Therapeutic alignments: examining police and public health/harm reduction partnerships

Ongoing calls for police reform across North America alongside the growing momentum for the removal of criminal sanctions for personal possession of drugs have placed policing agencies in an ambivalent position with respect to drug governance and people who use drugs (PWUD). Meanwhile, in response to the longstanding harms produced by drug law enforcement, calls for harm reduction policing have gained traction in recent years, resulting in collaborations between policing agencies and health services, including naloxone administration by police officers, post-overdose outreach and wellness checks, and integrated public health-public safety response and information sharing frameworks. Using situational analysis method, we consider the range of elements and actors which form these partnerships, and their broader structural, institutional, and policy effects. We detail the actual and potential implications of such forms of institutional coordination and alignment on health, equity, and the possibility of meaningful drug law reform. Our analysis reveals that rather than mitigating the harms of drug enforcement, such initiatives stand to undermine access to services and increase health system avoidance by eroding trust in public health and harm reduction among PWUD. We reason that the recasting of police as therapeutic agents and as embedded in medico-therapeutic practices reaffirms the role of punitive enforcement practices in drug governance.