

vision officers’ education surrounding Naloxone (American Probation and Parole

Association [APPA], 2019) and increase distribution efforts of the medication (see Horton

et al., 2017). However, research suggests that individuals on supervision have a fear that

possessing Naloxone will lead to negative consequences related to their supervision (e.g.,

violations; Anthony-North et al., 2018; Bennett et al., 2020; Lae et al., 2021; Sondhi et al.,

2016). These concerns act as a barrier for individuals on supervision to access and carry this

life-saving medication. While research has highlighted these concerns exist, little research

has explored the validity of these concerns. More specifically, community supervision offi-

cers’ overall knowledge and perceptions of their clients’ Naloxone possession remain

unknown. The current study aims to address this gap in the literature by surveying probation

and parole officers (POs) in the United States (n = 109) to better understand their overall

knowledge and perceptions of Naloxone.

NALOXONE: A HARM REDUCTION APPROACH TO REDUCING OPIOID OVERDOSE FATALITIES

Harm reduction strategies focus on minimizing the negative consequences of a behavior

when it is unlikely or unrealistic to achieve abstinence from that behavior (Logan & Marlatt,

2010; Marlatt, 1996). While harm reduction has been utilized to address many areas of

social concern (e.g., condoms, seatbelts, etc.), substance use harm reduction focuses on

reducing the net consequences for individuals who continue to use drugs (Lenton & Single,

1998; Marlatt & Witkiewitz, 2010). Research has found overwhelming evidence that sub-

stance use harm reduction strategies such as medication-assisted treatment, needle exchange

programs, Naloxone distribution, and supervised injection facilities successfully and