Relationships of Deterrence and Law Enforcement to Drug-Related Harms Among Drug Injectors in U.S. Metropolitan Areas

To understand associations of punitive policies to the population prevalence of injection drug users (IDUs) and to HIV seroprevalence among IDUs, the authors conducted a lagged-cross-sectional analysis of US metropolitan statistical area data.

After controlling for other metropolitan area characteristics, estimates of IDUs per capita and HIV seroprevalence among IDUs in 89 large US metro areas were regressed on three measures of legal repressiveness (hard drug arrests per capita; police employees per capita; and corrections expenditures per capita).

The researchers found no legal repressiveness measures were associated with IDUs per capita. However, all three measures of legal repressiveness were positively associated with HIV prevalence among IDUs.

These findings suggest that legal repressiveness may have little deterrent on drug injection and may have a high cost in terms of HIV and perhaps other diseases among injectors and their partners -- and that alternative methods of maintaining social order should be investigated, the authors concluded.

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