CMAJ: Drug Decriminalization in British Columbia Reduced Police Encounters but Did Not Change Overdose Outcomes

17 Sep CMAJ: Drug Decriminalization in British Columbia Reduced Police Encounters but Did Not Change Overdose Outcomes

MedicalResearch.com Interview with:

Adrienne Gaudreault, MPH
Medical Student, Dalhousie University

Dr. Daniel Myran

Daniel T. Myran, MD, MPH, CCFP, FRCPC
Public Health and Preventive Medicine
Ottawa Hospital Research Institute; Canada Research Chair
University of Ottawa Department of Family Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Gaudreault and Dr. Myran: In January 2023, British Columbia removed criminal penalties for possessing small amounts of certain drugs for personal use. The policy aimed to reduce harms associated with criminalization, such as using drugs alone or avoiding services because of fear of police involvement. In May 2024, possession was recriminalized in most public spaces following concerns about public drug use and safety. According to SAMHSA (Substance Abuse and Mental Health Services Administration), criminalization of drug possession has long been associated with reduced treatment uptake and increased likelihood of people using substances alone — the same harms the British Columbia policy aimed to address.

Our study examined how these changes were associated with police-recorded drug incidents, drug-related hospitalizations, and deaths from drug toxicity, compared with trends elsewhere in Canada. We found that decriminalization was associated with a substantial decrease in police-recorded drug possession incidents, consistent with one of the policy’s main goals. These incidents increased again following partial recriminalization. Decriminalization was not associated with statistically significant changes in hospitalizations or deaths relative to comparison regions during the study period.

MedicalResearch.com: Were there community-related associations, such as homelessness, vagrancy, or petty crime?

Gaudreault and Dr. Myran: Our analysis looked at police-recorded drug possession incidents, which were directly affected by the policy, and trafficking incidents, which we included as a comparator. We did not examine other community outcomes, such as theft, public drug use, or homelessness, so our findings cannot tell us whether these changed with decriminalization. Future research should examine these broad community impacts, including whether outcomes differ across subpopulation groups and how systemic factors shape these experiences.

MedicalResearch.com: What should readers take away from your report?

Gaudreault and Dr. Myran: Decriminalization was associated with a substantial reduction in police-recorded drug possession incidents, consistent with one of its main goals. This represents a meaningful change in how people who use drugs interact with the criminal justice system and may help reduce the harms associated with criminalization. Although we did not detect significant changes in hospitalizations or deaths compared with other regions, this does not necessarily mean that decriminalization is ineffective. Rather, our findings highlight the importance of understanding decriminalization as one component of a broader public health response to the toxic drug crisis, with its potential benefits shaped by how it is implemented and the availability of health and social services and supports.

MedicalResearch.com: What recommendations do you have for future research?

Gaudreault and Dr. Myran: Our study examined a relatively short period following decriminalization and partial recriminalization. Longer-term monitoring will be important to understand how these outcomes evolve. Future research should also examine outcomes beyond police-recorded incidents, hospitalizations, and deaths, including access to care, experiences of stigma, and community well-being. Examining how different approaches to implementation, including regulatory changes and the availability of health and social services, shape outcomes would help inform future policy decisions.

MedicalResearch.com: Is there anything else you would like to add?

Gaudreault and Dr. Myran: Behind these findings are people, families, and communities deeply affected by the toxic drug crisis. We hope this research contributes to an evidence-informed and compassionate discussion, with a shared focus on preventing deaths and improving people’s lives.

Disclosures: Dr. Myran reported receiving grants from Bruyère Health Research Institute during the conduct of the study. No other disclosures were reported.

Citations:
Gaudreault A, Gibb M, Talarico R, Herder M, Fischer B, Pinto AD, Myran DT. Impact of drug decriminalization and recriminalization on drug-related crime and health outcomes in British Columbia: a population-level time-series analysis. CMAJ. 2026;198:E1212-E1220. doi:10.1503/cmaj.260038

Gaudreault A, Talarico R, Herder M, Myran DT. Drug decriminalization in British Columbia and changes in drug crime and opioid and stimulant harms. JAMA. 2025;333(21):1922-1925. doi:10.1001/jama.2025.3006

For a broader overview of what the research shows about drug decriminalization policies, overdose outcomes, and public health approaches to the opioid crisis in North America, see this MedicalResearch.com overview of opioid crisis public health approaches — what the research shows.

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Last Updated on September 17, 2026 by Marie Benz MD FAAD