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Decriminalization in B.C.

Information for local governments  on decriminalization of people who use drugs.
On January 31, 2023, an exemption to the federal Controlled Drugs and Substances Act came into effect in British Columbia, removing criminal penalties for the possession of small amounts of some illegal substances for personal use by people over 18 years old. The purpose of the decriminalization exemption is to reduce the stigma associated with substance use and support people to access important health and social services. 

Changes to decriminalization in B.C. 

On May 7, 2024, the Federal Government announced that they have approved the Province of B.C.’s request to exempt public spaces from B.C.’s decriminalization policy, effective immediately. Law enforcement now has the authority to seize illegal drugs possessed in public, in any amount, and make an arrest. Guidance for police will stress that officers must consider whether it would be preferable to take no further action, to warn the individual, or with consent of the individual to refer them to services, when dealing with an alleged possession offence, especially when the alleged possession offence does not pose a risk to others in the community. 

Possession of substances under the 2.5g threshold for personal use by adults, in private residences, designated addictions health care facilities, places where individuals are lawfully sheltering, and overdose prevention and drug checking sites remains decriminalized. 

These changes come into effect immediately. More information can be found on the B.C. government's Decriminalizing people who use drugs in B.C. page. 


Decriminalization and its impact

In BC, illegal drug toxicity death is the second-highest cause of years of potential life lost (only cancer was higher), and the highest cause in the 10-59 year age group. Fentanyl and its analogues (similar substances) remain the main driver of illegal drug toxicity deaths. BC has undertaken a number of actions to support its response to the toxic drug supply, including the Take-Home Naloxone program, medication-assisted treatments, prescribed alternatives to toxic drugs, overdose prevention and supervised consumption services, and broader treatment and recovery supports; more information can be found on Toward the Heart, in the Adult Substance Use System of Care Framework, and in the Ministry of Mental Health and Addictions data snapshot.

Decriminalization is intended to reduce the stigma and criminalization that can prevent people who use drugs from accessing health and social services, and drive people to use alone where there is nobody to respond in the event of a drug poisoning event. It has been undertaken in part out of recognition that some groups have been more harmed by the criminalization of drugs than others, including but not limited to Indigenous, Black, and other racialized communities who experience disproportionate police interactions.
  
It is intended to approach substance use as a health matter and not a criminal justice issue, and to support pathways into the substance use system of care. Information about and a listing of mental health and substance use services can be found at:  Help Starts Here and Toward the Heart.
 
It will take time to understand the full impacts of decriminalization, and several evaluation and monitoring activities are underway. Findings to date have identified the following key results: 
  • In the first nine-month period after decriminalization was implemented, the number of possession offences decreased by 77%, and the number of seizures below 2.5g decreased by 96%, compared to the previous four years’ average.  
  • The North and Southeast regions of BC saw the biggest decrease in rates of possession charges.  
  • There is no systematically collected evidence about whether public substance use, including use in hospitals, increased or decreased since the implementation of decriminalization. 
  • Use of health care resources, including opioid agonist treatment (medication for opioid use disorder), overdose prevention sites, and drug checking remained stable in the ten months following the implementation of decriminalization, while the number of take-home naloxone kits shipped to participating sites increased. 
The BCCDC continues to work with the Ministry of Mental Health and Addictions to monitor and evaluate the decriminalization pilot. 

BC’s Ministry of Mental Health and Addictions monitoring can be found here: 
BCCDC reports on evidence related to decriminalization can be found here:
Patterns of Purchasing and Possession of Drugs
Awareness of Decriminalization
Interactions with Law Enforcement
Hesitance to Seek Services


Public substance use

Based on review of the available evidence and application of public health knowledge about substance use and consultation with public health, local governments, and people with lived and living experience of substance use, people use substances in public for many reasons: 

 
A common reason to use drugs in public is homelessness or housing instability. Homeless counts in BC indicate that homelessness has been increasing in recent years. Not being able to access overdose prevention services is another reason. Some people use in public because they don’t have access to any other spaces where they can have another person nearby, in case they need help. Regardless of where people use substances, using alone is a significant risk factor for death.

Health care providers encourage people who use substances to use with someone else nearby, stagger use, and have naloxone on hand. Many people prefer to use indoors, but the option of an indoor private space in which to follow health guidance is not available to everyone, for example people who are homeless or live in a place that has visitor restrictions. For some, the safety, support, and connection that is available to them through use in a public space can be lifesaving.

