ArticleThe International journal on drug policy2020
Police-related barriers to harm reduction linked to non-fatal overdose amongst sex workers who use drugs: Results of a community-based cohort in Metro Vancouver, Canada.
Article in The International journal on drug policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
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Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis.Harm reduction journal · 2024Pooled it
- Health inequities faced by sex workers.The Lancet. Public health · 2026Review
- Frequent police contact and nonfatal overdose among people who use drugs in rural Appalachia.Drug and alcohol dependence · 2026Article
- Take-home naloxone (THN) ownership among a community-based cohort of sex workers who use drugs in metro vancouver: longitudinal trends and structural determinants (2017-2024).Harm reduction journal · 2026Article
- How survivors of exploitation who use drugs navigate systems of care: an analysis of survivor insights using the intersectional risk environment.Harm reduction journal · 2026Article
- DIFFICULTY ACCESSING SUBSTANCE USE TREATMENT AMONG INDIGENOUS PEOPLE IN A CANADIAN INNER CITY SETTING.International indigenous policy journal · 2026Article
- Access to health and harm reduction services during drug decriminalization in British Columbia, Canada: a mixed-method study.BMC public health · 2026Article
- Let the girls know, "you can come here": qualitative experiences with harm reduction and health services among women who use drugs in Chicago.Harm reduction journal · 2026Article
- Use of clinic- and community-based overdose prevention services by sex workers who use drugs: findings from a community-based cohort in Vancouver, Canada (2017-2024).Harm reduction journal · 2026Article
- What we need, not what we're given: recommendations for action from young sex workers who use drugs.Harm reduction journal · 2026Article
- "Because we're the experts": centering the expertise of people who use drugs to identify and propose solutions for overdose prevention.Harm reduction journal · 2025Article
- Policing and access to harm reduction services among young people who use drugs and young Indigenous people who use drugs before and after the pilot implementation of decriminalization of personal possession.The International journal on drug policy · 2025Article
- "We're Not Gonna Aid You in Shooting Up": Stigma's Relationship to Harm Reduction in People Who Inject Drugs.Journal of general internal medicine · 2025Article
- "They won't prosecute, but they will though:" the continuing struggle between criminalization and harm reduction within the criminal justice system in the context of an opioid overdose crisis.Harm reduction journal · 2025Article
- Characterizing changes to harm reduction site operations in British Columbia following the implementation of the decriminalization of drugs: Findings from a provincial survey.Harm reduction journal · 2025Article
- Spatial epidemiology of nonfatal overdose in a community-based cohort of marginalized women in Vancouver, British Columbia (2014-2022).Drug and alcohol dependence · 2025Article
- "We've lost a lot of lives:" the impact of the closure of North America's busiest supervised consumption site on people who use substances and the organizations that work with them.Harm reduction journal · 2025Article
- Community-administered naloxone for overdose reversal: The role of sex worker-led programming and occupational violence in a community-based cohort (2018-2024).The International journal on drug policy · 2025Article
- Article
- A scoping review on barriers and facilitators to harm reduction care among youth in British Columbia, Canada.Harm reduction journal · 2024Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHigh rates of overdose and overdose-related mortality in North America represent a pressing health and social concern. Women sex workers face severe health and social inequities, which have been linked to structural factors including negative police interactions; however, little is known regarding the burden of overdose or how policing impacts overdose risk amongst sex workers who use drugs. Given this, we aimed to explore the independent effects of experiencing police-related barriers to harm reduction on non-fatal overdose amongst women sex workers who use drugs in Metro Vancouver, Canada over a 7.5-year period.
methodsData were drawn from An Evaluation of Sex Workers Health Access (AESHA), a community-based open prospective cohort of women sex workers in Metro Vancouver, from 2010 to 2017. Using multivariate logistic regression with generalized estimating equations (GEE), we used a confounder modeling approach to identify the independent effect of experiencing police-related barriers to harm reduction strategies on non-fatal overdose amongst sex workers using drugs within the last six months at each study visit.
resultsAmongst 624 participants, 7.7% overdosed within the last six months at baseline and 27.6% overdosed during the study period, contributing 287 non-fatal overdose events over the 7.5-year period. 68.6% reported police-related barriers to harm reduction strategies during the study. In a multivariate confounder model, exposure to police-related barriers to harm reduction strategies [AOR: 2.15, CI: 1.60-2.90] was independently associated with higher odds of non-fatal overdose after adjustment for key confounders.
conclusionsOur findings suggest that in the context of the current overdose crisis, adversarial policing practices may undermine access to lifesaving overdose prevention services and exacerbate overdose risks for marginalized women. Findings underscore the urgent need to scale-up access and remove barriers to progressive harm reduction strategies for women sex workers.
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