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

Substance Abuse Treatment, Prevention, and Policy

Jaime Arredondo¹  Arnulfo Bañuelos²  Alicia Harvey-Vera³  Erika Clairgue³  Gabriella K. Olgin³  Annick Bórquez³  Steffanie Strathdee³  Javier A. Cepeda⁴  Pieter Baker⁵  Leo Beletsky⁶  Mario Morales⁷ 

[1] Centro de Investigación y Docencia Económica, Aguascalientes, Mexico;Department of Planning and Special Projects, Secretaría de Seguridad Pública Municipal, Tijuana, Mexico;Division of Infectious Diseases and Global Public Health, University of California,San Diego, La Jolla, CA, USA;Division of Infectious Diseases and Global Public Health, University of California,San Diego, La Jolla, CA, USA;Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Division of Infectious Diseases and Global Public Health, University of California,San Diego, La Jolla, CA, USA;Graduate School of Public Health, San Diego State University, San Diego, CA, USA;Division of Infectious Diseases and Global Public Health, University of California,San Diego, La Jolla, CA, USA;School of Law and Bouve College of Health Sciences, Northeastern University, Boston, MA, USA;School of Government and Public Policy, University of Arizona, Tucson, AZ, USA;

关键词: People who inject drugs;    Law enforcement;    Harm reduction;    Referral;   

DOI  :  10.1186/s13011-020-00319-w

来源: Springer

【 摘 要 】

BackgroundLaw enforcement officers (LEOs) come into frequent contact with people who inject drugs (PWID). Through service referrals, LEOs may facilitate PWID engagement in harm reduction, substance use treatment, and other health and supportive services. Little is known about PWID and LEO attitudes and concerns about service referrals, however. The objective of this mixed-methods study was to examine the alignment of service referral preferences and acceptability among PWID and LEOs in Tijuana, Mexico.MethodsWe assessed service referral preferences and perceived likelihood of participation in health and social services, integrating data from structured questionnaires with 280 PWID and 306 LEOs, contextualized by semi-structured interviews and focus groups with 15 PWID and 17 LEOs enrolled in two parallel longitudinal cohorts in Tijuana, Mexico.ResultsAmong potential service referral options, both PWID (78%) and LEOs (88%) most frequently cited assistance with drug- and alcohol-use disorders. Over half of PWID and LEOs supported including harm reduction services such as syringe service programs, overdose prevention, and HIV testing. The majority of PWID supported LEO referrals to programs that addressed basic structural needs (e.g. personal care [62%], food assistance [61%], housing assistance [58%]). However, the proportion of LEOs (30–45%) who endorsed these service referrals was significantly lower (p <  0.01). Regarding referral acceptability, 71% of PWID reported they would be very likely or somewhat likely to make use of a referral compared to 94% of LEOs reporting that they thought PWID would always or sometimes utilize them. These results were echoed in the qualitative analysis, although practical barriers to referrals emerged, whereby PWID were less optimistic that they would utilize referrals compared to LEOs.ConclusionsWe identified strong support for LEO service referrals among both LEO and PWID respondents, with the highest preference for substance use treatment. LEO referral programs offer opportunities to deflect PWID contact with carceral systems while facilitating access to health and social services. However, appropriate investments and political will are needed to develop an evidence-based (integrated) service infrastructure.

【 授权许可】

CC BY