Seminole County, FL Sheriff Dennis Lemma has been a statewide and national leader on responding to and preventing opioid overdoses.

Sheriff Lemma spoke with PERF Executive Director Chuck Wexler about his agency’s strategy of building partnerships for treatment, while also pursuing murder charges against more than 25 dealers.

Chuck Wexler: How big is Seminole County? How many deputies do you have?

Sheriff Lemma: Seminole County is rather small geographically – a little over 310 square miles – with a population of half a million, just north of Orlando. Our agency consists of 1,400 members. About 600 are sworn deputy sheriffs, 300 are detention deputies, and the remainder are civilians.

We’re the third-most densely populated county in the state of Florida. In those 310 square miles there are eight police departments we work with closely. Seven are municipalities, and the eighth is an international airport police department.

Wexler: How did you start tackling the opioid issue, and what is the scope of the problem in Seminole County?

Sheriff Lemma: When Ashley Moody was elected Florida Attorney General in November 2018, I was part of her transition team. She asked me to take the lead on opioid work across the state of Florida. At that time, we were losing 19 people a day to opioid-related overdoses.

17 other leaders from across the state and I made some recommendations based on a white paper we authored in 2019.  Our governor, Ron DeSantis, created a statewide opioid task force, named Attorney General Moody the chair, and I was elected the vice-chair.

This was all coming together right around the time that COVID hit, and we found that COVID-19 brought with it an unprecedented increase in opioid-related overdoses and fatalities. That’s not unique to Seminole County. It’s happening across the state and in a good portion of the country.

Just here in Seminole County, in 2020 we had 750 overdoses and more than 110 overdose deaths. Prior to COVID-19, there’s never been something resulting in that many people dying of any one thing in our 110-year history as a county.

I’ve been with the Sheriff’s Office for 29 years, and we’ve always believed that crime is a symptom of another problem. If we address the underlying conditions that lead people down that path in the first place, we can not only save lives, but also reduce the criminal activity.

When the smoke clears with COVID, there’s going to be a lot of cleaning up to do with substance abuse and mental health. But we’ve done some pretty innovative things to combat it.

Wexler: Which opioids are you seeing in Seminole County?

Sheriff Lemma: We know the effects big pharma has had, particularly the Sackler family and Purdue Pharmaceutical, with the overprescribing of drugs. When the prescription pill monitoring systems were put in place, people were traveling from across the country to find a state where they could still “pill-shop.” Then-Florida Attorney General Pam Bondi worked with Governor Rick Scott to ban pill mills and implement a prescription pill monitoring system here.

Unfortunately, at that time there were more than 950 pill mills across the state of Florida. We know that created dependency on the substance. Through our research, we found that more than 80% of the people now addicted to opioids were at one time legally prescribed the drug by somebody they trusted. These are the physicians who were convinced by the Food and Drug Administration that with proper use of prescription painkillers, particularly OxyContin, there was a less than 0.5% chance they’d become addicted. Through the criminal and civil lawsuits, we know that simply was not the case.

Now we’re seeing the influx of fentanyl and carfentanil. Fentanyl is 100 times more potent than morphine, and 50 times more potent than heroin. A microgram, which is equivalent to eight grains of salt, is a lethal dose. We’re seeing this mixed in with knockoff versions of OxyContin made in clandestine labs. We’re also seeing it laced in other substances, like marijuana and cocaine. We’re reviving people and asking how long they’ve been doing heroin, and they respond that they don’t do heroin. That’s clearly leading to the unprecedented deaths.

Wexler: Can you tell us about your nonfatal and fatal overdose teams?

Sheriff Lemma: Our first approach is a nonfatal overdose team. Through research and evidence, we’ve concluded that the number one predictor of whether somebody will overdose and die is whether they have already overdosed and survived. A nonfatal overdose actually increases their likelihood of overdosing and dying within the next 12 months by over 800 times.

In many jurisdictions, when a person is found unconscious and is revived with some kind of opioid antagonist, like Narcan, they’re transported to a local hospital. Once the patient is stabilized, they’re released back into the environment they just overdosed in, which increases their likelihood of overdosing and dying very quickly.

In partnership with other organizations, including a large hospital chain, we send navigators from the Sheriff’s Office out to the person who has overdosed and, as importantly, to the family members behind them who are scratching their heads, crying into their pillows at night, and wondering what resources are available. Our investigators follow up and provide aftercare with that person, which can be up to 10 weeks to get them the help they need.

For fatal overdoses, every single fatal overdose is absolutely not an accidental death. Unfortunately, many jurisdictions across the country are still treating overdoses that way. If you forensically examine the phone, one of the five most frequently called numbers is probably going to be the drug dealer.

Our local state attorney, Phil Archer, has allowed us to charge more than 25 individuals with first degree murder when they have dealt deadly doses of narcotics.

