Illicit Trade, Law Enforcement, and Community Health: Mapping the Interdependencies
A Literature Review
Drawing on international and Canadian research, this literature review by the Institute on Governance (IOG) examines how the illicit drug trade, law enforcement, and community health shape one another.
The evidence shows that illicit markets are resilient and they adapt quickly to disruptions.
These adaptations increase overdose risk, market violence, and injection practices that spread HIV and hepatitis C. Criminalizing possession and use adds further harm.
Fear of arrest discourages people from calling for help or using overdose prevention services, arrest and incarceration erode access to housing, education, and employment, and overdose risk rises more than tenfold after release from custody.
The review concludes that enforcement is not irrelevant, but that approaches focused on enforcement outputs work poorly unless they are coordinated with health and social systems.