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Municipal police support for harm reduction services in officer-led referrals of people who inject drugs in Tijuana, Mexico
- Source :
- Harm Reduction Journal, Vol 18, Iss 1, Pp 1-10 (2021), Harm reduction journal, vol 18, iss 1, Harm Reduction Journal
- Publication Year :
- 2021
- Publisher :
- BMC, 2021.
-
Abstract
- Background Police constitute a structural determinant of health and HIV risk of people who inject drugs (PWID), and negative encounters with law enforcement present significant barriers to PWID access to harm reduction services. Conversely, police may facilitate access via officer-led referrals, potentiating prevention of HIV, overdose, and drug-related harms. We aimed to identify police characteristics associated with support for officer-led referrals to addiction treatment services and syringe service programs (SSP). We hypothesized that officers who believe harm reduction services are contradictory to policing priorities in terms of safety and crime reduction will be less likely to support police referrals. Methods Between January and June 2018, police officers (n = 305) in Tijuana, Mexico, completed self-administered surveys about referrals to harm reduction services during the 24-month follow-up visit as part of the SHIELD police training and longitudinal cohort study. Log-binomial regression was used to estimate adjusted prevalence ratios and model policing characteristics and attitudes related to officers’ support for including addiction treatment and SSP in referrals. Results Respondents were primarily male (89%), patrol officers (86%) with a median age of 38 years (IQR 33–43). Overall, 89% endorsed referral to addiction services, whereas 53% endorsed SSP as acceptable targets of referrals. Officers endorsing addiction services were less likely to be assigned to high drug use districts (adjusted prevalence ratio [APR] = 0.50, 95% CI 0.24, 1.08) and more likely to agree that methadone programs reduce crime (APR = 4.66, 95% CI 2.05, 9.18) than officers who did not support addiction services. Officers endorsing SSPs were younger (adjusted prevalence ratio [APR] = 0.96 95% CI 0.93, 0.98), less likely to be assigned to high drug use districts (APR = 0.50, 95% CI 0.29, 0.87), more likely to believe that methadone programs reduce crime (APR = 2.43, 95% CI 1.30, 4.55), and less likely to believe that SSPs increase risk of needlestick injury for police (APR = 0.44, 0.27, 0.71). Conclusions Beliefs related to the occupational impact of harm reduction services in terms of officer safety and crime reduction are associated with support for referral to related harm reduction services. Efforts to deflect PWID from carceral systems toward harm reduction by frontline police should include measures to improve officer knowledge and attitudes about harm reduction services as they relate to occupational safety and law enforcement priorities. Trial Registration: NCT02444403.
- Subjects :
- Male
Needlestick injury
Medicine (miscellaneous)
8.1 Organisation and delivery of services
Occupational safety and health
Substance Misuse
0302 clinical medicine
Law Enforcement
030212 general & internal medicine
Longitudinal Studies
Law enforcement
Substance Abuse, Intravenous
Referral and Consultation
media_common
Harm reduction
Substance Abuse
Police
Psychiatry and Mental health
Health psychology
Infectious Diseases
Public Health and Health Services
HIV/AIDS
Female
Mental health
Public aspects of medicine
RA1-1270
0305 other medical science
Intravenous
Referral
Health and social care services research
Adult
medicine.medical_specialty
media_common.quotation_subject
Addiction
Officer
03 medical and health sciences
Harm Reduction
Clinical Research
Behavioral and Social Science
medicine
Humans
Mexico
030505 public health
business.industry
Research
Prevention
Public Health, Environmental and Occupational Health
HIV
medicine.disease
Brain Disorders
Good Health and Well Being
Family medicine
Syringe service program
business
Drug Abuse (NIDA only)
People who use drugs
Subjects
Details
- Language :
- English
- ISSN :
- 14777517
- Volume :
- 18
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Harm Reduction Journal
- Accession number :
- edsair.doi.dedup.....eaeb8da4e39cf7cae2285f1fef4258fa