Advertisement

Journal of Urban Health

, Volume 83, Issue 5, pp 911–925 | Cite as

Street Policing, Injecting Drug Use and Harm Reduction in a Russian City: A Qualitative Study of Police Perspectives

  • Tim Rhodes
  • Lucy Platt
  • Anya Sarang
  • Alexander Vlasov
  • Larissa Mikhailova
  • Geoff Monaghan
Article

Abstract

We undertook a qualitative exploration of police perspectives on injecting drug use and needle and syringe access among injecting drug users (IDUs) in a Russian city which has witnessed explosive spread of HIV associated with drug injecting. Twenty-seven in-depth qualitative interviews were conducted in May 2002 with police officers of varying rank who reported having regular contact with IDUs. All interviews were tape-recorded, transcribed, translated and coded thematically. Accounts upheld an approach to policing which emphasised high street-based visibility and close surveillance of IDUs. IDUs were depicted as ‘potential criminals’ warranting a ‘pre-emptive’ approach to the prevention of drug-related crime. Street policing was described as a means of maintaining close surveillance leading to the official registration of persons suspected or proven to be users of illicit drugs. Such registration enabled further ongoing surveillance, including through stop and search procedures. While aware of drug users' reluctance to carry injecting equipment linked to their fears of detention or arrest, accounts suggested that the confiscation of previously used injecting equipment can constitute evidence in relation to drugs possession charges and that discovery of clean injecting equipment may be sufficient to raise suspicion and/or further investigation, including through stop and search or questioning. Our findings suggest an uneasy relationship between street policing and needle and syringe access, whereby policing strategies can undermine an HIV prevention ethos promoting needle and syringe accessibility among IDUs. We conclude that facilitating partnerships between policing agencies and HIV prevention initiatives are a critical feature of creating environments conducive for risk reduction.

Keywords

Harm reduction HIV/AIDS Injecting drug use Policing Russia Syringe exchange 

Notes

Acknowledgements

We are grateful for the support of the UK Department for International Development for project funding support, and to the UK Department of Health for core funding to the Centre for Research on Drugs and Health Behaviour. We also thank Alexandra Kornienko for her assistance during fieldwork. We would also like to thank the Togliatti City Department of Internal Affairs, the Togliatti City Department of Health, the Togliatti Harm Reduction Project Coordination Group, and the following individuals: Elvira Zhukova; Veronica Petrova; Yuri Pevzner; Alexander Shakhov; and Adrian Renton.

