title: The Cedar Project: impacts of policing among young Aboriginal people who use injection and non-injection drugs in British Columbia, Canada.
abstract: BACKGROUND
  Policing has profound health implications for people who use illicit drugs. Among Aboriginal communities, distrust of police is common, due partly to legacies of colonial policing. In response to the paucity of research among Aboriginal people who use drugs, this paper aims to: (1) Describe the policing experiences of young Aboriginal people who use drugs; (2) Identify policing activities associated with unsafe injection practices; and (3) Elucidate barriers to positive police relations.
  
  
  METHODS
  The Cedar Project is a cohort study involving young Aboriginal people in Vancouver and Prince George, British Columbia, who use illicit drugs. This mixed-methods study (N=372) used period prevalence from 2007 to 2010 to describe policing experiences, mixed effects regression models to identify correlates of policing activities, and thematic qualitative analysis to assess attitudes to police relations.
  
  
  RESULTS
  Many participants were stopped by police (73%), experienced physical force by police (28%), had drug equipment confiscated (31%), and changed location of drug use because of police (43%). Participants who reported dealing drugs (40%) were significantly more likely to experience police engagement. Among participants in Prince George, 4% reported to have had non-consensual sex with members of the criminal justice system. Policing activity was significantly associated with syringe sharing, rushed injection, and reused syringe. Due to personal experience, practical concerns, and intergenerational legacies of unfair policing practices, most participants did not want a positive relationship with police (57%). Desire for a positive relationship with police was directly associated with being helped by police, and inversely associated with being stopped by police and experiencing physical force by police.
  
  
  CONCLUSIONS
  Policing activities may be impacting the well-being of Aboriginal people who use drugs. Due to focused prosecution of street-level drug dealing, some police may favor enforcement over harm reduction. Positive police engagement and less aggressive policing may enhance perceptions of police among young Aboriginal people who use drugs.
authors.affiliation: University of British Columbia, School of Population and Public Health, Canada; Centre for Health Evaluation and Outcome Sciences, Canada.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Pan
authors.forename: Chief Wayne M
authors.initials: CW
authors.lastname: Christian
authors.forename: Margo E
authors.initials: ME
authors.lastname: Pearce
authors.forename: Alden H
authors.initials: AH
authors.lastname: Blair
authors.forename: Kate
authors.initials: K
authors.lastname: Jongbloed
authors.forename: Hongbin
authors.initials: H
authors.lastname: Zhang
authors.forename: Mary
authors.initials: M
authors.lastname: Teegee
authors.forename: Vicky
authors.initials: V
authors.lastname: Thomas
authors.forename: Martin T
authors.initials: MT
authors.lastname: Schechter
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Spittal
mesh_terms: D000328:Adult; D001955:British Columbia; D002170:Canada; D015331:Cohort Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D008297:Male; D016495:Police / Q000706:statistics & numerical data*; D012044:Regression Analysis; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology*
keywords: Aboriginal people; Canada; Drug use; Longitudinal; Mixed-methods; Policing