Research snapshot: Perspectives from people who use drugs on criminalization and stigma

What you need to know

The authors explain stigma as having three parts: structural, social and self. 
Structural stigma trickles down into social and self-stigma. To reduce stigma, we need to change how we view drugs and the people who use them. Ways of changing how we view people who use drugs (PWUD) include decriminalizing, legalizing, regulating and/or supplying safe drugs.

What is this research about?

Evidence shows that drug laws do not reduce the number of PWUD. Studies have shown that policing worsens social, health, legal and environmental issues that PWUD face.

Figure 1: Layers of stigma

Top layer: structural stigma: laws and how they create exclusion of PWUD. Middle layer: Social stigma: the myth that PWUD are dangerous and to blame for their condition. Bottom layer: self-stigma: when PWUD believe social stigma.

Figure 1 depicts the layers of stigma experienced by PWUD. PWUD perceived structural stigma as a direct cause of social and self-stigma.

The authors also want to contribute to the small but growing field of research that focuses on the views of PWUD. Despite being the most impacted by drug laws, PWUD are often not included in drug law decisions.

This article focuses on how PWUD perceive the harms of drug laws and policy options to reduce stigma, such as decriminalization, legalization, regulation and/or safe supply.

What did the researchers do?

The researchers interviewed 24 PWUD between July and September 2020. The criteria for participation were:

  1. be 18 years or older
  2. have used illegal drugs in the past 12 months
  3. are interested in discussing drug laws or their experience with police
  4. have access to a telephone for the interview.

Researchers found participants through fliers and word of mouth.

What did the researchers find?

Researchers concluded that PWUD saw social and self-stigma as direct results of structural stigma. The participant’s thoughts were placed into six themes:

  1. Self-stigma: Many participants felt that society told them that being a drug user meant they could not also be decent human beings.
  2. Social stigma: Participants felt drug laws shaped stigma and that the public’s opinions on PWUD were untrue and outdated.
  3. Structural stigma: Participants felt that the harms from drug laws were worse than the harm of drugs themselves. They described engaging in crime or sex work because their criminal records prevented them from getting a job. Participants said drug laws created barriers to them using social supports.
  4. Lack of Action: Participants were frustrated with the government’s lack of policy action on the drug poisoning crisis, resulting in needless suffering and death. They felt that stigma was the result of drug laws and that the stigma prevented real progress in the area of drug reform.
  5. Drug law reform: Several participants felt that law reform was a necessary step to reducing stigma but that the change would be slow. One participant felt it would make it easier to talk about their drug use with family and friends.
  6. Shifting drugs away from policing: Participants felt that changing drug laws could improve their relationship with police, who are often called to overdose emergencies. One participant suggested that if laws were changed, it would be easier to trust the police. If PWUD feel they can trust the police, then the police will be able to connect PWUD to social services.

Limitations of the research

The researchers noted two limitations to this paper. Firstly, some participants were recruited through the Drug User Network of BC, which may bias the sample toward PWUD who share similar views on drug policy. Secondly, the interviews were done by phone due to COVID-19 and may have reduced the quality of the interviews. Additionally, conducting interviews by phone means that only participants with access to a phone, access to a private space to use the phone, and comfortable interviewing on the phone could be included.

How can you use this research?

For policy makers and health promoters, this research strengthens the understanding that stigma trickles down from laws to public opinion. Reforming drug law is the first step to tackling stigma.

Similarly, the researchers highlighted that changing laws does not erase existing stigma. The researchers suggest that we can reduce stigma by being open to new research on other types of stigma-reducing drug policies, such as decriminalization, legalization, regulation and/or safe supply.

Finally, the researchers suggest that this paper highlights the value of including PWUD within policy decisions. PWUD gave insight into how structural stigma prevents them from engaging in everyday life, such as employment and accessing services. When PWUD are not allowed to lead a normal life due to stigma, they need to break laws to survive.

About the researchers 

Benjamin D. Scher1, Scott D. Neufeld, Amanda Butler3, Matthew Bonn4, Naomi Zakimi3, Jack Farrell3 and Alissa Greer3

  1. Department of Social Policy and Intervention, University of Oxford, Oxford, UK
  2. Department of Psychology, Brock University, St. Catharines, ON, Canada
  3. School of Criminology, Simon Fraser University, Burnaby, BC, Canada
  4. Canadian Association of People Who Use Drugs, Dartmouth, Nova Scotia, Canada

See more related to