References

  1. 1.
    Blankenship KM, Bray SJ, Merson MH. Structural interventions in public health. AIDS. 2000;14(Suppl 1):S11–S21.PubMedCrossRefGoogle Scholar
  2. 2.
    Blankenship KM, Friedman SR, Dworkin S, Mantell JE. Structural interventions: concepts, challenges and opportunities for research. J. Urban Health; 2006 (in press).Google Scholar
  3. 3.
    Rhodes T, Singer M, Bourgois P, Friedman SR, Strathdee SA. The social structural production of HIV risk among injecting drug users. Soc Sci Med. 2005;61:1026–1044.PubMedCrossRefGoogle Scholar
  4. 4.
    Galea S, Ahern J, Vlahov D. Contexual determinants of drug use risk behaviour: a theoretic framework. J Urban Health. 2003;80:50–58.CrossRefGoogle Scholar
  5. 5.
    Galea S, Nandi A, Vlahov D. The social epidemiology of drug use. Epidemiol Rev. 2004;26:36–52.PubMedCrossRefGoogle Scholar
  6. 6.
    Barnett T, Whiteside A. HIV/AIDS and development: case studies and a conceptual framework. Eur J Dev Res. 1999;11:200–234.CrossRefGoogle Scholar
  7. 7.
    Rhodes T, Simic M. Transition and the HIV risk environment. Br Med J. 2005;331:220–223.CrossRefGoogle Scholar
  8. 8.
    Rhodes T, Ball A, Stimson GV, Kobyshcha Y, Fitch C, Pokrovsky V, et al. HIV infection in the newly independent states, eastern Europe: the social and economic context of epidemics. Addiction. 1999;94:1323–1336.PubMedCrossRefGoogle Scholar
  9. 9.
    Kerr T, Small W, Wood E. The public health and social impacts of drug market enforcement: a review of the evidence. Int J Drug Policy. 2005;16:210–220.CrossRefGoogle Scholar
  10. 10.
    Burris S, Blankenship KM, Donoghoe M, Sherman S, Vernick JS, Case P, Lazzarini Z, Koester S. Addressing the ‘risk environment’ for injection drug users: the mysterious case of the missing cop. Milbank Q. 2004;82:125–156.PubMedCrossRefGoogle Scholar
  11. 11.
    Des Jarlais D. Structural interventions to reduce HIV transmission among injecting drug users. AIDS. 2000;14(Suppl 1):S41–S46.PubMedCrossRefGoogle Scholar
  12. 12.
    Friedman SR, Cooper HLF, Tempalski B, Keem M, Friedman R, Flom PL, Des Jarlais DC. Relationships of deterrence and law enforcement to drug-related harms among drug injectors in U.S. metropolitan areas. AIDS. 2006;20:93–99.PubMedCrossRefGoogle Scholar
  13. 13.
    Koester S. Copping, running and paraphernalia laws: contextual variables and needle risk behaviour among injection drug users in Denver. Human Organ. 1994;53:287–295.Google Scholar
  14. 14.
    Bluthenthal RN, Kral AH, Lorvick J, Watters J. Collateral damage in the war on drugs: HIV risk behaviors among injection drug users. Int J Drug Policy. 1999;10:25–38.CrossRefGoogle Scholar
  15. 15.
    Taussig JA, Weinstein B, Burris S, Jones ST. Syringe laws and pharmacy regulations are structural constraints on HIV prevention in the U.S. AIDS. 2000;14(Suppl 1):S47–S51.PubMedCrossRefGoogle Scholar
  16. 16.
    Fitzgerald J, Dovey K, Dietze P, Rumbold G. Health outcomes and quasi-supervised settings for street injecting drug use. Int J Drug Policy. 1994;15:247–257.CrossRefGoogle Scholar
  17. 17.
    Maher L, Dixon D. Policing and public health. Law enforcement and harm minimization in a street-level drug market. Br J Criminol. 1999;49:488–508.CrossRefGoogle Scholar
  18. 18.
    Aitken C, Moore D, Higgs P, Kelsall J, Kerger M. The impact of a police crackdown on a street drug scene: evidence from the street. Int J Drug Policy. 2002;13:193–202.CrossRefGoogle Scholar
  19. 19.
    Small W, Kerr T, Charette J, Schechter M, Spittal P. Impacts of intensified police activity on injection drug users: evidence from an ethnographic investigation. Int J Drug Policy. 2006;17:85–95.CrossRefGoogle Scholar
  20. 20.
    Bluthenthal RN, Kral AH, Lorvick J, Watters JK. Impact of law enforcement on syringe exchange programes: a look at Oakland and San Francisco. Med Anthropol. 1997;18:61–83.PubMedCrossRefGoogle Scholar
  21. 21.
    Davis CS, Burris S, Kraut-Becher J, Lynch KG, Metzger D. Effects of an intensive street-level police intervention on syringe exchange program use in Philadelphia. Am J Public Health. 2005;95:233–235.PubMedCrossRefGoogle Scholar
  22. 22.
