IV. Negotiating Relationships with Law Enforcement

Health departments can be a natural ally given their common interest in reducing the spread of infectious disease and promoting greater public health. The support of health departments can build the credibility of the SAP and garner support from neighbors, the community at-large and law enforcement. However, it may be necessary to educate health departments about the benefits of SAPs, provide scientific evidence supporting their implementation, and describe challenges that can be imposed by certain regulation strategies.

A supportive and engaged health department can validate SAPs as important tools in promoting community health and potentially provide the legal basis for operation. Health departments can allocate valuable funding toward syringe access services. In addition, they can provide numerous resources to the SAP such as access to testing services, vaccination, healthcare referrals and other service linkages. Health departments that are on board with the SAP may also be able to coordinate provision of syringes as well as disposal of biohazard and sharps.

There can also be challenges when collaborating with health departments. Perhaps the biggest challenges will be related to the bureaucracy that can be tied to governmental systems. Health departments may have strict reporting and regulation requirements that, while often valuable, can also be very time-consuming and inefficient. Some policies imposed by health departments may be hard to reconcile with SAP participants (i.e. policies around exchange vs. distribution, limits to the number of syringes that can be exchanged and/or limits on secondary exchange). SAPs may feel a certain loss of autonomy under health department regulation. However, the benefits of collaboration, including the impact on project sustainability often outweigh the drawbacks.

The following principles foster successful collaboration between SAPs and health departments: • Clear understanding of expectations from both parties • Open lines of communication • Reporting SAP achievements, challenges, noteworthy incidents and ongoing needs in a timely manner • Commitment to mutual support and flexibility • Willingness to listen to and learn from each other

relATiOnSHiPS wiTH lAw enfOrceMenT

SAPs are responsible for negotiating and communicating with law enforcement to protect their program operations and their participants. Without proper education, law enforcement officers may target SAPs and their participants. This diminishes the effectiveness of the program and places participants at increased risk of prosecution. If people are targeted and arrested at or near the SAP, participants may lose trust and therefore be less willing to access services. Poor interactions with law enforcement can have a number of negative consequences for participants. Fear of law enforcement may keep IDUs from: • Visiting the SAP • Returning used syringes • Collecting a sufficient number of syringes • Calling 911 in cases of overdose • Properly disposing of used syringes • Practicing safer injection and overdose prevention strategies

A great number of the cases that law enforcement deals with involve drug use on some level. Law enforcement officials are unlikely to have a complete understanding of harm reduction, HIV and HCV transmission, and may also lack information on laws around syringe possession and related public health provisions. Many police officers have fears of accidental needle stick and drug users in general, often expressed in the form of hostility.

Nonetheless, as harm reduction teaches, it is important to meet law enforcement where they’re at. It is important to acknowledge the frustration and helplessness that law enforcement officers can experience as a result of the cyclical nature of drug use and their interactions with drug users. Ongoing and persistent education, training and proactive communication are key to building understanding and avoiding problems.

The following recommendations can be adopted to build strong, productive relationships with law enforcement: • Begin building relationships with law enforcement as soon as possible. Introduce yourself early to police chiefs and captains, meet with community affairs/relations officers, district attorneys and support staff. • Always prioritize confidentiality and safety of participants when engaging with law enforcement. • Be respectful and honest when communicating with law enforcement. • Always provide contact information and make yourself available to address concerns and issues. • Acknowledge law enforcement’s perspective and role on drug issues and emphasize the ways that SAPs support them (i.e. reducing accidental needle stick). • Ask to speak at shift change roll calls. In many places, there will be a roll call before each new police shift comes on where announcements can be made. This is a perfect opportunity to briefly educate officers about the SAP and its benefits to law enforcement. It also provides law enforcement with a name and contact person to turn to with concerns. • Negotiate agreements with police to ensure that participants will be safe to come and go from the SAP without fear of arrest, intimidation or harassment. • Train law enforcement on legal statutes that protect the SAP and its participants. Educate law enforcement about the relevant policies and procedures of the SAP. • Inform police and other law enforcement about the full range of services provided by the SAP, including referrals to drug treatment, counseling, education about HIV, HCV and other blood-borne viruses, etc. • Ensure that SAP participants understand their rights regarding syringe possession. • Offer to provide police with sharps containers, puncture-proof gloves and needlestick information as needed. • Invite police to serve on SAP advisory boards whenever appropriate. • Educate IDUs about the importance of proper sharps disposal and teach participants how to inform police that they have syringes prior to being searched. • Suggest that SAP participants document badge number, location and time if syringes or SAP card are confiscated by a police officer. • Train staff on how to engage with law enforcement and when it is appropriate and necessary to call law enforcement for assistance or allow law enforcement onsite at the SAP. • Develop an onsite protocol for encounters with law enforcement that includes information on maintaining participant confidentiality, designated staff to engage with law enforcement, which information the SAP is and is not legally required to share with law enforcement, and any established contacts the SAP has with law enforcement. • Establish monitoring processes to gather data (wrongful arrests, unlawful confiscation of syringes/SAP cards, increased surveillance of SAP and interactions with participants coming to and from an SAP).