Canada has long pursued progressive drug reform policies, which have been largely praised by liberals. The government opened its first safe injection site in North America in 2003, and there are currently 39 across the country. In comparison, Australia has only two.
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02-22, 2025In 2018, Canada legalized cannabis. In 2023, its western province of British Columbia (BC) took a step that drug reform advocates globally had been urging governments to take: ceasing the prosecution of people carrying small amounts of heroin, cocaine, methamphetamine, and ecstasy. This three-year pilot program was introduced amid an overdose crisis in the region. In the six years before the reform, BC accounted for about a third of Canada’s overdose and drug-related deaths.
However, two years into the pilot, drug users in Vancouver are still dying. In recent months, parts of the Canadian media and public, as well as some politicians, have begun to push back against the reform, casting doubt on its future. So, is decriminalization working?
In April 2024, the Canadian government shifted its approach to the decriminalization trial, narrowing its scope to apply only to private residences and designated locations, such as homeless shelters or healthcare clinics, including supervised consumption sites. This decision frustrated public health professionals like Dr. Kora DeBeck, a scientist at the British Columbia Centre on Substance Use, which monitors the drug trial. She stated that decades of research have shown that (drug prohibition) has failed individuals and communities on multiple levels. We know that drugs are easily accessible, and many people still want to use them. But she also pointed out that drug prohibition has many problems. Moving to (decriminalization) is a different attempt, a first step towards real reform.
Since the decriminalization trial began in 2023, overdose deaths in Vancouver have more than quadrupled in a decade. In 2014, 369 people died of illicit drug overdoses in BC. In 2017, 1,208 people died. By 2023, at least 2,511 people in BC died from drug overdoses. In 2016, the province declared a public health emergency. Dr. DeBeck described it as an "unprecedented toxic drug crisis" and said "it has really devastated communities."
In 2019, the Vancouver City Council issued a "Safe Supply Declaration," acknowledging that most overdose deaths in the province were due to a "drug supply poisoned by fentanyl," a synthetic opioid more potent than heroin. The declaration stated, "Further contaminants...make reversing overdoses more difficult and complicated." It also noted, "We often call this crisis an overdose crisis, but in reality, we are in the midst of a drug poisoning crisis." One of the main reasons for overdoses is the contamination of the illicit drug supply, and we believe that future deaths are preventable if people can access a regulated safe supply.
The decriminalization pilot program aimed to reduce the stigma that prevents drug users from accessing life-saving medical care and "harm reduction" programs like needle exchanges and safe injection sites. It should also keep people out of the criminal justice system. In the first nine months of the trial, drug possession charges in Vancouver fell by 76% compared to the annual average of the previous four years. But Dr. DeBeck said that while the reforms changed how police and the law treat drug users, they could never solve the problem of the often-contaminated black market drug supply. By the end of the program's first year, toxic drug deaths in BC reached a record high, averaging seven deaths per day in 2023. Dr. DeBeck said the public had unrealistic expectations of what the program could achieve on the streets of BC.
Dr. DeBeck explained that the cause of overdose deaths in Vancouver, and across Canada, is fentanyl in the unregulated toxic drug supply. The (drug supply) is still produced by organized crime and drug trafficking groups, and laced with fentanyl and benzodiazepines. So, what people are seeing on the streets is continued suffering and continued scenes that can be described as street disorder. She never expected to see a reduction in overdoses. She believes that some of the public may have been misled into thinking that this was what they should expect, and what they hoped for, but that was never a realistic goal. Public discussion was not based on science or data. What she heard was that people thought decriminalization led to street disorder.
The trial's reversal effectively made drug use a crime in most public places, giving police the power to confiscate drugs again, move people out of public areas, and arrest drug users. The decision was made in response to pressure from those who opposed the pilot program, including Kevin Falcon, then leader of the opposition in BC, who called it a "harmful experiment." Some residents and business groups, such as the "Save Our Streets" coalition, complained about public drug use on public transportation and in retail areas, although provincial officials reported that they had not seen any evidence that this had increased after decriminalization.
Premier David Eby insisted in a statement that his government "cares and has compassion for those struggling with addiction" but will not tolerate "street disorder." He said the changes would ensure "police have the tools they need to keep communities safe and comfortable." However, the Harm Reduction Nurses Association (HRNA) opposed the "punitive and political" changes, saying they would push people into alleys and other hidden parts of the city, where they are most likely to die from overdoses. The group of frontline health workers argued that "there is ample evidence" that the number of homeless people in BC has increased amid (the region's housing crisis) and that a lack of housing, health, and harm reduction services leaves people with few other options. DJ Larkin, co-counsel for the HRNA, said after the legal changes that when we see drug use in public places, it is because people do not have housing, services, or safe places to go, and people are afraid for their lives.
The HRNA has proposed alternative legal and policy responses that they say would improve public safety and better protect the lives of people at risk of overdose, including investing in housing and public health programs.
In February, the BC Coroners Service reported that toxic drug deaths in the province fell by 13% in 2024, the lowest level since 2020. Fentanyl remains the leading factor in drug deaths, detected in 78% of drug tests. Chief Coroner Jatinder Baidwan said the decline in toxic drug deaths is not unique to BC, with similar data reported in other Canadian jurisdictions and internationally. Dr. Baidwan said in a statement that this does not diminish the fact that 2,253 members of our community died in 2024, leaving behind grieving loved ones, friends, colleagues, and teammates. Our thoughts are with all those affected by this crisis.
Dr. DeBeck said that treating drug dependence as a police problem rather than a health crisis will continue to put drug users at risk. She said that we know that interactions between police and drug users cause a lot of harm. For example, when police confiscate drugs from a person who is dependent on drugs, (that person is put in) a vulnerable state, and they have to find other ways to get drugs again, especially if they are physically dependent on drugs. This can lead to more crime...or they may also go to a less reliable supplier. Ultimately, Dr. DeBeck said there is clear evidence that funding harm reduction services—such as addiction treatment and drug testing facilities, as well as providing affordable housing—is a "more productive path" to saving lives.
Dr. DeBeck concluded that the reality of research and data shows that police are a very poor tool for dealing with drug abuse, or even problems like public drug use. What really helps is better housing and providing people with other places to go and activities to do. From my perspective, decriminalization is just a small part of what we need. I think that if we are really going to address this challenge, and the absolutely devastating situation of overdose deaths, we need to do more than just decriminalization. Changing the way police interact with drug users is beneficial. Drug abuse is not a moral failing, nor is it a criminal justice issue. It should fall under the purview of health and public health.
