Summary
Between June 2009 and June 2012, a community-recruited sample of people who inject drugs (IDU) in Bangkok participated in a serial cross-sectional mixed-methods study and completed interviewer-administered questionnaires and semi-structured in-depth interviews. Audio-recorded interviews were transcribed verbatim and a thematic analysis was conducted to document the character of IDUs’ encounters with police. A variety of multivariate regression techniques were used to estimate independent relationships between exposures to specific policing tactics and indicators of drug-related harm, as well as to examine a temporal trend of street-level availability of illicit drugs. Respondents’ narratives indicated that drug policing involved numerous forms of human rights infringements and negatively influenced healthcare access among IDU in Bangkok. Reports of beatings and drug testing by police were common (38% and 67%, respectively) and were independently associated with various indicators of drug-related harm, including syringe sharing and barriers to healthcare. Street-level availability of illicit drugs increased significantly between 2009 and 2011. The findings indicate that the over-reliance on repressive drug policing is not suppressing the illegal drug market and is instead contributing to police-perpetrated abuses, the perpetuation of risky injection behaviour, and an impediment to healthcare among IDU in Bangkok. These findings raise concern about the ongoing policing practices and point to the need for providing greater police oversight, as well as a shift toward more balanced approaches to drug control in this setting.