# Harm Reduction Policing? A Qualitative Study of Police Culture and Enforcement Practices Toward People Who Use Drugs Amidst Efforts to Align Public Health and Public Safety Systems

> **NIH NIH R36** · UNIVERSITY OF TEXAS AT AUSTIN · 2024 · $50,929

## Abstract

Project Summary
The recent convergence of the overdose epidemic and continued racialized police violence has accelerated
efforts to mitigate the racially disparate harms of policing toward people who use drugs (PWUD) by aligning
law enforcement’s role as first responders with evidence-based public health approaches to drug use rooted in
harm reduction. Police departments now commonly equip officers with naloxone, participate in partnerships
with healthcare service providers, and have a lead role in celebrated diversion programs targeting PWUD and
other marginalized populations. Despite initial evaluations of these approaches showing promise in isolation,
widespread and enduring reform across the institution of policing has not materialized. Punitive enforcement of
drug offenses remains central to the institution of policing. True harmonization of criminal justice and public
health systems requires broad changes to well-established cultural and institutional norms. The proposed R36
application builds on pilot program evaluations and studies examining changes in isolated measures of police
enforcement by examining how police officers in Baltimore City, Maryland, negotiate, contest, and make sense
of drug policy reforms and guidance from public health authorities in order to understand how the broader
cultural shift toward evidence-based approaches to substance use is being translated into policing practices
that are ultimately experienced by PWUD. Through in-depth interviews with Baltimore Police Department
(BPD) leadership (n=20), observations of BPD public-facing events (n=15), and observational ride-alongs with
street-level officers (n=60), this research aims to qualitatively explore, 1) how police leadership integrate harm
reduction approaches to drug enforcement into the department’s organizational approach to PWUD, and 2)
street-level officers’ beliefs, attitudes, and enforcement practices towards PWUD. Analysis of interview
transcripts and observation fieldnotes will be conducted using an abductive approach, drawing on theories and
concepts from studies of organizations and organizational change, police culture, risk environments and
structural determinants of health. The PI of the proposed R36 application, Bradley Silberzahn, is a doctoral
candidate in the Department of Sociology at the University of Texas at Austin (UT Austin). Brad will lead all
study procedures, as well as a broader expert panel comprised of faculty from UT Austin, Johns Hopkins
Bloomberg School of Public Health, and New York University’s School of Global Public Health. This research
will inform ongoing debates over drug policy and the role of law enforcement in harm reduction, as well as
identify barriers and avenues for widespread and enduring police reform that facilitates police enforcement
practices that are in alignment with, not antithetical to, public health.

## Key facts

- **NIH application ID:** 10916417
- **Project number:** 5R36DA058861-02
- **Recipient organization:** UNIVERSITY OF TEXAS AT AUSTIN
- **Principal Investigator:** Bradley Edward Silberzahn
- **Activity code:** R36 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $50,929
- **Award type:** 5
- **Project period:** 2023-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10916417

## Citation

> US National Institutes of Health, RePORTER application 10916417, Harm Reduction Policing? A Qualitative Study of Police Culture and Enforcement Practices Toward People Who Use Drugs Amidst Efforts to Align Public Health and Public Safety Systems (5R36DA058861-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10916417. Licensed CC0.

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