Unpacking the Effects of Decriminalization: Understanding Drug Use Experiences and Risks among Individuals Who Use Drugs in British Columbia.
Farihah Ali, Cayley Russell, Margret Lo, Matthew Bonn, Geoff Bardwell, Jade Boyd, Elaine Hyshka, Jürgen Rehm
Author Information
Farihah Ali: Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, 33 Ursula Frank St, Toronto, ON, M5S 2S1, Canada. farihah.ontcrism@gmail.com. ORCID
Cayley Russell: Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, 33 Ursula Frank St, Toronto, ON, M5S 2S1, Canada. ORCID
Margret Lo: Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, 33 Ursula Frank St, Toronto, ON, M5S 2S1, Canada. ORCID
Matthew Bonn: Canadian AIDS Society, 5445 Carling Street, Ottawa, ON, Canada. ORCID
Geoff Bardwell: School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada. ORCID
Jade Boyd: Department of Medicine, University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada. ORCID
Elaine Hyshka: School of Public Health, University of Alberta, 3-300 ECHA, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada. ORCID
Jürgen Rehm: Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, 33 Ursula Frank St, Toronto, ON, M5S 2S1, Canada. ORCID
OBJECTIVES: On January 31, 2023, a three-year exemption from the Controlled Drugs and Substances Act was granted to the Canadian province British Columbia (BC), allowing the cumulative possession of 2.5 g of specific unregulated drugs amongst adults. The goals of the policy are to reduce health, social, and economic harms associated with criminalization, stigma, drug overdose deaths, as well as drug seizures, arrests, and associated enforcement and court costs. As the inaugural year has passed, we aimed to assess people who use drugs' awareness and knowledge of the, as well as the policy's impact on their drug use patterns and overdose risk. METHODS: We conducted 100 telephone-based semi-structured interviews with people who use drugs from across BC, exploring changes in drug use experiences and perceived overdose risk since the implementation of the policy. Participants also completed an interviewer-administered survey assessing socio-demographics and substance use patterns. We utilized a qualitative content analysis approach to analyze the interview data. RESULTS: Our findings indicate a general awareness of the policy among participants, although some policy details were often misunderstood, and participants expressed the need for more widespread dissemination of policy information. While the majority of participants reported that their drug use patterns remained unchanged after decriminalization, some made subtle adjustments, such as carrying under the 2.5 g threshold to minimize the risk of criminalization. Participants highlighted several policy benefits and concerns, including its potential to reduce criminalization and stigmatization, but also increase public drug consumption. Participants offered suggestions for policy improvement. CONCLUSION: These findings underscore the need for ongoing monitoring of the impacts of decriminalization regarding its potential impact on people who use drugs' drug use patterns and related risks. Reevaluation of the possession threshold and efforts to enhance education and awareness about the policy could help achieve the policy's goals.
