Abstract
BackgroundThailand has for years attempted to address illicit drug use through aggressive drug law enforcement. Despite accounts of widespread violence by police against people who inject drugs (IDU), the impact of police violence has not been well investigated. In the wake of an intensified police crackdown in 2011, we sought to identify the prevalence and correlates of experiencing police beating among IDU in Bangkok.MethodsCommunity-recruited samples of IDU in Bangkok were surveyed between June 2009 and October 2011. Multivariate log-binomial regression was used to identify factors associated with reporting police beating.ResultsIn total, 639 unique IDU participated in this serial cross-sectional study, with 240 (37.6%) participants reporting that they had been beaten by police. In multivariate analyses, reports of police beating were associated with male gender (Adjusted Prevalence Ratio [APR] = 4.43), younger age (APR = 1.69), reporting barriers to accessing healthcare (APR = 1.23), and a history of incarceration (APR = 2.51), compulsory drug detention (APR = 1.22) and syringe sharing (APR = 1.44), and study enrolment in 2011 (APR = 1.27) (all p < 0.05). Participants most commonly reported police beating during the interrogation process.ConclusionsA high proportion of IDU in Bangkok reported having been beaten by the police. Experiencing police beating was independently associated with various indicators of drug-related harm. These findings suggest that the over-reliance on enforcement-based approaches is contributing to police-perpetrated abuses and the perpetuation of the HIV risk behaviour among Thai IDU.
Highlights
Thailand has for years attempted to address illicit drug use through aggressive drug law enforcement
Thailand has experienced longstanding epidemics of illicit drug use and human immunodeficiency virus (HIV) among inject drugs (IDU), with an estimated 5% of the population using illicit drugs in 2007 and an estimated 30–50% of IDU living with HIV/AIDS over two decades [6,7]
Reports of police beatings were significantly and positively associated with male gender; a history of heroin injection (PR: 2.45; 95% CI: 1.45–4.15), midazolam injection (PR: 1.52; 95% CI: 1.10–2.10), and crystal methamphetamine injection (PR: 1.47; 95% CI: 1.17–1.84); a history of syringe sharing (PR: 1.93; 95% CI: 1.52–2.45); a history of incarceration (PR: 3.00; 95% CI: 1.98–4.56); a history of compulsory drug detention (PR: 1.33; 95% CI: 1.06–1.66); a history of methadone treatment enrolment (PR: 1.74; 95% CI: 1.30–2.33); reporting barriers to accessing healthcare (PR: 1.55; 95% CI: 1.25–1.93); HIV seropositivity (PR: 1.35; 95% CI: 1.08–1.67); a history of non-fatal overdose (PR: 1.60; 95% CI: 1.32–1.95); and study enrolment in 2011 (PR: 1.39; 95% CI: 1.13–1.71)
Summary
Thailand has for years attempted to address illicit drug use through aggressive drug law enforcement. Illicit drug use remains a significant problem, and the dominant response continues to be the enforcement of drug laws that criminalize illicit drug use and trafficking [1]. Thailand enacted a new law that reclassified people who use drugs as “patients” not “criminals” in 2002, the criminal laws governing drug use remain in effect, and the Thai government has continued to support intensive police crackdowns, as well as compulsory detention and incarceration of people who use drugs [8]. The Thai government promised that the police would not breach due process again, recent reports suggest that police misconduct has continued during subsequent crackdowns. Other reports documented police misconduct and fatal shootings of suspects during drug suppression operations in 2012 [16,17]
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