Police & Harm Reduction: How Law Enforcement Can Advance Public Safety, Public Health, and Public Confidence

Based on the direct experiences of law enforcement officers from around the world, this guidance report from the Open Society Foundations' Public Health Program showcases alternatives to common punitive models for policing. The briefing document is intended as a resource for law enforcement personnel on how to incorporate, support, and create space for approaches that aim to increase public safety and health, as well as to reduce harm to people who use drugs.

According to the Open Society Foundations, in many cities around the world, communities face significant health and safety challenges associated with drug use. These may include the spread of disease, issues related to homelessness, rising rates of overdose deaths, and drug-related crime. Law enforcement personnel often find themselves tasked with handling these challenges. Many of these issues, however, are not well addressed by punitive measures like criminal investigation or arrest. This is in large part due to the assumption - despite evidence to the contrary - that policing, arrest, and incarceration will prevent people from using drugs. As a result, law enforcement officers and communities grow frustrated with the ineffective pattern whereby people are arrested, detained, and released - only to be arrested again.

In contrast, harm reduction policing engages communities in a manner that builds trust, addresses the needs of individuals using drugs, and reduces adverse effects of drugs and drug enforcement. On this model, progress is measured not, for example, just by positive or negative urinalysis, but by the steps people take to stabilise and improve their lives, such as showing up for health appointments, reducing use, moving off the street and into housing, managing anger, and committing fewer incidents of public misconduct. Experiences with harm reduction in jurisdictions around the world have demonstrated a number of positive outcomes, including improved police and community relationships.

Facilitating positive outcomes for law enforcement and the public can involve:

• Knowledge and integration of harm reduction tools and approaches.
• Communication and positive relationships with affected community members and other service providers working in the same area.
• An emphasis on the protection of the safety, health, and dignity of community members, including people who use drugs, through tools other than arrest and detention.
• Introduction of operational guidance and policy to improve practices related to drug users and possession of drugs for personal use.
• Officer performance metrics and incentives that support both public safety and health-oriented objectives.
• Organisational culture that reinforces the move from being a force to a service and that assumes a broader view of the impact of law enforcement on society.

The report provides a number of recommendations and examples to illustrate what law enforcement can do in supporting harm reduction efforts. Some examples include:

1. To save lives, officers can: Create space for, rather than interfering with, harm reduction services (e.g., supervised drug consumption rooms); prioritise saving lives in cases of overdose or victimisation (e.g., work with public health partners to create "health hubs" around drug users and overdose victims); and increase officer health and safety (police who use drugs themselves can also benefit from harm reduction services).
2. Engage the community and build partnerships. For example, in 2015, the Ukrainian police launched a national police reform effort after years of reported corruption, misconduct, and gaps in public safety protection. Part of the effort requires working together to educate members of the community about the value and need of harm reduction health services. Helping communities to be familiar with services and what happens there often diminishes community fears and improves the sense of security and collective response to drugs.
3. Ensure that there are clear instructions and operational guidance on how to address harm reduction services. For example, in 2009, the Kyrgyz Ministry of Interior issued Instruction 417, which advised police not to interfere with services such as needle and syringe programmes or outreach to people who use drugs or sex workers. Instruction 417 also outlined the national police's responsibility to protect and uphold citizen rights, especially the rights of vulnerable populations like injection drug users, and addressed police occupational health and safety concerns.
4. Support alternatives to arrest, involving officers at all levels at the design stage, especially those who will be implementing these strategies. Doing so helps build their ownership over the strategies and helps identify any practical operational considerations.
5. Develop new officer performance metrics, incentives, and management. Some jurisdictions have moved away from measuring arrests or seizures made, citations or summonses issued, or arrests leading to conviction, instead measuring things like levels of community satisfaction and trust, community victimisation and perception of safety, the quality of police contacts, or a decision to refer someone to a harm reduction service provider instead of arresting them. These metrics can be attached to professional incentives such as rewards, medals, citations, promotions, or informal congratulations that recognise both officer knowledge of harm reduction strategies and implementation of referrals to services.
6. Support training and culture change. In addition to making it clear that the harm reduction approach is an expected part of daily duties, training can serve as an entry point to relationships with civil society partners, including harm reduction experts and drug users, in ways that challenge stereotypes. Law enforcement may also hold public forums with strategic partners so that the community can be educated about what the police are doing, which helps build a true partnership between police and the community. For example, as a way to engage officers and to develop better community and police relationships, the narcotics division of the Uganda National Police began a training series for senior law enforcement officers across the country. The sessions were jointly led by civil society partners and law enforcement and, as a way to undo stereotypes, they included drug users themselves. These sessions provided an entry point for law enforcement to reflect on issues as peers and to work with one another to discuss and confront entrenched culture and beliefs about drug use.

The brief concludes with links to selected handbooks and manuals.