    Rhodes T, Mikhailova L, Sarang A, Lowndes CM, Rylkov A, Khutorskoy M, et al. Situational Factors influencing drug injecting, risk reduction and syringe exchange practices in Togliatti City, Russian Federation. Soc Sci Med. 2003;57:39–54.PubMedCrossRefGoogle Scholar
  23. 23.
    Wood E, Kerr T, Small W, Jones J, Schechter MT, Tyndall MW. The impact of police presence on access to needle exchange programs. J Acquir Immune Defic Syndr. 2003;34:116–118.PubMedCrossRefGoogle Scholar
  24. 24.
    Fitzgerald J. Policing as public health menace in the policy struggles over public injecting. Int J Drug Policy. 2005;16:203–206.CrossRefGoogle Scholar
  25. 25.
    Best D, Strang J, Beswick T, Gossop M. Assessment of a concentrated high-profile police operation: no discernable impact on drug availability price or purity. Br J Criminol. 2001;41:738–745.CrossRefGoogle Scholar
  26. 26.
    Bastos FI, Strathdee S. Evaluating effectiveness of syringe exchange programmes. Soc Sci Med. 2000;51:1771–1782.PubMedCrossRefGoogle Scholar
  27. 27.
    Rhodes T, Lowndes CM, Judd A, Mikhailova L, Sarang A, Rylkov A, et al. Explosive spread and high prevalence of HIV infection among injecting drug users in Togliatti City, Russia. AIDS. 2002;16:F25–F31.PubMedCrossRefGoogle Scholar
  28. 28.
    Rhodes T, Sarang A, Bobrik A, Bobkov E, Platt L. HIV transmission and HIV prevention associated with injecting drug use in the Russian Federation. Int J Drug Policy. 2004;15:39–54.CrossRefGoogle Scholar
  29. 29.
    Rhodes T, Platt L, Maximova S, Koshkina E, Latshevskaya N, Hickman M, Renton A, Bobrova N, McDonald T, Parry JV. Prevalence of HIV, hepatitis C and syphilis among injecting drug users in Russia: a multi-city study. Addiction. 2006;101:252–266.PubMedCrossRefGoogle Scholar
  30. 30.
    Des Jarlais DC, Grund JP, Zadoretzky C, Milliken J, Friedman P, Titus S, et al. HIV risk behaviour among participants of syringe exchange programmes in central/eastern Europe and Russia. Int J Drug Policy. 2002;13:165–174.CrossRefGoogle Scholar
  31. 31.
    Polobinskaya SV. Russian Legislation and the Prevention of HIV among Intravenous Drug Users. (Information booklet), Moscow: Open Society Institute; 2002.Google Scholar
  32. 32.
    Butler WE. HIV/AIDS and Drug Misuse in Russia: Harm Reduction Programmes and the Russian Legal System. London: International Family Health; 2003.Google Scholar
  33. 33.
    Burris S. Harm reduction: what's a lawyer to do? Int J Drug Policy. 2006;17:47–50.CrossRefGoogle Scholar
  34. 34.
    Human Rights Watch (2004) Lessons Not Learned: Human Rights Abuses and HIV/AIDS in the Russian Federation, Human Rights Watch, 16:5(D).Google Scholar
  35. 35.
    Platt L, Hickman M, Rhodes T, Mikhailova L, Vlasov A, Tilling K, et al. The prevalence of injecting drug use in a Russian city: implications for harm reduction and coverage. Addiction. 2004;99:1430–1438.PubMedCrossRefGoogle Scholar
  36. 36.
    Rhodes T, Platt L, Judd A, Mikhailova L, Sarang A, Wallis N, Alpatova T, Hickman M, Parry JV. Hepatitis C virus infection, HIV co-infection, and associated risk among injecting drug users in Togliatti, Russia. Int J STD AIDS. 2005b;16:749–754.PubMedCrossRefGoogle Scholar
  37. 37.
    Rhodes T, Judd A, Mikhailova L, Sarang A, Khutorskoy M, Platt L, et al. Injecting equipment sharing among injecting drug users in Togliatti city, Russian Federation. J Acquir Immune Defic Syndr. 2004;35:293–300.PubMedCrossRefGoogle Scholar
  38. 38.
    Bourgois P, Lettiere M, Quesada J. Social misery and the sanctions of substance use: confronting HIV risk among homeless heroin addicts in San Francisco. Soc Probl. 1997;44:155–173.CrossRefGoogle Scholar
  39. 39.
    Bourgois P. U.S. inner-city apartheid: the contours of structural and interpersonal violence. In: Scheper-Hughes N, Bourgois P, eds. Violence in War and Peace: An Anthology. Oxford: Blackwell; 2003:297–303.Google Scholar
  40. 40.
    Cooper H, Moore L, Gruskin S, Krieger N. Characterising perceived police violence: implications for public health. Am J Public Health. 2004:94:1109–1118.PubMedCrossRefGoogle Scholar
  41. 41.
    Iguchi MY, London JA, Forge NG, Hickman L, Fain T, Riehman KS. Elements of well-being affected by criminalizing the drug user. Public Health Reports. 2002;117(Suppl 1):S146–S150.PubMedGoogle Scholar
