"We're Actually More of a Likely Ally than an Unlikely Ally": Relationships Between Syringe Services Programs and Law Enforcement

Abstract

Syringe Services Programs (SSPs) provide sterile needles and a range of health services (e.g., HIV and HEP-C testing, overdose prevention education, provision of naloxone) to a hard-to-reach population, including people who inject drugs (PWID), aiming to prevent the transmission of infectious diseases. We performed a qualitative needs assessment of existing SSPs in the state of Colorado in 2018-2019 to describe the SSP activities, needs, and barriers. We performed semi-structured interviews with key program staff of SSPs (n=11). All interviews were digitally recorded, transcribed, and validated. Qualitative researchers coded each transcript and maintained coding consistency through coding statistics (Kappa coefficient > 0.80) between coders. Memos were written to synthesize main themes. Nearly all the SSPs discussed their relationships with law enforcement at length. All SSPs viewed having a positive relationship with law enforcement as critical to the success of their program. Main factors that influence the quality of relationships between SSPs and law enforcement included: 1) alignment in agency culture, 2) support from law enforcement leadership, 3) police officers’ participation and compliance with the Law Enforcement Assisted Diversion (LEAD) program, which provides intensive case management for low-level drug offenders, and 4) implementation of the “Needle-Stick Prevention Law” and Drug Paraphernalia Law Exemption. All SSPs expressed a strong desire to have positive relationships with law enforcement and described how a collaborative working relationship was critical to the success of their programs. Our findings suggest effective strategies to foster relationships between SSPs and law enforcement as well as key barriers to address.