Theme: Epidemiology & Public Health Research Year: 2024
Background: Gaps remain in understanding how traditional policing practices may influence health inequity across diverse substance-using populations. This is problematic given that several cities across Canada are considering or have implemented the decriminalization of personal possession of drugs and require evidence to support policy decision making. We sought to characterize the correlates of police contact and police violence among people who inject drugs (PWID) in Toronto, Canada.
Methods: Quantitative data were generated from a Toronto-based cohort of PWID between November 2019 and February 2023. Data were restricted to the most recent interview provided by participants. We estimated covariate-adjusted prevalence ratios (PR) using modified Poisson regression. Outcomes were defined as past six-month experiences of a) police contact, and b) police physical force.
Results: Among 420 participants, the median age was 39.5 (range: 20.0-75.0), 258 (61.4%) were men, and 228 (54.3%) reported recent contact with police, among whom one-third (n=76) reported experiencing police physical force. In adjusted analyses, once a week or greater use of stimulants (PR: 1.51, 95% confidence interval [CI]: 1.20-1.92) and participation in informal or illegal income generation (PR: 1.64, 95% CI: 1.27-2.12) was positively associated with recent contact with police, while belonging to a racialized, non-Indigenous group (PR: 0.66, 95% CI: 0.45-0.98) was negatively associated with the outcome. Indigenous ancestry (PR: 1.64, 95% CI: 1.10-2.44) and non-fatal overdose (PR: 1.61, 95% CI: 1.05-2.47) were both positively associated with experiencing police physical force in adjusted analyses.
Conclusion: Among PWID with recent police contact, a high proportion reported having experienced police violence, with Indigenous participants and those experiencing overdose at greatest risk. Our findings highlight the need to examine the contribution of drug policy to systemic discrimination. Policy reform should prioritize reducing the impact of policing practices from undermining the health, safety, and wellbeing of equity-deserving people who inject drugs.
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