Measuring improvement in knowledge of drug policy reforms following a police education program in Tijuana, Mexico

Abstract

BackgroundMexico’s 2009 “narcomenudeo reform” decriminalized small amounts of drugs, shifting some drug law enforcement to the states and mandating drug treatment diversion instead of incarceration. Data from Tijuana suggested limited implementation of this harm reduction-oriented policy. We studied whether a police education program (PEP) improved officers’ drug and syringe policy knowledge, and aimed to identify participant characteristics associated with improvement of drug policy knowledge.MethodsPre- and post-training surveys were self-administered by municipal police officers to measure legal knowledge. Training impact was assessed through matched paired nominal data using McNemar’s tests. Multivariable logistic regression was used to identify predictors of improved legal knowledge, as measured by officers’ ability to identify conceptual legal provisions related to syringe possession and thresholds of drugs covered under the reform.ResultsOf 1750 respondents comparing pre- versus post training, officers reported significant improvement (p < 0.001) in their technical understanding of syringe possession (56 to 91%) and drug amounts decriminalized, including marijuana (9 to 52%), heroin (8 to 71%), and methamphetamine (7 to 70%). The training was associated with even greater success in improving conceptual legal knowledge for syringe possession (67 to 96%) (p < 0.001), marijuana (16 to 91%), heroin (11 to 91%), and methamphetamine (11 to 89%). In multivariable modeling, those with at least a high school education were more likely to exhibit improvement of conceptual legal knowledge of syringe possession (adjusted odds ratio [aOR] 2.6, 95% CI 1.4–3.2) and decriminalization for heroin (aOR 2.7, 95% CI 1.3–4.3), methamphetamine (aOR 2.2, 95% CI 1.4–3.2), and marijuana (aOR 2.5, 95% CI 1.6–4).ConclusionsDrug policy reform is often necessary, but not sufficient to achieve public health goals because of gaps in translating formal laws to policing practice. To close such gaps, PEP initiatives bundling occupational safety information with relevant legal content demonstrate clear promise. Our findings underscore additional efforts needed to raise technical knowledge of the law among personnel tasked with its enforcement. Police professionalization, including minimum educational standards, appear critical for aligning policing with harm reduction goals.

A scoping review of harm reduction training for police officers

“…Information on the number of training recipients per session was also limited and varied. Some training programs were offered to groups of four to eight police officers while others had groups of 20 to 50 per session until all departmental officers had been trained.…”

“…Integrated training models are those that were delivered in‐station and integrated into regularly scheduled in‐service trainings ( n = 6), such as ‘roll call trainings’ for improving policing practice or for monitoring and responding to police‐related problems . To assist integration, one source established a memorandum of understanding with the Tijuana Ministry of Public Safety to integrate training into the police department's annual training effort . In another example, harm reduction training was initiated in response to an internal policy (Instruction [‘Prikaz’] 417) and was held separate from other trainings .…”

“…Globally, patterns of drug policy and use of psycho‐active drugs (hereafter referred to as ‘drugs’) for non‐medical and/or non‐prescribed purposes have been dramatically evolving over the past two decades . It is recognised that war on drugs approaches fail to reduce drug use, production and sale . In the last several years, preventable overdose deaths, especially due to opioid use, have increasingly been reported in North America, while concerning trends have also emerged in Australia and countries in Europe and Asia .…”

The effect of public health-oriented drug law reform on HIV incidence in people who inject drugs in Tijuana, Mexico: an epidemic modelling study

“…In 2015, less than one in ten police officers correctly identified the possession threshold for heroin, 28 just over half correctly recognised syringes to be legal, and twothirds reported making at least one arrest for syringe possession in the past 6 months. During interviews with high-level police, public health, and drug treatment sector officials, participants expressed confusion about the reform, 29 and typically identified mass-media as their source of information.…”

“…15 Preliminary findings suggest improved understanding of the legal status of syringe, heroin, and marijuana possession, along with better attitudes about public health-driven drug law reform. 28,30 Future work should assess the effect of this police education programme on HIV transmission in people who inject drugs.…”