Social Worker with a Gun: The Role of Policing in Harm Reduction among Addicts

Hannah Schwendeman
Hank and Max
Hank has been evicted again, his shack ripped down by highway patrol. The officer in
charge told him Youre on state property! Were teachin you a lesson. Cold and shivering,
Hank sets up in his buddy Maxs encampment to cook a bag of heroin. Hank reaches into his
sock and pulls out a syringe so old the numbers on the chamber have faded, explaining that the
cops took all my clean ones. They sit together, a pizza box as their preparation table, and settle
in for the evening (Bourgois 112).
Introduction
From the perspective of these street addicts, police officers are destabilizing, destructive,
and demeaning. Fear of arrest and eviction is chronic due to harsh drug policies along with the
enforcement of ordinances against public intoxication, urination, and sleeping outside (Bourgois
112-113). Police (and much of society) view these addicts as failures, a social nuisance, or
simply do not wish to see them at all. The relationship between the police and addicts is
obviously fraught with tension, with the police enforcing law and order and addicts rebutting
both of these principles, at least on the surface. However, while the police are seen as an
instrument of oppression and aggression to many addicts, they are also representatives of the
institution most likely to improve addicts circumstances due to their discretion and authority.
But can the police, in their institutional role of security and order, also act as harm reductionists?
On a foundational level, the principles of harm reduction do align with security and order;
therefore such principles can and should be enacted by the police without comprising their
position.
In this paper, I will explore the relationship between street drug addicts and police
officers, primarily using the work of Egon Bittner, Loader and Walker, as well as public health
articles regarding the effects of law enforcement practices on addicts. For the purposes of this

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paper, I define addict as an individual engaging in a maladaptive pattern of substance abuse

manifested by recurrent and significant consequences related to the repeated use of drugs
(National Association 269); more specifically, I will address the relationship between injection
drug users (such as heroin and methamphetamine addicts) and the police. I will present tangible
suggestions through which the police can develop their contact with street addicts, while also
recognizing the permanent tensions between these populations. I will suggest that the
discretionary power that is central to policing is also the mechanism through which the police
can more authentically engage with addicts. Utilizing the conception of specific and general
order, I will argue that while the police and drug addicts will always be in an oppositional
relationship, there are real ways in which the police can more appropriately engage with street
addicts; furthermore, it is fundamentally the responsibility of the police to consider the public
health consequences and experiences of drug addicts when using their discretionary power on the
street.
The Public Health Consequences of Law Enforcement
Law enforcement practices influence the everyday choices of addicts, especially
regarding the safety of their drug use. A variety of studies have been conducted on how the
police influence the behaviors of injection drug users, also referred to as IDUs. Research has
demonstrated that repressive legal action is associated with higher rates of HIV/AIDS among
injectors. Ethnographic and quantitative studies have documented that the climate of fear and
uncertainty the law enforcement system creates for IDUs contributes to unhygienic practices,
such as storing drugs in the nose or mouth. Fear of arrest can lead drug injectors to avoid needle
exchanges or utilize unsafe injecting practices. In order to escape police detection, injection drug
users feel pressured to hurriedly consume drugs, which increases risk. They may also inject in
unsafe environments, or shooting galleries, where a large population of drug users will gather

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to inject drugs (Burris 134; Friedman 97). The aggressive enforcement of paraphernalia laws
promotes the reuse of dirty needles and creates a disincentive for addicts to turn their needles
into syringe exchanges (Bourgois 303). Researchers have documented that while police
intervention can successfully reduce open drug sales in markets when targeted, it can also lead to
a significant reduction in participation in nearby syringe exchange programs (Davis 233). The
criminalization of drug use and abuse negatively impacts the health, safety, and social position of
drug users.
Not only is increased police presence correlated with unsafe injecting practices, such as
sharing needles (as demonstrated by Hank and Maxs story), but police action can disperse a
population of addicts, making it more difficult for public health services to keep in contact with
their community (Small 85). This is a contentious issue between public health workers and police
officers, as outreach programs are motivated to maintain close relationships with these
populations and therefore need to know their location; aggressive law enforcement tactics will
almost certainly shift (if not completely alter) the geographic patterns of addicts. It is not merely
arrests that can increase risk for IDUs, but a variety of police practices and interactions; indeed
any large-scale police operation has the potential to unsettle drug users (Davis 234). While the
police and public health outreach programs often interact with the same marginalized
populations, their goals and focus are obviously contrasting. Public health workers primarily
seek to identify causality of the issue and control the risk factors associated; unlike police
officers, they do not discriminate between victim and offender or assign blame to the situation
(Joseph 238). Due to these conflicting philosophies, an operation that may be successful
according to policing standards, such as a decrease in drug sales in a particular environment or
the seizure of paraphernalia and narcotics, can and has translated into a public health issue.

