Supervised injection services (SIS) provide safer spaces for people to inject drugs and help reduce the risk of overdose and behaviours linked to HIV and hepatitis C. Now more than ever, as Canada continues to experience an overdose crisis that took nearly 4,000 lives in 2017, people who use drugs need barrier-free access to these services. Policing practices – such as arresting people near harm reduction programs – can be major barriers to SIS attendance and operation.
We recently completed a study focused on how to improve SIS-police relationships. For this research, we interviewed SIS managers, program coordinators and police liaisons in Europe, Australia, Quebec and British Columbia, reviewed international literature on harm reduction training for police, and conducted focus group consultations with Toronto-based SIS/harm reduction workers, people who inject drugs and police. Our multi-stakeholder team (including researchers, SIS managers, harm reduction workers and student trainees) used the information we gathered to identify factors that may help to improve relationships between SIS and local police. Here are our five recommendations:
1. Early SIS-police engagement and dialogues
Relationship-building dialogues should start as early as possible, ideally during community planning for an SIS, or at least well before the opening of a new SIS. Early stakeholder engagement and communication give the police time to learn about the role of the SIS in the community and prepare for changes in policing practices. Officially sanctioned sites receive federal exemptions from enforcement of drug laws inside their premises. Police in neighbourhoods where services are established should understand the importance and implications of these exemptions before an SIS opens in the community.
2. Support of SIS from police chiefs and senior administrators
When municipal police chiefs and senior administrators vocalize their support for SIS, they send the important message that these services are regarded as credible and valuable by frontline officers and many community members. Early dialogues also foster buy-in from senior police when they are invited to learn about the ways an SIS can help protect the lives of people who use drugs.
3. Dedicated police liaisons for SIS
Police officers designated as local SIS liaisons can help improve interactions between people using the SIS and the police if problematic encounters occur, acting as mediators if needed. Problems can include police improperly searching or arresting SIS users. Police liaisons can assist with communicating to other officers concrete and mutually agreed-upon practices for interacting with SIS.
4. Agreements on police entry and presence
The effectiveness of an SIS depends on people who use drugs trusting and being willing to use the service. To preserve service uptake, police should not enter an SIS during operating hours, nor maintain close proximity to an SIS, such as parking a police vehicle right in front of a facility. There might, of course, be times when police need to enter an SIS, such as when they are called by staff or are in pursuit of a suspect. Formal protocols and policies developed between the SIS and the police can help establish appropriate boundaries and support conflict resolution.
5. Regular face-to-face (non-adversarial) contact
Scheduled check-ins or meetings, including organized police tours or visits to their local SIS during non-operational hours, can promote mutual familiarity. Regular in-person contact with the SIS appears to be just as educational as formal training, if not more so, by showing police officers how an SIS works and promoting the health of people who use drugs.
As the overdose crisis continues across Canada, ensuring that people who use drugs have unhampered access to health services is crucial. Increasing police understanding of the need and role of harm reduction in addressing this crisis may improve their cooperation with SIS and reduce barriers to access. Strong local leadership and a spirit of collaboration from police, public health, health services and community members are essential to cultivate the five factors we have outlined.
Tara Marie Watson has a PhD in criminology and is currently a research fellow at the Centre for Addiction and Mental Health in Toronto. Her research interests include drug policy, harm reduction, cannabis legalization, and impacts involving diverse populations. For over a decade, she has coordinated and conducted qualitative research related to harm reduction programs for people who use drugs.
Carol Strike, PhD, is a professor at the Dalla Lana School of Public Health, University of Toronto, and a scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital. Her research program aims to improve health services for people who use drugs and other marginalized populations.