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Governments must strike a balance of relative impacts, while recognising that using the criminal justice system to combat drug use is problematic; be it due to social harm (e.g., conviction records and incarceration) or the fact that it is not fiscally sustainable. For instance, people interacting with the UK justice system on drug offences make up 14% of the untried population in custody and 21% of those convicted but unsentenced in custody. In the US, drug offenders make up approximately 12.5% of sentenced individuals in state prisons (127,661 people). Consequently, states, counties, and local jurisdictions have made an effort to divert some of the lowest-level offences (e.g., drug possession) away from formal justice system sanctions. While diverting drug offenders has generally been shown to help reduce social and fiscal problems, drug poisoning (overdose) rates remain high in many countries as well. The UK reports that the most recent age-adjusted, drug overdose death rate is approximately 84 deaths per million people, while the US reports a rate is closer to 217 deaths per million. With this context, some people question if diversion promotes drug use and is a missed opportunity for the justice system to act as an avenue to treatment. In an effort to gauge the aggregate impact of pre-arrest (police-led) diversion, we employ a synthetic control design in an interrupted time series analysis examining the UK and US, among others. Relying on official data over the last 10 years, we compare jurisdictions that engaged in a systematic diversion effort (e.g., West Midlands, UK and Oregon, US) to similar areas that did not, while controlling for multiple factors on which the jurisdictions may differ (e.g., police workforce size, unemployment, population). We discuss the detectable impact of pre-arrest diversion on key outcomes and implications regarding police reported crime, arrests, and prosecutions.