  42. 42.
    Roberts DE. The social and moral cost of mass incarceration in African American communities. Stanford Law Rev. 2004;56:1271–1305.Google Scholar
  43. 43.
    Singer M. AIDS and the health crisis of the U.S. urban poor: the perspective of critical medical anthropology. Soc Sci Med. 1994;39:931–948.PubMedCrossRefGoogle Scholar
  44. 44.
    Parker RG, Easton D, Klein CH. Structural barriers and facilitators in HIV prevention: a review of international evidence. AIDS. 2000;14(Suppl 1):S22–S32.PubMedCrossRefGoogle Scholar
  45. 45.
    Beyer L, Crofts N, Reid G. Drug offending and criminal justice responses: practitioners’ perspectives. Int J Drug Policy, 2002;13:203–211.CrossRefGoogle Scholar
  46. 46.
    Beletsky L, Macalino GE, Burris S. Attitudes of police officers towards syringe access, occupational needle-sticks, and drug use: a qualitative study of one city police department in the United States. Int J Drug Policy. 2005;16:267–274.CrossRefGoogle Scholar
  47. 47.
    Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci Med. 2003;57:13–24.PubMedCrossRefGoogle Scholar
  48. 48.
    Bobrova N, Rhodes T, Power R, Alcorn R, Neifeld E, Kraskiukov N, Latyshevskaia N, Maksimova S. Barriers to accessing drug treatment in Russia: a qualitative study among drug injectors in two cities. Drug Alcohol Depend. 2006;82(Suppl 1):57–64.CrossRefGoogle Scholar
  49. 49.
    Mokieno M, Mokienko I. Harm reduction programme in Sakhalin, Russia. Twelfth International Conference on the Reduction of Drug Related Harm, New Delhi, India; 2001.Google Scholar
  50. 50.
    Platt L, Rhodes T, Judd A, Koshkina E, Maximova S, Latishevskaya N, et al. Syphilis among injecting drug users in three cities in Russia: the effect of sex work. Am J Public Health; 2006 (in press).Google Scholar
  51. 51.
    Kleinman A, Das V, Lock M eds. Social Suffering. Berkeley: University of California Press; 1997.Google Scholar
  52. 52.
    Singer M, Toledo E. Oppression Illness: Critical Theory and Intervention with Women at Risk for AIDS. Washington, District of Columbia, American Anthropology Association; 1995.Google Scholar
  53. 53.
    Pederson D. Political violence, ethnic conflict, and contemporary wars: broad implications for health and social well-bring. Soc Sci Med. 2002;55:175–190.CrossRefGoogle Scholar
  54. 54.
    Farmer P, Connors M, Simmons J. Women, Poverty and AIDS: Sex, Drugs and Structural Violence. Monroe, Maine: Common Courage; 1996.Google Scholar
  55. 55.
    Hough M. Drug user treatment within a criminal justice context. Subst Use Misuse. 2002;37:985–996.Google Scholar
  56. 56.
    Smith BW, Novak KJ, Frank J, Travis LF. Multi-jurisdictional drug task forces: an analysis of impacts. J Crim Justice. 2000;28:543–556.CrossRefGoogle Scholar
  57. 57.
    Midford R, Acres J, Lenton S, Loxley W, Boots K. Cops, drugs and the community: establishing consultative harm reduction structures in two Western Australian locations. Int J Drug Policy. 2002;13:1810188.CrossRefGoogle Scholar
  58. 58.
    Small W. Two cultures passing in the night. Int J Drug Policy. 2006;16:221–222.CrossRefGoogle Scholar
  59. 59.
    Hammett TM, Bartlett NA, Chen Y, Ngu D, Cuong D, Dinh, Phuong N, Minh, et al. Law enforcement influences on HIV prevention for injection drug users: observations from a cross-border project in China and Vietnam. Int J Drug Policy. 2005;16:235–245.CrossRefGoogle Scholar

Copyright information

© The New York Academy of Medicine 2006

Authors and Affiliations

  • Tim Rhodes
    • 1
  • Lucy Platt
    • 1
  • Anya Sarang
    • 2
  • Alexander Vlasov
    • 3
  • Larissa Mikhailova
    • 4
  • Geoff Monaghan
    • 5
  1. 1.Centre for Research on Drugs and Health Behaviour, Department of Public Health and PolicyLondon School of Hygiene and Tropical MedicineLondonUK
  2. 2.Russian Harm Reduction NetworkRussian FederationMoscowRussia
  3. 3.Department of Internal AffairsRussian FederationTogliattiRussia
  4. 4.Togliatti City Narcological ServicesRussian FederationTogliattiRussia
  5. 5.United Nations Office on Drugs and Crime, Regional Office for Russia and BelarusRussian FederationMoscowRussia

Personalised recommendations