Background: Given most research on inequitable policing practices has focused on people who use drugs (PWUD) in the United States and other settings in North America, we sought to characterize the correlates of police contact and police violence among PWUD in Toronto, Canada, the nation’s largest multiracial city.

Methods: Survey data were collected from a cohort of PWUD between November 2019 and February 2023. This cross-sectional analysis used participants’ most recent interview. We estimated covariate-adjusted prevalence ratios (PR) using modified Poisson regression. Outcomes were past six-month experiences of police contact and police physical force.

Results: Among 418 participants, the median age was 39.5, 257 were men (61.5 %), and 225 (53.8 %) reported recent contact with police, among whom 73 (32.4 %) reported violent police encounters. Frequent use of stimulants (PR: 1.32, 95 % CI: 1.09–1.60), illegal income generation (PR: 1.42, 95 % CI: 1.14–1.76), and non-fatal overdose (PR: 1.19, 95 % CI: 1.00–1.41) were positively associated with police contact, while residing outside of the downtown core (PR: 0.78, 95 % CI: 0.63–0.98) was negatively associated. Being Indigenous (PR: 1.98, 95% CI: 1.34–2.93), identifying as lesbian, gay, bisexual, or another sexual minority (PR: 1.66, 95 % CI: 1.05–2.62), and past six-month use of drug or alcohol treatment other than opioid agonist therapy (PR: 1.64, 95 % CI: 1.07–2.51) were positively associated with police violence.

Conclusions: Police violence was common among PWUD with recent police contact. Indigenous and sexual minority participants, and participants engaged in drug or alcohol treatment were more likely to experience violent police encounters. Our findings highlight systemic racism and discrimination within law enforcement practices. Criminal legal reform must reduce the disproportionately high burden of harmful police practices among equity-deserving PWUD.

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