Police officers’ attitudes and practices toward harm reduction services in Sweden – a qualitative study

Since the 1980s, Swedish drug policy has combined a restrictive zero tolerance approach with a strong focus on street level drug law enforcement by the police. However, in recent years access to harm reduction services has increased through local initiatives and new national guidelines. The aim of this study was to explore how Swedish police officers view harm reduction services users and act towards services in a national drug policy setting of zero tolerance.

Using a qualitative research design, we conducted 19 in-depth interviews with police officers who worked in drug law enforcement in Malmö. We conducted a qualitative textual analysis of the data.

Police officers largely supported harm reduction services and refrained from overtly enforcing drug laws in the vicinity of these services. Officers engaged in boundary work that assigned the responsibility of care of marginalized people who use drugs (PWUD) to the health care system, while including policing of drug market problems, young drug users and dealers in their own jurisdiction. Opioid substitution treatment was seen as positive, although diversion of medicines was defined as a problem within police jurisdiction. Needle exchange was defined as an important public health service and a no-go zone for the police. Several officers were open to carrying naloxone on duty but wanted more information about its use.

The general support among police officers for harm reduction services is an indication of a changing drug policy landscape in Sweden. Officers’ support for and willingness to carry naloxone suggests that such a program for police officers is plausible in Sweden. Drug policy should take police officers’ views into consideration and there is a need for collaboration between police and services. Further research should focus on how the police employ boundaries since police actions may impact on the success of harm reduction services.