“Pick up anything that moves”: a qualitative analysis of a police crackdown against people who use drugs in Tijuana, Mexico

Abstract

Background: Homeless people who use drugs (PWUD) are often displaced, detained, and/or forced into drug treatment during police crackdowns. Such operations follow a zero-tolerance approach to law enforcement and have a deleterious impact on the health of PWUD. In Mexico, municipal police officers (MPOs) conducted the largest crackdown documented at the Tijuana River Canal (Tijuana Mejora) to dismantle an open drug market. We analyzed active-duty MPOs' attitudes on the rationale, implementation, and outcomes of the crackdown. We also included the involvement of non-governmental allies in the disguised imprisonment as drug treatment referral and potential legal consequences of having illegally detained PWUD. Methods: Between February-June 2016, 20 semi-structured interviews were conducted with MPOs in Tijuana. Interviews were transcribed, translated and coded using a consensus-based approach. Emergent themes, trends and frameworks were analyzed through a hermeneutic grounded theory protocol. Results: Participants recognized the limitations of Tijuana Mejora in effectively controlling crime and addressing drug treatment solutions. MPOs perceived that the intent of the operation was to displace and detain homeless PWUD, not to assist or rehabilitate them. The police operation was largely justified as a public safety measure to reduce the risk of injury due to flooding, decrease drug consumption among PWUD and protect local tourism from PWUD. Some participants perceived the crackdown as a successful public health and safety measure while others highlighted occupational risks to MPOs and potential human rights violations of PWUD. Conclusions: Tijuana Mejora illustrated why public and private actors align in enforcing zero-tolerance drug policy. Perceptions of care are often based on captivity of the diseased, not in health and well-being of PWUD. Officer perceptions shed light on the many limitations of this punitive policing tool in this context. A shift towards evidence-based municipal strategies to address drug use, wherein police are perceived as partners in harm reduction rather than antagonists, is warranted.

Preferences and acceptability of law enforcement initiated referrals for people who inject drugs: a mixed methods analysis

“…A self-referral program might be theoretically practical in Tijuana; however, mistrust toward the police will need to be overcome for PWID to voluntarily approach officers. In addition, previous analyses from our study found that LEOs were often reluctant to refer PWID due to fear of being accused of kidnapping [28]. While both PWID and LEOs reported a relatively high acceptance of a theoretical referral program, there is currently no system in place to facilitate voluntary referrals.…”

“…Additionally, few police officers believed current policing strategies were effective or that arrest efficiently reduced drug use [18]. Similarly, LEOs in Tijuana found current policing strategies ineffective at reducing drug use [28].…”

“…The drug treatment resources that currently exist in Tijuana and other parts of Mexico range from abstinence-based centers that often violate human rights to voluntary, evidence-based methadone maintenance clinics [27]. To reduce visibility of drug use as part of the city's beautification efforts, LEOs have previously referred PWID to services [28]. However, these referrals have been limited to forced referrals to compulsory abstinence programs [27].…”

Reducing police occupational needle stick injury risk following an interactive training: the SHIELD cohort study in Mexico

“…A substantial and growing body of empirical literature enumerates the harms of abusive practices by police. [3][4][5][6] Little is known, however, about how police occupational health concerns and stressors may shape officer behaviour. Recognising the role of policing as a structural driver of health outcomes also highlights the paucity Strengths and limitations of this study ► Presents the first longitudinal analysis on police behavioural change resulting from a training intervention to reduce needle stick injury (NSI) and officer practices deleterious to public health.…”

Municipal police support for harm reduction services in officer-led referrals of people who inject drugs in Tijuana, Mexico

“…An estimated 12,000 PWID reside in Tijuana where HIV prevalence is approximately 4.2%, a burden of disease approximately ten times the national average [14]. Robust local research has described a blighted history of abusive drug law enforcement practices including large-scale police 'crackdown' operations, routine spatial regulation of homeless PWID, human rights abuses by police, forced drug detoxification, in addition to aggressive policing near harm reduction services [18,27,34,35,42,[46][47][48][49][50][51].…”