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However, it is possible for public health and criminal justice goals to be integrated. A
recent example of such collaboration is Drug Treatment Courts, which represent a marriage
between communities that have been traditionally at odds and foreign to each other including
treatment communities, courts, defense attorneys, and police (Hora 12). Criminal justice officers
have recognized that incarceration cannot successfully treat drug addicts or rehabilitate their
criminal behavior (Hora 445; Hora 453). Drug courts demonstrate that legal systems can be more
than solely punitive. This system acknowledges that drug possession and drug use is not merely
an instance of law breaking, but also a public health issue that stems from structural disparities.
While the politics, efficiency, and implications of drug courts are beyond the scope of this paper,
I include this example to establish that while public health and criminal justice perspectives are
often opposing, it is possible for these systems to be integrated towards the common goal of
safety and security.
On the street, there are tangible methods through which the police can improve their
relationship with street addicts. Police officers can avoid interacting with drug users while they
are injecting to reduce the risk of dangerous injection practices. Officers can rely on warnings to
drug users and referrals to addiction treatment, rather than arresting non-violent street addicts. In
other words, police can avoid arresting individuals whose only crime is their drug use. These
cautioning policies can be considered a balanced approach to drug abuse that informs violators
of their crime and provides information regarding treatment and other social support programs.
In this manner, the police are not wholly condoning criminal behavior while also avoiding harsh
punishment or negative altercations (Goetz 481). Confiscating and destroying only drugs, not
drug paraphernalia, can decrease the public health risks associated with aggressive law
enforcement (Small 92-93). Police officers should not interrogate or arrest addicts within the
vicinity of a syringe exchange program; by engaging in law enforcement practices in this

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environment, police deter the population from accessing a public health resource and breed
mistrust of the organization. Furthermore, police officers need to be educated on the realities of
drug addiction and the philosophy of harm reduction; by understanding the reality of addiction,
as well as the institutional factors influencing these individuals behavior, police officers can
more authentically engage with addicts. By recognizing that drug addiction is not a choice, a
sign of weakness, or a moral deficiency, police officers (and citizens in general) can develop
more appropriate responses to addicts and hopefully make a positive difference. More generally,
the police should always treat their constituents with respect and dignity, even those they do not
understand. The most marginalized individual is still a citizen and a person worthy of kindness
and acceptance. These small changes of honesty and understanding would certainly enhance the
everyday street encounters between the police and addicts.
The Police and Hegemonic Reinforcement
Because addicts are a marginalized, criminalized population, the police interact with them
more frequently. This street reality illustrates one of the intrinsic elements of policing: their
reinforcement of social divisions. According to Egon Bittner, by distributing surveillance and
intervention selectively [the police] contribute to already existing tensions in society; in other
words, the social divisiveness of policing is inherent to their work (100). As the police engage in
society and perform their daily functions, they also maintain the hegemonic structure. Therefore,
as the police frequently interact with the most socially excluded populations of a society, they
also reinforce the systemic oppression of these groups. From this theoretical position, it would
seem impossible for the police to advance the lives of drug addicts. How can an oppressor
positively influence the oppressed? Especially when considering the harsh drug policies in this
country, it seems foolhardy to expect the police to create better relationships with addicts. How

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can the police do their job while also treating drug addicts respectfully? Through the most
central, yet individual component of their job: discretion.
Police Discretion
Discretion lies at the heart of the policing function (Maher 492). Egon Bittner argues
that discretion is central to policing because the law is defeasible. Because both the
understanding and the application of law is subjective, the reality of everyday police work then
bears little formal connection to law enforcement. Furthermore, because the environment in
which the police work is multifaceted, dynamic, and unpredictable, the polices authority to use
force is effectively unbound in practice, even if it is defined by law. The police possess the
legitimate authority to use force when necessary, but because of the unpredictability of their
work, this authority is in reality unrestrained. In other words, it is the individual police officer
working on the street that ultimately determines the enforcement of the law.
If the decisions of the police are determined by discretion, then the reality of police action
is found on the street-level and not in formal law. Law is not directly applied from word to street,
but is filtered and reinterpreted through various perspectives and systems. Burris argues that law
consists of four components: formal law; criminal justice procedures and policies; practices,
attitudes, and beliefs of street officers; and finally, in relation to this specific population, the
knowledge and beliefs of injection drug users. All of these pieces inform how policies are
enacted by police officers regarding drug addicts and transform policy into practice; this
transformation in turn influences the health outcomes of injection drug users (127-128).
Therefore, written statutes, everyday practices of police officers and criminal justice officials,
individual personalities, and cultural understandings of drug addicts are all implicated in the
application of drug policy onto the populace and the public health consequences of this
application. When the police are conscious of this multifaceted process, they can be more aware
of the ramifications of their day-to-day choices on the street.

