Recent increasing police activities focused on people who inject drugs in Thailand have involved reported injustices that may lead to riskier behaviors in people who inject drugs (PWID), according to a study published this week in PLOS Medicine. The results of the study, by Thomas Kerr and colleagues, from the University of British Columbia, Canada, found that urine drug testing, which has become widely available since around 2000, was identified as a key tool used by the police, with some police requesting PWID to provide urine samples in public places.
A recent crackdown on PWIDs in 2011 has led to increases in drug-related arrests and compulsory detentions in Thailand. In this qualitative study, the researchers interviewed 42 PWID from the community in Bangkok, and asked them about their encounters with police during the past three years. Participants reported various police activities, including false accusations, coercion of confessions, excessive use of force, and extortion of money, and were reluctant to report these activities to the authorities. Some PWIDs reported avoiding police by staying indoors, which may limit their access to health services, while others reported changes in their drug-using behavior from street drugs towards misuse of prescribed pharmaceuticals.
The study included a small convenience sample of PWID and may not be generalizable outside of Bangkok, however the findings do document reported misconduct in police activities with PWID and highlight the potential for widespread misuse of urine drug testing.
The authors say: "This study suggests that policing in Bangkok has involved injustices, human rights abuses, and corruption, and policing practices in this setting appeared to have increased PWID's vulnerability to poor health through various pathways."
In a linked Perspective, Scott Burris from Temple University (uninvolved in the study), United States, and Stephen Koester from the University of Colorado Denver, United States, examine policing activities in other countries and discuss the need for better integration of public health policy with policing activity.