The impact of a police crackdown on a street drug scene: evidence from the street

Aitken, Campbell; Moore, David; Higgs, Peter; Kelsall, Jenny; Kerger, Michael

doi:10.1016/s0955-3959(02)00075-0

Cited by 239 publications

(169 citation statements)

References 6 publications

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“…[31][32][33][34][35][36][37][38][39][40][41] Notably, however, some past research suggests that SEPs are able to maintain the volume of syringes they distribute during police drug crackdowns, though the number of injectors going to the SEPs declines. 82,83 Our findings suggest that sustaining the volume of syringes flowing into communities when drug-related enforcement activities intensify is not enough; drug-related arrests appear to hinder injectors' ability to actually use these syringes. When enforcement activities escalate, injectors may not carry syringes to their injection site in order to reduce their risk of being identified as a user during a police search.…”

Section: Discussionmentioning

confidence: 88%

Spatial Access to Sterile Syringes and the Odds of Injecting with an Unsterile Syringe among Injectors: A Longitudinal Multilevel Study

et al. 2012

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Despite the 2010 repeal of the ban on spending federal monies to fund syringe exchange programs (SEPs) in the USA, these interventions-and specifically SEP site locations-remain controversial. To further inform discussions about the location of SEP sites, this longitudinal multilevel study investigates the relationship between spatial access to sterile syringes distributed by SEPs in New York City (NYC) United Hospital Fund (UHF) districts and injecting with an unsterile syringe among injectors over time (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006). Annual measures of spatial access to syringes in each UHF district (N = 42) were created using data on SEP site locations and site-specific syringe distribution data. Individual-level data on unsterile injecting among injectors (N = 4,067) living in these districts, and on individual-level covariates, were drawn from the Risk Factors study, an ongoing cross-sectional study of NYC drug users. We used multilevel models to explore the relationship of district-level access to syringes to the odds of injecting with an unsterile syringe in 975% of injection events in the past 6 months, and to test whether this relationship varied by district-level arrest rates (per 1,000 residents) for drug and drug paraphernalia possession. The relationship between district-level access to syringes and the odds of injecting with an unsterile syringe depended on district-level arrest rates. In districts with low baseline arrest rates, better syringe access was associated with a decline in the odds of frequently injecting with an unsterile syringe (AOR, 0.95). In districts with no baseline syringe access, higher arrest rates were associated with increased odds of frequently injecting with an unsterile syringe (AOR, 1.02) When both interventions were present, arrest rates eroded the protective effects of spatial access to syringes. Spatial access to syringes in small geographic areas appears to reduce the odds of injecting with an unsterile syringe among local injectors, and arrest rates elevate these odds. Policies and practices that curtail syringe flow in geographic areas (e.g., restrictions on SEP locations or syringe distribution) or that make it difficult for injectors to use the sterile syringes they have acquired may damage local injectors' efforts to reduce HIV transmission and other injection-related harms.

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Section: Discussionmentioning

confidence: 88%

Spatial Access to Sterile Syringes and the Odds of Injecting with an Unsterile Syringe among Injectors: A Longitudinal Multilevel Study

et al. 2012

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“…Overall, 92% were male and 99% considered themselves Hispanic or Latino. Median age was 34 years [interquartile range (IQR): [28][29][30][31][32][33][34][35][36][37][38][39][40] and median time since first injection was 12.5 years (IQR: [8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Study Populationmentioning

confidence: 99%

“…In particular, there is growing evidence that policing practices have a substantial impact on IDUs' ability to adhere to safe injection practices. Qualitative studies have shown that fear of police detection and detainment can discourage purchase and carrying of sterile syringes, even in settings where over-the-counter syringe sales and possession are legal, leading to syringe sharing [10][11][12][13][14]. Fears of police detection also lead to hurried injection, particularly in public places, resulting in sharing of syringes and other injection paraphernalia [10][11][12]14,15].…”

Section: Introductionmentioning

confidence: 99%

“…Qualitative studies have shown that fear of police detection and detainment can discourage purchase and carrying of sterile syringes, even in settings where over-the-counter syringe sales and possession are legal, leading to syringe sharing [10][11][12][13][14]. Fears of police detection also lead to hurried injection, particularly in public places, resulting in sharing of syringes and other injection paraphernalia [10][11][12]14,15]. Further, there is evidence that aggressive policing practices lead to higher utilization of shooting galleries, where drugs can be used hidden from public view and previously used injection equipment is obtained readily [13,16,17].…”

Section: Introductionmentioning

confidence: 99%

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Syringe possession arrests are associated with receptive syringe sharing in two Mexico–US border cities

