Police in Ontario are increasingly interfering with the operation of health services, our recent study found. This obstructs people from accessing life-saving care. “People would like to access our services but cannot,” one service provider told us.

Our study, which is set to be released in September, was led by the co-executive directors of the HIV Legal Network and a criminologist at Toronto Metropolitan University. As part of a research project examining the health impacts of Canada’s current drug laws across four Ontario cities, we interviewed 22 people who use drugs and were previously charged with a drug offense, as well as eight service providers, five drug policy experts, and six lawyers who observe the impacts of drug laws on their clients and the broader communities they serve.

Communities across Canada continue to experience the devastating toll of the toxic drug crisis. While some regions have scaled up harm reduction initiatives, including supervised consumption services and safer supply programming, these efforts have been limited and are facing growing attacks and hostile legislation, leading to closures and bans in some provinces. 

Members of the research team heard about frequent unannounced police visits to local harm reduction programs.

One drug policy expert explained that “overdose prevention sites are only as effective as they are accessible … People are continuing to be at risk just for traveling to these sites.” 

Members of the research team heard about frequent unannounced police visits to local harm reduction programs. Our community-based colleagues told us that during these visits, police would enter the premises, search clients’ belongings, interrogate staff, and at times arrest service users for a breach or outstanding warrant, mirroring excessive and questionable practices documented elsewhere. 

“The police keep an eye on the clientele that’s gathering when they’re going by,” explained one service user.

Participants in our study spoke about this kind of interference as a major part of their experience accessing programming. “In the past little bit, the police presence has gotten a lot higher … they’ve ramped up the police presence for sure,” explained a service user in a separate city.

This was reflected by service providers as well: “You won’t see someone around for a while because they’re trying to avoid a warrant,” one said. “Or again they will be trespassed from the property [by police] for dealing. That one’s been happening more frequently … it makes it difficult for that person to access services.”

Police opposition to supervised consumption sites has been longstanding, based on unfounded beliefs that the sites contribute to “public disorder” and generate crime. This has in many cases led to direct police surveillance of health services (e.g., parking outside, interrogating service users); the seizure and destruction of harm reduction supplies during interactions with clients; and intensive street-level policing in close proximity to the sites. 

Previous research has established that police surveillance of or presence at supervised consumption sites creates barriers in accessing essential health care. When faced with surveillance and potential criminalization, people will often instead choose to avoid services altogether. This leads to practices that aggravate risk of overdose and other harms, including using in isolation, rushed consumption, choosing not to carry harm reduction supplies, and interruptions to medical treatment. 

“The data over many, many years now indicates that fear of policing and criminalization, even short of arrest, and that can include things like being stopped or ID’d/carded/searched, causes people to use in more isolation,” one drug policy expert told us. 

“People are being pushed into more dangerous, more marginal situations by police involvement.” 

Aggressive policing and interference of this kind often leads people to think that health services are, in the words of one of our research participants, a “trap.” 

These fears and related avoidance are often amplified for parents, migrants with precarious status, people involved in the distribution or selling of drugs or other informal economies, and racialized and Indigenous people who are already subject to profiling and targeted enforcement by police. Health care avoidance in turn drives health inequity among people who are disproportionately impacted by the toxic drug supply. 

“Police are increasing their patrols; you might be forced to use at a house that is honestly not very safe for you but is the best option, because better to run the risk of nodding off and getting robbed versus getting run in by the police and having everything confiscated or getting more charges or seeing there’s an active warrant and ending up in jail …” one service provider said. “People are being pushed into more dangerous, more marginal situations by police involvement.” 

 This sentiment was echoed by supervised consumption site users: “People who are actively using, in case they go down in a fentanyl overdose, they’re afraid to go there,” said one. 

Previous efforts have been made between health care/harm reduction organizations and local police to foster ”cooperative” relationships—for example, through negotiated boundary agreements. While in some places these informal agreements worked reasonably well in the past, our study shows that they are quickly eroding or have been replaced with outright hostility from law enforcement. 

Police surveillance and obstructionism aren’t limited to supervised consumption sites, but also include hindering or interfering with outreach workers trying to support their clients. 

“I’ve had police threaten to arrest me before because we wouldn’t allow them into our workplace,” one provider told us.

“Sometimes we were unable to access certain places because the police would say, ‘No you cannot go in there, the clients that you’re trying to see are trespassing. You can’t go in. They can’t be there. And if we catch you in here, we’re going to arrest you,’” one service provider said. “That again is isolating clients because people will still stay there. If we get caught providing services, there is a risk for arrest.”  

“I’ve had police threaten to arrest me before because we wouldn’t allow them into our workplace …” another provider told us. “I’ve had police say, ‘You know, whatever you think that they are, they’re criminals at the end of the day and you’re protecting criminals,’ and like, reprimanded me, and they can get aggressive.” 

These experiences are evidence of a growing and troubling trend. In addition to the belief among law enforcement that harm reduction “enables” drug use, it appears that they also think harm reduction “enables” crime. Alarmingly, they are targeting health care and harm reduction workers who deliver lifesaving services in the context of an unprecedented public health emergency.  

“We have had harm reduction workers be followed and considered part of drug investigations because of our proximity to places and spaces where drugs are being purchased and sold and consumed,” one service provider explained.

These practices create a climate of fear and risk eroding the long tradition of harm reduction offering a sanctuary or “demilitarized” zone in drug law enforcement. They are also a violation of the right to health, and undermine the privacy and confidentiality of people accessing key services. 

“It makes it harder for us to actually connect with the people that we’re trying to connect with …” a service provider told us. “The community is terrified now of outreach workers because they’re afraid that someone will notice and call the police on them.”  

“If simple possession was decriminalized, people could reasonably access sites without being scared that it’s a trap.”

The growing crisis of police interference and obstruction highlights the precarious gains made by harm reduction and health care allies in Ontario. An increasingly hostile political and legal environment appears to be directly translating into greater police interference with health services. Recent legislation providing police with additional powers risks worsening an already untenable situation. 

“I’m anticipating relationships with the police will only get worse as [our city] seems to be defunding harm reduction,” one service provider said.

The recent closure of roughly half of supervised consumption sites in Ontario, and the denial of Toronto’s decriminalization request, risk adding fuel to the fire. 

“If simple possession was decriminalized, people could reasonably access safe injection or supervised injection sites without being scared that it’s a trap or that when they leave, police are going to arrest them—they wouldn’t have necessarily been using on the street and been in the crosshairs of the police,” one of the lawyers we interviewed told us.  

We are facing a pressing need for public health leadership to reign in excessive and abusive police practices. The situation demands meaningful protections in the form of binding buffer zones around all health services, formal non-interference perimeters defined by clear policies and protocols, and provincial directives barring police from surveilling health care facilities—as well as the broader overhaul of prohibitionist and punitive drug laws. 

“That’s what prohibition does …” as one Ontario service provider summarized; “reducing the ability for us to do our work, folks to access our work, because of the stigma that comes with these laws [which] is huge and honestly going to become more and more of a concern.”   

The study described was funded by the Public Health Agency of Canada, Intersectoral Action Fund.

Dylan De Marsh is the digital and strategic communications officer at HIV Legal Network. He previously worked with PARN-Your Community AIDS Resource Network in Peterborough for 12 years.

Ann De Shalit is a SSHRC postdoctoral fellow and adjunct professor at the University of Windsor in Ontario. She has been involved in community-based research on drug policy and harm reduction for 10 years.

Top photograph (cropped) of police car in Toronto by Dominik drz via Pexels 

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