What you need to know
In 2022, Health Canada approved a three-year exemption from the Controlled Drugs and Substances Act that decriminalized possession of certain illegal substances for personal use among adults in the province of British Columbia (BC). This exemption includes a cumulative threshold of 2.5 grams of opioids, cocaine, methamphetamine and methylenedioxy-methylamphetamine (MDMA). Researchers conducted interviews with people who use drugs in BC to understand the impact of the 2.5-gram threshold and how it might affect people who use drugs. The researchers interviewed 45 people who use drugs weekly or were receiving opioid agonist treatment. Participants said the 2.5-gram threshold limit might increase their risk of drug-related harms such as overdose and arrest. The researchers caution that it will be vital to monitor and evaluate the impacts of the threshold to ensure it does not result in further harms to people who use drugs.
What is this research about?
Canada is battling the worst drug overdose crisis in history, and BC has one of the highest overdose rates. Many overdose deaths in BC are due to a drug supply that is contaminated with fentanyl and fentanyl analogs, as well as opioids laced with benzodiazepine.
Recognizing the criminal justice approach in Canada was ineffective in decreasing overdose rates, the Government of Canada granted BC an exemption under Section 56.1 of the Controlled Drugs and Substance Act. This exception decriminalized personal possession of certain illegal substances for a three-year period, which started on January 31, 2023.
The policy includes a cumulative threshold of 2.5 grams of opioids, cocaine, methamphetamine and methylenedioxy-methylamphetamine (MDMA). Possession of more than 2.5 grams of any of these substances will result in a possession or trafficking offence.
BC is the first province to put this drug policy in place and researchers surveyed people who use illicit drugs in the province to find out what they thought about the policy and the 2.5-gram threshold limit before the policy came into effect.
What did the researchers do?
The study started after the decriminalization policy was announced and ran from June 9 to October 28, 2022. The 45 participants either were people who use illicit drugs or were receiving opioid agonist treatment for a substance use disorder. Some worked in the harm reduction field. They participated in phone interviews about various aspects of decriminalization, with a focus on the benefits, challenges, concerns and risks of the policy and, specifically, about the 2.5-gram threshold before it was put into effect.
What did the researchers find?
Participants were an average of 40 years old, 53 per cent identified as male and 60 per cent were white. One-third were unhoused or lacking permanent housing.
The researchers reported their results under two categories:
- implications for substance use profiles and buying patterns
- implications of police enforcement.
Substance use profiles
Most participants felt the 2.5-gram threshold was too low for their patterns of substance use. This was particularly the case among those who used substances more frequently and those who had high tolerance levels and needed to use more at a time.
Some participants felt the policy would probably not affect their use patterns because they were not likely to buy or carry more than 2.5 grams at a time. The majority of these participants were unstably housed.
Implications of the cumulative threshold on purchasing
Many participants, especially those who use more than one substance, said they usually buy different amounts of each substance and carry them with them at one time, so they would be likely to carry more than the 2.5-gram threshold. They felt this threshold amount was arbitrary and reflected the lack of engagement of people who use drugs in planning and implementing the policy.
They pointed out that some substances, such as methamphetamine and cocaine, are usually packaged and sold in larger quantities, while others, such as heroin and fentanyl, are usually sold in small amounts. For this reason, many suggested setting different thresholds for different substances rather than make the threshold cumulative.
Implications for bulk purchasing
Many participants felt the threshold would make it difficult to buy in bulk, which helps them save money. This was especially important to participants living in smaller or Northern communities, who often need to travel great distances to access a dealer or source. These participants felt they would have to buy their substances more often, which would mean paying more for them.
Bulk buying also allowed them to buy from trusted dealers or sources. Staying below the 2.5-gram threshold would force them to buy more often and likely from different sources, which would put them at higher risk of buying contaminated substances and of increased police surveillance.
Implications of police enforcement
Many participants believed that enforcement of the threshold would be left up to the police and, based on past experience, believed they would do so inconsistently. The perception was that this would undermine the objectives of the decriminalization policy.
Potential for net widening
Many feared police would use the threshold as an opportunity to approach people who use drugs to “check” that they were carrying under the threshold. They believed this could have a net-widening effect, where people would be criminalized who were not before the policy came into effect. Some feared this would affect the dealers and suppliers they trusted to supply a safe supply.
Potential for discrepancies between communities
Many participants felt there might be differences in how police apply and enforce the policy depending on the community. Particularly, they worried that policing culture, ideologies and practices might be harsher in some communities, particularly those in rural and remote settings.
Limitations of the research
The researchers recognized that participants did not represent all people who use drugs in the province of BC. Due to the recruitment methods used, participants may be more familiar with harm reduction services and advocacy groups than the general population of people who use drugs. Also, the researchers did not separate data on gender, age and ethnicity, factors that are important to consider in understanding the impact of the threshold.
How can you use this research?
This research provides insights on the perceptions of people who use drugs regarding threshold limits and the application of police discretion in implementing the policy. The study findings point to the importance of recognizing the history of negative experiences with police among people who use drugs. They also underscore the importance of having people with lived experience of substance use at the table when creating policies that decriminalize possession of drugs.
About the researchers
Farihah Ali1,2*, Cayley Russell1,2, Alissa Greer8, Matthew Bonn3, Daniel Werb9,10,11, Jürgen Rehm1,2,3,4,5,6,7
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
- Ontario Node, Canadian Research Initiative in Substance Misuse, Toronto, Ontario, Canada
- Canadian Association of People Who Use Drugs, Dartmouth, Nova Scotia, Canada
- Department of Psychiatry, Dalla Lana School of Public Health, & Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- School of Criminology, Simon Fraser University, Burnaby, British Columbia, Canada
- Centre on Drug Policy Evaluation, Unity Health Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Division of Infectious Diseases and Global Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA