ABSTRACT
In recognition of the enormous harms resulting from aggressive enforcement of prohibitionary drugs control laws, many jurisdictions now authorise police officers to divert community members to social and health services in instances that would have previously resulted in an arrest for minor drug-related activity. This partnership between law enforcement and public health actors has obvious benefits compared with conventional policing practices. But while the model has produced positive outcomes in some settings, implementation challenges have been considerable in others. Aligning law enforcement and public health activities is especially complicated in large US cities where systems for delivering social and health services are chronically underfunded. In these settings, such programmes can perpetuate the medicalisation of chaotic substance use, homelessness, and other social distress, producing substantial incidental harm while obscuring more effective upstream strategies for promoting individual and community health. In this chapter, the authors explore these issues in describing the development of a pre-booking programme in Philadelphia, the poorest large city in the United States. Accounting for local context, the authors contend, is essential to understanding the potential value and possible pitfalls of pre-booking programmes as a replacement for many current drugs policing practices.