 

In recent years, smoking has become the most common mode of consumption of unregulated substances. It can be more difficult to find indoor places to smoke drugs, due to no-smoking rules in housing and other environments. Many overdose prevention sites also do not accommodate smoking. This leaves people who use drugs with few places indoors to use, and may increase the need to use outdoors, and the visibility of doing so. 

 

 

There is a high risk of overdose death for anyone using substances that are accessed from the street drug market because of the toxic and unpredictable nature of the drug supply. Restricting public consumption without creation of better alternatives can displace people who use substances to places where they are less likely to be noticed and responded to if they overdose. This may also lead to people using alone without supports, increasing the risk of fatal overdoses. Opioid overdose is reversible and survivable if quickly recognized and treated with naloxone. 

 

 
A: The risk of infection from a community-acquired needlestick injury is extremely low
People may be worried about blood-borne infections from inappropriately discarded syringes. However, the risk of infection from community-acquired needle stick injuries is extremely low. A review of 14 studies of children with accidental needlestick injuries found no cases of transmission of blood-borne infection. 

Safe syringe disposal practices greatly reduce the risk of a community needlestick injury occurring in the first place. Improper syringe disposal can be a reaction to the presence of police and concerns about syringes being used as evidence of illegal drug use. Under decriminalization, people who inject substances may be less likely to hide their syringes, meaning fewer inappropriately discarded syringes.

Use of illegal drugs by injection is decreasing in British Columbia, while smoking is increasing, which may also impact how frequently inappropriately discarded syringes are present in the community. 

The BC Centre for Disease Control has produced fact sheets on community syringe distribution, responding to discarded syringes, and community needlestick injuries; these are available on Towardtheheart.com. 

The following actions can help reduce the number of improperly discarded syringes, including installing sharps disposal boxes, recruiting pharmacies to participate in disposal programs, supporting syringe-pick up programs (“rig digs” or “needle hunters”), and support health authority-led harm reduction services (including overdose prevention sites). Including people who use substances at the outset of a program significantly impacts its future success. Drug paraphernalia bylaws, syringe buy-back, or requiring return of used syringes to access additional supplies (“1-1 exchange”) are not recommended because these approaches can increase unsafe practices, including syringe re-use, which can increase risk of HIV and hepatitis C transmission.


 
A: There is no risk of overdose from touching fentanyl  

There has been widespread inaccurate information on dermal (through the skin) fentanyl exposure risk. There is no risk to the public of overdose from accidentally touching fentanyl. Further, there are no recorded overdoses in BC from anyone touching fentanyl. Accidental or incidental dermal illegal fentanyl exposure (i.e., touching fentanyl on bare skin) for a short duration does not present a health risk. For more information on what to do if someone touches an unknown substance, review this one-pager (i.e., wash your hands with soap and water and avoid touching the eyes, nose, and mouth). More information can be found in this position statement from the American College of Medical Toxicology (ACMT) and American Academy of Clinical Toxicology (AACT).

 
A: Accidental, short-term exposure to smoke or vapour from illegal substances is not a significant health risk 

There are no recorded overdoses in BC from accidental second-hand exposure to smoke or vapour from illegal substances.  Exposure to smoke and vapour from an illegal substance is different than experiencing toxicity.  With fresh air, any mild symptoms, such as light-headedness, will dissipate. For more information on what to do if someone was accidentally exposed to smoke or vapour from an illegal substance, review this one-pager. 

Burning of any substance produces vapours and small particles that are harmful to the airways and lungs with repeated, long-term exposure. People generally have substantially lower second-hand smoke exposure outdoors than indoors. Outdoors, smoke accumulates much less because there is no enclosure, there is natural ventilation, people are further apart, and smoke disperses quickly with distance. Risks are higher with indoor, long-term, repeated exposure to smoke. Accidental, short-term exposures to second-hand smoke are of much lower concern. In addition, illegal substances, such as crack, fentanyl, and heroin are generally burned for a shorter duration than cannabis and tobacco, meaning there is less time for smoke or vapour to accumulate. 

In addition to the strategies described above (which include supporting the expansion of supportive housing), communities can help reduce public smoking of illegal drugs and encourage safer use by working with health authorities to implement inhalation overdose prevention services (e.g., by identifying facilities, supporting zoning changes or exemptions as necessary, and conducting outreach to increase stakeholder support). Guidelines for safe operation of outdoor inhalation OPS is available in the provincial Overdose Prevention Services Guide. Guidelines for indoor inhalation OPS are forthcoming from the BC Centre for Disease Control. 

