Exploring willingness to engage with law enforcement among syringe service program participants in New York City

Abstract Background In New York City (NYC), 1,487 unintentional overdose deaths occurred in 2017, largely driven by the presence of fentanyls in the illicit drug market. In response to fentanyl-involved overdoses, law enforcement entities both nationally and in NYC have taken a new interest in overdose events. This study explored attitudes toward and willingness to engage with police among NYC syringe service program (SSP) participants, a population likely to have had experiences with overdose and/or police. Methods Between March and July 2017, 332 surveys were conducted with a convenience sample of NYC SSP participants. Results Most respondents (76%) reported ever being arrested for a drug-related crime. Few respondents (5%) reported a previous arrest in the context of an overdose event. Of the 62 respondents who had witnessed an overdose in the previous 12 months, 25% had not called 911 because of concerns about law enforcement. Over half (51%) of all respondents reported they would not be willing to aid police in their investigation of the person who supplied the drugs. Conclusion Police investigations of both fatal and non-fatal drug overdose events have the potential to exacerbate mistrust of law enforcement and discourage emergency medical service utilization among PWUD.