CMAJ Podcasts
What drug decriminalization in British Columbia could and could not achieve
Sep 21, 2026
Canadian Medical Association Journal
On January 31, 2023, the government of British Columbia implemented a temporary, three-year drug decriminalization policy. Under the policy, adults (18 and older) could possess up to a combined 2.5 grams of specified illegal drugs—including opioids, cocaine, methamphetamine, and MDMA—for personal use without criminal charges, prosecution, or confiscation. The policy was intended to reduce the health and social harms of illicit substance use.
A new study in CMAJ evaluated changes in drug-related hospitalizations and deaths alongside police interactions such as arrests during and after the period of decriminalization. Dr. Blair Bigham and Dr. Mojola Omole speak with coauthor Dr. Daniel Myran about the study, "Impact of drug decriminalization and recriminalization on drug-related crime and health outcomes in British Columbia: a population-level time-series analysis." He explains that the policy had no impact on hospitalizations and deaths but significantly reduced police interactions.
The hosts then speak with Dr. Alexis Crabtree, coauthor of an accompanying commentary, "What decriminalization in British Columbia could and could not achieve." She explains that one goal was to reduce stigma and, in turn, increase interaction with substance use supports. Instead, she says, the policy may have increased stigma—though the reduction in police interactions alone may justify it.
Together, the authors argue there is no silver bullet for reducing the harms of substance use. Any solution will need to be multipronged and long lasting.
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