Police drug crackdowns and hospitalisation rates for illicit-injection-related infections in New York City

Using longitudinal data, this analysis tests the hypothesis that eight police drug crackdowns implemented in 27 New York City police precincts between 1995 and 1999 were associated with subsequent increases in monthly precinct-specific hospitalisation rates for illicit-injection-related abscesses, cellulitis, and endocarditis. Crackdowns are sustained police initiatives designed to reduce the possession and sale of illicit drugs through heightened surveillance and arrests of drug users and street-level dealers. We linked hospitalisation data (48,986 illicit-injection-related abscess or cellulitis cases and 5452 illicit-injection-related endocarditis cases) and arrest and United States Census data to police precincts to calculate hospitalisation and arrest rates. Analyses indicate that drug-related arrest rates climbed 39% in the crackdowns’ first year compared with the previous year. Contrary to our hypothesis, we found evidence of a stasis or decline in hospitalisation rates in the crackdowns’ first year, based on multivariate Poisson regression models that included sensitivity analyses that accounted for the increased incarceration of injectors after each crackdown's onset. We discuss several possible explanations for these findings and conclude that future research is warranted regarding the relationship between police strategies and drug users’ health that incorporates inmate health data and both individual-level and precinct-level data.