British Columbia’s drug decriminalization policy was associated with a substantial decrease in police encounters for drug possession, while neither decriminalization nor the subsequent partial recriminalization was associated with detectable changes in deaths due to drug toxicity or drug-related hospitalizations, found new research in CMAJ ( Canadian Medical Association Journal ) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.260038 .
In January 2023, the Government of British Columbia introduced a time-limited initiative that decriminalized possession of up to 2.5 grams of opioids, cocaine, methamphetamine, and methylenedioxymethamphetamine (MDMA or ecstasy). The aim was to reduce overdose deaths and increase treatment engagement by reducing fear and stigma that lead to hiding substance use or using drugs alone and avoiding treatment and support. In May 2024, following concerns about drug use in public and public safety, the government partially recriminalized possession in most public spaces, while it remained decriminalized in designated spaces. In January 2026, the government of BC opted not to renew the decriminalization initiative.
“These regulatory shifts — the initial decriminalization and subsequent partial recriminalization — allow for the evaluation of changes in drug-related health and drug crime outcomes over time,” writes Dr. Daniel Myran, Gordon F. Cheesbrough Research Chair at North York General Hospital, and a scientist with the University of Toronto’s Department of Family Medicine, ICES, and the Bruyère Health Research Institute, with coauthors.
Over the 5-year study period from August 2020 to March 2025, the authors compared changes in police encounters for drug possession and trafficking and opioid- and stimulant-related hospitalizations and deaths from drug toxicity in BC to other parts of Canada before and after decriminalization and partial recriminalization. In total, 97 630 instances of police encounters for drug possession, 75 485 for drug trafficking, 161 278 opioid-related hospitalizations, 113 747 stimulant-related hospitalizations in Canada, and 29 730 drug toxicity deaths occurred in BC, Ontario and Alberta.
Decriminalization in BC was associated with a 39% decrease in police encounters for drug possession, which returned to pre-decriminalization levels after partial recriminalization. Decriminalization in BC was not associated with changes in drug-related hospitalizations or overdose deaths. The partial recriminalization period aligned with declines in both drug-related hospitalizations and overdose deaths in BC; however, similar declines occurred in the rest of Canada, suggesting that broader national trends likely accounted for these changes.
“The findings of this study reinforce that BC’s temporary decriminalization achieved the intended effect of reduced criminalization of drug possession among people who use drugs. The absence of changes in overdose outcomes highlights that there are no simple solutions to the overdose crisis in Canada and that other factors and interventions are urgently needed to improve key health outcomes related to drug use,” said Dr. Myran.
Although decriminalization was not associated with changes in hospitalizations or deaths from drug toxicity, the authors suggest it may have had positive benefit for people who use drugs.
“Decriminalization was intended to reduce the harms associated with criminalizing people who use drugs, and our findings suggest that it meaningfully reduced police-reported possession incidents,” said study coauthor Adrienne Gaudreault, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia. “At the same time, changing possession laws alone cannot make an unpredictable and highly toxic drug supply safer. Decriminalization should be understood as a component of a comprehensive public health response that must also address the toxicity of the drug supply.”
In a related commentary https://www.cmaj.ca/lookup/doi/10.1503/cmaj.261198 , Dr. Alexis Crabtree, British Columbia Centre for Disease Control and the School of Population and Public Health, University of British Columbia, Vancouver, BC, with coauthor writes, “decriminalization may be best understood as a complex systems intervention, with myriad effects — and possible unintended consequences — emerging from interactions across institutions and sectors. The lesson from BC is not that decriminalization is irrelevant, but that such policies must be supported within prepared, trusted, and adequately resourced systems.”
Canadian Medical Association Journal
Observational study
People
Impact of drug decriminalization and recriminalization on drug-related crime and health outcomes in British Columbia: a population level time-series analysis
14-Sep-2026