There is also a legislative measure, which is supported by the Florida Sheriffs Association, that would allow for three things. One, it would allow for an increased penalty for drug dealers selling in proximity to a drug treatment facility. Here in Florida, there’s an increased penalty if you’re selling in proximity to a church, a playground, or a public park, but there is no increased penalty if you’re a dealer selling drugs in proximity to a location where somebody is trying to get clean.

Two, it would allow for drug dealers to be charged with a third-degree felony. As law enforcement agencies become more accustomed to deploying opioid antagonists, such as Narcan, in many cases the drug dealer is being saved from felony prosecution when we save the person’s life. This would allow a new third-degree felony charge of culpable negligence if we have to administer Narcan to bring a person back to life, and then we track that drug dealer down.

Three, many people who are overdosing and dying have some type of cocktail of substances in their system. There may be a high prevalence of cocaine, marijuana, or other substances. Percentage-wise, the fentanyl may not be the primary cause of death, but it still may be a lethal dose. We’re working to change the definitions in Florida law to allow for charging somebody with murder if they deal a lethal dose of fentanyl or carfentanil but it’s not the primary substance in the person’s system.

Wexler: How do you support treatment options?

Sheriff Lemma: In Florida, sheriffs are responsible for county law enforcement, as well as county probation and the correctional facility. In our correctional facility, we do all three forms of FDA-approved medical-assisted treatment. The medical doctors in our facility, who work for my office, can administer methadone, buprenorphine, and vivitrol. We also do cognitive behavioral therapy.

Our local hospital group, AdventHealth, has partnered with our county to create a clinic across from our facility called the Hope and Healing Center. At their discretion, deputy sheriffs and police officers will be able to bring people there for a pre-arrest diversion program. That will avoid putting someone in jail when they really need treatment. But that will only come at the recommendation at the arresting officer.

Wexler: How did your partnership with AdventHealth develop?

Sheriff Lemma: AdventHealth is a faith-based hospital group that always wants to do something remarkable for the community. I had some conversations with their CEO. We benefit from their compassion and altruism. We shared the effect this issue is having on our community, and said that the greatest responsibility of a civilized society is to protect and preserve human life. We also estimated the cost of traditional incarceration if we don’t break the cycle and fix what’s broken. If a parent is either addicted to a substance or incarcerated, the children are eight times more likely to engage in maladaptive behavior themselves.

Wexler: How do you pay for these programs?

Sheriff Lemma: We were able to do all of this without shifting the burden to taxpayers. This did not increase our budget at all. It’s funded independently through our public/private partnerships with organizations like Walmart. Our mental health provider, Aspire, has received grants. We have had incredibly generous people contribute. And AdventHealth provides about $1.5 million of in-kind services through clinical staff hours per year.

The building we use was a work-release center. When COVID hit, I shifted about 300 of our employees into more remote work. I worked with the county to give the building to AdventHealth. So you don’t see the sheriff’s office logo or a reference to a county clinic on the building. You walk up and feel like you’re walking into a state-of-the-art medical environment for AdventHealth.

Wexler: Do your deputies carry naloxone?

Sheriff Lemma: They do. I’m on the board of directors for a foundation in honor of David and Jackie Siegel, who are the owners of Westgate Resorts. They lost their 18-year-old daughter Victoria to an overdose. David did a lot of work in Washington, D.C. to promote access to Narcan. He funded a lot of the initiatives in Florida and provided support to law enforcement agencies. That and other grants have helped agencies across our state.

We also have a unique relationship with the Washington/Baltimore HIDTA (High Intensity Drug Trafficking Area). In 2019 they offered a grant opportunity for states to apply for an ODMAP expansion grant. ODMAP is the best way to document these incidents and share information across the country. The Seminole County Sheriff’s Office applied for that grant on behalf of the state of Florida, and we were awarded $750,000 to expand ODMAP usage across our state. We awarded funding to five jurisdictions across the state to help us roll out ODMAP.

As soon as COVID-19 clears, we’ll keep pushing all law enforcement agencies across our state and country to use Narcan and have some type of collaboration with EMS to track overdoses and make sure we’re getting accurate, timely data.

Wexler: Why is it important for sheriffs to take on this issue?

Sheriff Lemma: When I started 30 years ago, I never thought we’d have our deputy sheriffs and police officers carrying medicine on their belts to bring people back to life.

When we first started going down this path, some people were skeptical. Then law enforcement officers and corrections personnel started to see someone’s life transform in front of them, and we felt good about it. I think all of us who have taken the oath to join this occupation did it because we wanted to help somebody.

And from a law enforcement perspective, if we can fix substance abuse, mental health, and poor parenting, then we can ultimately reduce crime. Dependency, mental health, and poor parenting lead to criminal activity. If we can address those on the front end, it’s cheaper, saves lives, and ultimately reduces crime.


The PERF Critical Issues Report is part of the Critical Issues in Policing project, supported by the Motorola Solutions Foundation.


PERF also is grateful to the Howard G. Buffett Foundation for supporting this work.