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Both the choice to enforce the law and the law itself are subjective experiences; therefore,
there is a distinct gap between formal and practiced law. It is in this gap that the police work.
When the police choose not to arrest a drug abuser, but instead refer them to a clinic, they are
engaging within this space between formal and practiced law. A drug addict in possession of
narcotics is a criminal and according to formal law, should be arrested; however, the police can
and do evaluate situational factors in their arrests, which can benefit the citizen. But this
discretion can also be utilized to demean individuals. Even when the possession of drug
paraphernalia is legal, street addicts have experienced harassment and further interrogation from
police officers due to carrying syringes (Small 90). Here, the police officer assumes the addict is
not aware of their legal right to carry syringes, a policy which benefits their public health, and
takes advantage of their discretionary power to humiliate them. While police officers ability to
move outside formal laws constraints can be positive, this unconstrained position can also inflict
unnecessary harm. These examples illustrate how the law can be reconstituted to fit the situation
and how the polices discretionary power shapes the criminals experience of the law on the
street.
Police officers should consider the public health consequences of their discretionary
decisions when working on the street. Because the police make choices about how and when to
enforce the law...[m]inimizing drug-related harm should be a factor that feeds into that choice
(Maher 507). Indeed, some public health officials have argued that police discretion is required
in order for harm reduction principles to be incorporated into policing. According to the
Advisory Council on the Misuse of Drugs in England, harm reduction principles are not
incompatible with vigorous street policing, indeed in many circumstances may actually require
it (Goetz 479-481). Because the police have the immutable capacity to decide whether a
situation requires legal action (and also determine what that legal action will be), the police are

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in a unique position to redirect the application of formal law. This discretion is especially
significant in a country with harsh drug policies as the police can regulate the enforcement of
these laws to meet the situation. Discretion is central in the shift from punitive to treatment
measures regarding drug abusers; with each individual police officers decision to incarcerate or
to rehabilitate, these relationships can evolve little by little. When harm reduction is framed
within larger crime prevention goals by individual police officers (as it has been in foreign
countries), these attitudes can be more successfully integrated into their practices. Rather than
feeling like a social worker with a gun instead of a cop, this perspective recognizes that harm
reduction measures ultimately reduce crime and increase order and security in society (Goetz
490).
Order Maintenance
Because law is defeasible, the role of the police officer cannot be defined simply as law
enforcement. Bittner argues that police are not law enforcers; rather, they are protectors of
societal peace, which sometimes requires enforcing the law. Law enforcement is a means, not an
end of the police. The function of the police then is to maintain order and security for the
populace. Citizens rely on the police to deal with fissures of ordering, even those involving
intimates (Manning 63). Police can comfort because they have the ability to address morally
ambiguous and precarious circumstances. When citizens lives become chaotic, unmanageable,
or dangerous, we call the cops to reinstate order. But this begs the question, what kind of
order? Whose order and for what purpose?
In the domain of order maintenance, the police can enact both specific and general order;
the delineation between these forms of order, coined by Marenin, illuminates the tenuous
position the police hold in society and the duality of their role. Specific order refers to the
reinforcement of existing social structures; in other words, policing as a means of hegemonic
stability. This idea relates to Bittners claim that the police are more likely to interact with