 
A: Witnessing peers, parents, and caregivers using substances are more significant factors that influence youth initiation into substance use 

One concern from the public regarding public consumption is the possible impact witnessing public use will have on youth. Youth are most at risk of starting substance use when witnessing use or offered substances in the home or within their peer group – i.e., risk is increased when witnessing use by people they know and trust. The potential impacts on decriminalization on youth are part of the provincial monitoring and evaluation plan for decriminalization.

 
A: A continuum of supports at the local level are important for youth to develop healthy relationships with substances.

There is already a range of initiatives that can support youth to have a healthy relationship to substance use and promote mental health. Some examples of these types of activities include youth recreational, leadership and employment opportunities; school-based programs that aim to prevent substance use harms; community spaces that foster community connectedness and strengthen supports for families and caregivers; food security initiatives; and including social and affordable low-barrier housing in community planning. 

 
A:  Witnessing public substance use is not a significant trigger for relapse. 

Some people choose abstinence from specific substances following a history of problematic use or for other reasons. People with a past history of problematic use may still experience cravings for the substance and may have concerns that witnessing public use will trigger those cravings and potentially a return to use of the substance.


Relapses are common in the recovery journey of people experiencing substance use. Some important circumstances that do increase the likelihood of relapse are negative life events (e.g., recent unemployment, child apprehension, etc.); conflict with family, caregivers, and friends; lack of follow-up from health services; stigma and discrimination against people who use substances; and lack of engaging recreational activities. Unstable housing, lack of supportive social networks, lack of programs or supports to maintain recovery, and the cost of recovery services may increase the likelihood of relapse. 


Communities can support their residents in recovery through evidence-based strategies. They can leverage existing programs that provide meaningful volunteer and paid employment opportunities; provide opportunities to build social connections among community members; and support health authority-led substance use prevention, treatment, and harm reduction initiatives.


Supporting Health

Substance use occurs along a continuum from helpful to harmful, and what is observed in public spaces is only one aspect of substance use in a community. A holistic response should therefore focus on the entire spectrum of substance use, including promotion of physical, social, and emotional well-being of all community members. Action on the social determinants of health is essential as a complement to programs that focus specifically on prevention and treatment of mental health and substance use concerns.

Communities can take a health-promoting approach to substance use

A range of strategies, programs and partnerships are needed to take a health- and equity- promoting approach to addressing concerns about public substance use in communities across B.C. Through support and connection with people who use drugs, many community concerns about substance use can begin to be addressed. For example:   

Build relationships with key community partners to address substance use in health promoting ways  

Local governments, health authorities, and other partners can continue to build their relationships with each other on these topics. Within the health authorities there are a number of staff positions that can help, including regional harm reduction coordinators, decriminalization leads, and Medical Health Officers. 

Community organizations serving people who use substances are also important resources. Communities that have been hardest hit by the overdose crisis may also have Community Actions Teams that bring together partners to provide focused, action-oriented strategies to address the overdose crisis at the local level. The Community Action Initiative shares information and lessons from these teams.

Engage with people with lived and living experience of substance use  

Communities can create healthier and safer environments for everyone by engaging people with lived and living experience of substance use at all stages of planning. 

Drug user groups are an important resource as they carry practical knowledge and resources to support people who use substances, and work to improve the relationships between people who use substances and their communities.

Support initiatives for affordable, accessible, and low barrier housing   

People without homes or who are precariously housed are more likely to use substances in public. Housing is more than an alternative to public substance use – it improves people’s health and allows them to make healthier choices. As well, offering substance use and harm reduction services within supportive housing protects people who use substances while addressing concerns from other community members. It is important that housing be inclusive of youth and pregnant and parenting people. Connect with BC Housing for more information.

Support implementation of Overdose Prevention Services

Overdose prevention services are evidence-based health care services that decrease the risk of fatal overdose and connect people who use drugs to social and medical supports. Local governments can help reduce public use of drugs and encourage safer use by working with health authorities and community organizations to implement of overdose prevention services (e.g., by identifying facilities, supporting zoning changes or exemptions as necessary, and conducting outreach to increase stakeholder support).

Support access to safer alternatives to the toxic drug supply

The high risk of drug toxicity and fatal overdose is not present with legal substances (alcohol, tobacco, cannabis) because they come from a regulated and predictable supply and are much less likely to lead to poisoning and death. The toxic and unpredictable nature of the illegal drug supply is a main reason why a different approach to legal versus decriminalized substances is needed at this time.

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