Pollini

Brouwer

Lozada³

et al. 2007

Addiction

121

113

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Aims To identify factors associated with receptive syringe sharing among injection drug users (IDUs) and elucidate the association between syringe possession arrests and syringe sharing.Design Cross‐sectional study.Setting Mexican border cities of Tijuana, Baja California and Ciudad Juarez, Chihuahua.Participants IDUs in Tijuana (n = 222) and Ciudad Juarez (n = 206) were recruited using respondent‐driven sampling (RDS). IDUs were ≥ 18 years and had injected illicit drugs in the past month.Measurements An interviewer‐administered survey was used to collect quantitative data on socio‐demographic, behavioral and contextual characteristics, including self‐reported syringe sharing and arrests for syringe possession. Associations with receptive syringe sharing were investigated using logistic regression with RDS adjustment.Findings Overall, 48% of participants reported ever being arrested for carrying an unused/sterile syringe, even though syringe purchase and possession is legal in Mexico. Arrest for possessing unused/sterile syringes was associated independently with receptive syringe sharing [adjusted odds ratio (AOR) = 2.05; 95% confidence interval (CI): 1.26, 3.35], as was injecting in a shooting gallery (AOR = 3.60; 95% CI: 2.21, 5.87), injecting in the street (AOR = 2.05; 95% CI: 1.18, 3.54) and injecting methamphetamine (AOR = 2.77; 95% CI: 1.41, 5.47) or cocaine (AOR = 1.96; 95% CI: 1.15, 3.36). More than half of participants (57%) had been arrested for possessing a used syringe; in a second model, arrest for used syringe possession was also associated independently with receptive sharing (AOR = 2.87; 95% CI: 1.76, 4.69).Conclusions We documented high levels of syringe‐related arrests in two Mexican–US border cities and an independent association between these arrests and risky injection practices. Public health collaborations with law enforcement to modify the risk environment in which drug use occurs are essential to facilitate safer injection practices.

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“…), where their health is placed at risk [16]. Displacement of drug users contributes to their low uptake of public health and social services [17]. Because many drug smokers are stimulant users who are historically very difficult to engage in drug treatment, SIRs represent a pivotal entrypoint where they can begin to be reached.…”

mentioning

confidence: 99%

Commentary on Salmon et al. (2010): The case for safer inhalation facilities—waiting to inhale

Strathdee¹,

Navarro²

2010

Addiction

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Commentary on Salmon et al. (2010):The case for safer inhalation facilities-waiting to inhalea dd_2917 684..685 In recent years, a flurry of scholarly reports have demonstrated the effectiveness of supervised injection facilities (SIFs) as a strategy to reduce physical and social harms associated with injection drug use. Empirical data on SIFs lagged well behind their scale-up, but SIFs have now been shown to decrease HIV risk behaviors [1], overdose deaths [2] and public disorder [3], and increase uptake of detoxification services [4]. In this issue, Salmon and colleagues [5] demonstrate dramatic decreases in ambulance attendances at opioid-related overdoses in the period following the opening of the Sydney SIF, a finding that supports program cost-effectiveness [6]. While SIFs remain controversial, there are at least 90 SIFs in 40 cities globally. To this end, SIFs are becoming increasingly viewed as a necessary component of a comprehensive strategy to reduce drug-related harms and facilitate uptake of medical care and drug treatment among streetbased drug users [3,7].A logical extension of SIFs are supervised inhalation rooms (SIRs), intended for individuals who smoke or snort drugs such as crack cocaine, heroin and methamphetamine; yet most supervised drug consumption programs target drug injectors exclusively. In fact, SIRs operate in only a few countries (e.g. Germany, Holland, Switzerland and Spain) [8][9][10][11], and none have been evaluated formally.The rationale for SIRs may be less obvious than that for SIFs, but is no less important. Sharing of crack pipesparticularly among individuals with sores on their lips as a result of burns and cuts-may contribute to infectious disease transmission [12,13]. Inhalation of methamphetamine has been associated independently with human immunodeficiency virus (HIV) infection among female sex workers, even after accounting for injection drug use [14]. A recent laboratory study suggests that methamphetamine accelerates HIV replication [15]. Furthermore, police crackdowns often drive drug users into clandestine spaces (e.g. abandoned buildings, etc.), where their health is placed at risk [16]. Displacement of drug users contributes to their low uptake of public health and social services [17]. Because many drug smokers are stimulant users who are historically very difficult to engage in drug treatment, SIRs represent a pivotal entrypoint where they can begin to be reached. In Vancouver, willingness to use an inhalation room was associated independently with working in the sex trade, sharing crack pipes, having crack pipes confiscated by police, smoking crack in public places and having burns from hurried drug consumption [9]. As many cities are witnessing decreasing numbers of drug injectors but increasing numbers of people who smoke/snort drugs [18], SIRs warrant a close second look.A powerful case can be made in support of SIRs based upon the personal experience of one of the authors of this commentary (J.R.N.), who helped to coordinate a drug consumption facilit...

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The impact of a police crackdown on a street drug scene: evidence from the street

Cited by 239 publications

References 6 publications

Spatial Access to Sterile Syringes and the Odds of Injecting with an Unsterile Syringe among Injectors: A Longitudinal Multilevel Study

Spatial Access to Sterile Syringes and the Odds of Injecting with an Unsterile Syringe among Injectors: A Longitudinal Multilevel Study

Syringe possession arrests are associated with receptive syringe sharing in two Mexico–US border cities

Commentary on Salmon et al. (2010): The case for safer inhalation facilities—waiting to inhale

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