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marginalized groups and thus contribute to their oppression. Within this framework, the
relationship between the police and the addict is fundamentally opposing, with the police as the
oppressor and the addict as the oppressed. The maintenance of specific order is intricately linked
to the coercion and violence of the state (Loader 13). The threat of violence must remain present
and legitimate in order for laws to be followed and reason to be maintained. The state both
legitimizes and controls violence, in order for security to be achieved.
Specific order can also be understood as the control of behavior deemed reprehensible or
contrary to the states interests. Foucault argues that it is society that defines, in terms of its own
interests, what must be regarded as a crime: it is not therefore natural (Lawrence 445). Drug
abuse is often seen not as a medical problem or disease, but a moral weakness. Because drug use
and addiction is viewed as irresponsible and immoral, it is criminalized in order to expunge such
practices from the community and the state. Through the law, the state monitors citizens and
penalizes unproductive or unacceptable actions, structures, and persons. In sum, the police
implement the states force over the populaces behaviors and in doing so, maintain existing
societal power structures.
However, the police are also charged with defending general order or the preservation of
basic standards of public tranquility in which all social groups have a stake (Loader 13).
General order then can be considered as security with the goal of societal and democratic peace.
Loader and Walker frame this security as a Public Good for all citizens and argue for the
establishment of a more positive, collective perception of the police. As maintainers of security
and peace, the police embody the state and allow for security to be shared. From this perspective,
police work actively promotes democratic rights within a community of citizens, rather than
being considered a threat to such rights (Loader 17). Such a conception relates to Foucaults
discussion of the Polizei, or policing in the original sense of fostering morality and stability. In

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the framework of the Polizei, the police govern not by the law but by a specific, a permanent,
and a positive intervention in the behavior of individuals (Foucault 415). The authority of the
police over social interactions is thus a collective good according to this conception, a means of
social progress. The category of general order distinguishes the polices affirmative mission to
ensure societal peace.
The separation of specific and general order is especially useful when discussing the
polices relationship with criminalized populations like addicts. This approach recognizes that
while the police contribute to the oppression of addicts, they can simultaneously preserve
security and order that most basically improve society. This is not to say that every instance
where a drug user is arrested or harassed is both oppressive and promoting peace. Rather, that is
possible within the realm of policing (and within their discretionary power) to preserve security
and basic standards, even though this preservation occurs within a hegemonic structure. Given
their street-level interactions, powerful institutional backing, and authority, the police are best
equipped to tackle the public health issues related to drug addiction. Within the framework of
general order, drug treatment and public health considerations do fall under the scope of order
maintenance and therefore under the authority of the police. In other words, the police and the
addict are in foundationally opposing social positions; but the police can still contribute to the
welfare of these individuals in their everyday practices. Indeed, they are ultimately responsible
for this welfare.
Some might argue that from the perspective of general order it is the policemans duty to
crack down on drug users and addicts even more, because this population symbolically
represents social corruption. As potential sources of disorder and violence, the drug addict
population cannot be condoned in an ordered and peaceful society. Because they are considered
to be morally reprehensible and promote fear within the community, addicts should be removed

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from the public space (Maher 491). However, this perspective is short-term and focuses on the
visible, rather than the tangible. A truly orderly society will dig to the root of immoral or
disorderly issues to eradicate them, not make these issues invisible. A society that promotes
general order should not merely appear to be peaceful and secure, but its citizens should all
experience this peace, especially marginalized populations like addicts.
Others might contend that it is not the polices job to protect the health of drug addicts.
While public health is not the polices sole concern, it is relevant to consider the addicts health
from the perspective of order. If the police are fundamentally seeking to maintain societal order,
then the health and conduct of drug addicts does fall under their realm of obligations. A
community will be more peaceful and orderly if drug users have access to public health services
and treatment. On a more pragmatic level, the police simply interact with addicts more
frequently and have more opportunities to influence this populations experience. With better
education on drug addiction and a recognition of this groups difficulties, the police can
significantly impact their relationships with these individuals. While there are institutional
challenges, police officers have the expertise, the opportunity, and the resources to positively
impact addicts lives, if they gain the skills and knowledge to do so.
Conclusion
If we acknowledge that the police are not law enforcers, but agents of security and peace,
then it is possible for the police to enact forms of prevention and treatment for drug addicts. If an
addict is not merely seen as a criminal or a vagrant, but a citizen, then the relationship between
the police and this population can advance. This is certainly not an easy fix, nor do I presume to
consider this a solution. I simply argue that we can accept the essential opposition of the police
to the addict, while also recognizing the responsibility of the police to serve this population with
respect and with the ultimate goal of security and peace for all citizens. Through their
discretionary power, the police can and should improve the public health and welfare of addicts,

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because they are the best positioned in todays society to do so. If the police can be cognizant of
their position towards addicts then they can begin to make small, yet significant differences in
these interactions. By being respectful, rather than judgmental or punitive, they can ultimately
shift their relationship to addicts. By recognizing the link between order and health, respect and
authority, the police can begin to authentically connect with people like Hank and Max.

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