“Starting to Brew”: How Decriminalisation Impacts People Using Drugs in Canada

Stigma is a common experience in the lives of people who use drugs. It affects how they are treated by others, how they access healthcare and other supports, and even how they see themselves. Feeling judged, criminalised, or ashamed can stop people from getting the help they need, and these experiences are often made worse by drug policies that punish people who use drugs instead of supporting them. 

In 2023, the province of British Columbia (BC), Canada, amended its existing drug policy, aiming to start the process of drug policy change. The province launched a three-year pilot project decriminalising personal possession of small amounts (up to 2.5g) of certain drugs like opioids, cocaine, MDMA and methamphetamine, without being charged, arrested, or having their drugs seized. Instead, they would be encouraged to access community-based harm reduction and treatment services. The goal was to treat drug use as a health issue, not a crime, and reduce the stigma that often keeps people from accessing care, ultimately reducing overdose deaths in the province. 

Recognising these long term aims of decriminalisation, our research explored whether experiences of stigma have improved because of the policy so far. We interviewed 100 people across BC who frequently use drugs to understand how their experiences with stigma – whether from others, institutions, or themselves – have changed since decriminalisation was implemented. We also asked them how they believe the policy may affect stigma in the future and if they had any suggestions on how the policy can achieve its stated goals. 

Stigma runs deep – and change takes time

Most participants told us their experiences with stigma had not changed much since the new policy came into effect. Many said that drug use stigma is within healthcare settings, in the legal system, and in public attitudes, and still affects how they are treated and supported by others. As one participant shared:

“[People who use drugs] don’t use [drugs] out in public because of how people look at us. Because of how people still treat us. And I don’t think that’ll ever change because there’s such a negative stigma on drug use.”

Some people felt that things had actually gotten worse because of the policy. They noticed more visible drug use in public spaces, which they believed had led to people judging them more, leading to public frustration. On the other hand, some others felt slightly more accepted as someone who uses drugs, and less afraid of being arrested. They said that the policy made it easier to seek support or talk more openly about their drug use, as described by the following participants:

“I think [decriminalisation] gets people to understand better that [people who use drugs] are people too, and we just need help, right?”

What needs to change to truly end stigma?

Despite the mixed responses, many participants expressed hope that decriminalization could reduce drug use stigma in the long run, if it’s supported by meaningful investments in health and social services. However, many stressed that decriminalisation by itself is not enough. More housing and supervised spaces to use drugs safely are needed, especially for those who smoke their drugs. When people have nowhere else to go, they’re more likely to use in public, increasing both their risk of harm and public visibility of drug use, a key factor that seems to drive public stigma. For this reason, safe consumption spaces and housing supports are critical as they move drug use out of the public eye and into safer, more private spaces. As one person said:

“[People who use drugs] need a place to go. And housing. A lot of [people who use drugs] they’re using publicly because they’re living outside and there’s no available housing.” 

Another recommendation to reduce stigma was the need for public education campaigns to help educate the public and change their attitudes about drug use. Participants described the need for better understanding about why people use drugs and how harm reduction strategies, like decriminalization, can keep everyone, users and non-users, safe. As one person shared:

“I think there needs to be more broad sharing and understanding [of information]. Whether that’s through documentaries, or storytelling, or information that really personalises things a bit more to just show [the public], just to help people have a bit more compassion and understanding [for people who use drugs].”

There is also a need to train police, criminal justice representatives and healthcare providers so they can approach people who use drugs with empathy, not judgement. 

Looking ahead

Our findings show that policies like decriminalisation can influence how people experience stigma, but change won’t happen overnight. Reducing stigma requires more than removing criminal penalties; it means investing in the supports people need: housing, safe spaces, healthcare, and education. 

As BC’s decriminalisation policy continues, it is important that people who use drugs remain at the centre of the conversation. Their lived experiences offer crucial insight into what’s working, what’s not, and what’s needed next to have a lasting impact.

You can access our published paper here.