Police Perceptions of Supervised Consumption Sites (SCSs): A Qualitative Study

Abstract

Police are key stakeholders in cities considering supervised consumption site (SCS) implementation. We examine police perceptions of SCSs using data collected between 2008 and 2010. Data from interviews and focus groups conducted with police officers of varied ranks (n = 18) in Ottawa and Toronto, Canada, were analyzed using thematic analyses. Participants opposed SCS implementation in their respective cities. The police views we heard invoke values and perspectives on evidence that differ from those used in research. Whether these divergent frameworks are reconcilable is a question for future research. Study limitations are noted. The Ontario HIV Treatment Network funded the study.

RÉSUMÉ

Perceptions policières des sites de consommation supervisée (SCS): étude qualitative. Les policiers sont des intervenants clés dans les villes qui contemplent la mise en place de sites de consommation supervisée (SCS). Nous explorons les perceptions policières des SCS à l'aide de données recueillies entre 2008 et 2010. Les données tirées d'entrevues et de groupes de discussion ayant eu lieu avec des agents de police de divers grades (n = 18) à Ottawa et Toronto (Canada) ont été soumises à des analyses thématiques. Les participants s'opposaient à la mise en oeuvre de SCS dans leurs villes respectives. Les opinions policières exprimées invoquaient des valeurs et des points de vue sur les preuves qui différaient de ceux adoptés dans la recherche en santé. Des études futures devront déterminer si ces cadres de référence divergents peuvent être réconciliés. Nous prenons note des limites de l’étude, financée par l'Ontario HIV Treatment Network.

RESUMEN

Las percepciones de la policía sobre las salas de consumo supervisado: un estudio cualitativo. La policía es una parte interesada en las ciudades que están considerando la implementación de salas de consumo supervisado. Usando datos recolectados entre el 2008 y el 2010, se examinaron las percepciones que la policía tiene de las salas de consumo supervisado. Se hizo un análisis temático de los datos de entrevistas y grupos de enfoque con policías de varios rangos (n = 18) que se llevaron a cabo en Ottawa y Toronto, Canadá. Los participantes se oponían a la implementación de salas de consumo supervisado en sus respectivas ciudades. Las opiniones de los policías invocan valores y perspectivas sobre la evidencia que son diferentes a las que se utilizan en la investigación. La reconciliación de estos marcos divergentes es una cuestión para futuras investigaciones. Se reconocen las limitaciones del estudio. El Ontario HIV Treatment Network financió este estudio.

Keywords :

• harm reduction
• supervised consumption sites
• police
• law enforcement
• illicit drugs
• perceptions

THE AUTHORS

Tara Marie Watson is a Ph.D. candidate at the Centre for Criminology and Sociolegal Studies at the University of Toronto, Toronto, ON, Canada. Her doctoral research examines the policies and practices of regulating people who use substances within the Canadian federal prison system. As a research coordinator, she has contributed to studies that: are examining the feasibility of and the potential impact of supervised consumption sites; evaluated the uptake of best practices for Ontario needle and syringe programs; completed a review for the Ministerial Council on HIV/AIDS on the effectiveness of harm reduction programs in the context of HIV and hepatitis C prevention; and will develop national best practices for harm reduction programs in Canada. Her research interests include drug policy, addictions, corrections and punishment, risk and regulation, and organizational risk management.

Dr Ahmed Bayoumi is a scientist at the Centre for Research on Inner City Health at the Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada, a general internist and HIV physician at St. Michael's Hospital, and Director of Clinical Epidemiology and Health Care Research in the Department of Health Policy, Management and Evaluation at the University of Toronto, Toronto, ON, Canada. He holds a Canadian Institutes of Health Research/Ontario Ministry of Health and Long-Term Care Chair in Applied Health Services Research and Drug Policy focusing on equity in resource allocation. His research interests include studying how to incorporate equity concerns into resource allocation decisions in a manner that is defensible, transparent, and principled. He also studies economic evaluation, decision analysis, and quality of life assessment for HIV-related health interventions, and studies of the access to the delivery of health services, particularly to people living with HIV, injection drug users, and other marginalized populations. His work has included cost-effectiveness analyses of screening strategies for HIV, drug treatments for HIV and related conditions, and supervised injection sites for injection drug users. He has worked closely with the Ontario HIV Treatment Network Cohort Study, a large observational database of people living with HIV in Ontario, and is an Adjunct Scientist at the Institute for Clinical Evaluative Sciences. He is Vice-President Elect of the Society for Medical Decision Making, an Associate Editor of the society's journal, and was co-chair of the 2010 meeting.

Gillian Kolla, MPH, is a Ph.D. student at the Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. She is interested in the risk environments of people who use drugs, particularly the ways in which structural factors contribute to HCV and HIV risk.

Rebecca Penn is currently a doctoral student at the Dalla Lana School of Public Health's Social and Behavioural Science program, University of Toronto, Toronto, ON, Canada. Prior to attaining her Master's in health promotion, Rebecca worked in the community mental health sector as a case manager for women experiencing homelessness and mental health and substance use issues.

Dr Benedikt Fischer, Ph.D., is Professor and Applied Public Health Chair, and Director, Centre for Applied Research in Mental Health and Addictions (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada, and senior scientist, Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada. His main research foci include illicit substance use, comorbidities, and interventions specifically in marginalized or high-risk populations, within a public health framework.

Janine Luce, MA, is the Manager of Public Policy at the Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada. Janine has worked on several provincial, federal, and municipal drug policy issues, addiction treatment systems policy, and mental health systems policy. She has over 10 years experience in program management in health and educational programs in the areas of homelessness, HIV/AIDS, mental health, and addictions.

Dr Carol Strike is an Associate Professor at the Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. She has a Ph.D. in Public Health Sciences and an M.Sc. in epidemiology. Through her community-based research program, she is committed to understanding how individual, social, and structural inequities impact on health and well-being. Current studies include an evaluation of how a peer-based intervention may reduce initiation into injection drug use; stigma and symbolic violence among methadone patients; the feasibility and potential impact of supervised consumption sites in Toronto and Ottawa; improving relationships between Aboriginal mothers with substance use problems, substance use treatment, and child welfare; food insecurity among drug injectors; physician compliance with methadone treatment guidelines; and the use of arts-based research methods as an approach to engage people with acute health problems in research. In April 2007, her team won the national Kaiser Foundation Award for Excellence in Leadership in recognition of meritorious contributions to the reduction of drug-related harm. In 2011, she won the Badgley Award for Teaching Excellence.