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B.C.'s drug decriminalization experiment didn't change overdose deaths: study
British Columbia’s contentious experiment decriminalizing fentanyl, cocaine and other hard drugs was hailed by provincial health leaders as a “vital” means of keeping people from dying from drug overdoses.
It appears it didn’t. New research found no significant changes in drug-related hospitalizations or toxic drug deaths compared with the rest of Canada, where the drug laws hadn’t changed.
“I think there’s a real risk of over-promising simple solutions” to the opioid crisis, said the study’s senior author, Dr. Daniel Myran, in an interview.
Although drug poisoning deaths dropped slightly in B.C. after decriminalization, the changes didn’t differ relative to other provinces, according to the study published in this week’s issue of the Canadian Medical Association Journal.
Overdose deaths fell by 19 per cent in B.C. but were down 25 per cent in Ontario over the same period.
“There is no effect that you’re seeing in B.C. that is not occurring in Ontario,” said Myran, who is the Gordon F. Cheesbrough Research Chair at North York General Hospital and associate professor and scientist at the University of Toronto’s department of family medicine.
“I do think that the premise of ‘we’re going to see these very large health benefits related to acute overdoses’ has not been borne out by the data we’re presenting here.”
Under a pilot project that launched Jan. 31, 2023, B.C. allowed adults to possess up to 2.5 grams of heroin, fentanyl, crack or powder cocaine, methamphetamine and MDMA (ecstasy) for their personal use.
People found carrying drugs below the 2.5-gram threshold were no longer to be arrested, charged or have their drugs seized. Instead, police were directed to offer information on social supports and help with referrals to treatment, if requested.
The province was granted a time limited, three-year exemption from the federal government’s Controlled Drugs and Substances Act.
The intent was to reduce risky behaviours, such as using alone, or using in unsafe locations, and end the “shame and stigma” that can keep people with drug addictions from reaching out for life-saving help, BC’s ministry of health said in a news release at the time.
B.C.’s provincial health officer, Dr. Bonnie Henry, called the exemption “a vital step to keeping people alive and help connect them with the health and social support they need.”
Local communities, however, soon began raising the alarm over growing public disorder and open drug use in parks, playgrounds and other public spaces.
Midway through, the policy was partly rolled back: In May 2024, possession of any amount of drugs in all public places, including hospitals, on transit and in parks, was re-criminalized, though possession below the 2.5 gram threshold remained legal for adults in certain designated spaces, including private homes and overdose prevention sites.
The 2.5-gram policy expired on Jan 31, 2026, and wasn’t renewed. “The pilot hasn’t delivered the results we hoped for,” Josie Osborne, then B.C.’s health minister, told reporters in announcing the experiment was over.
Osborne said it was “difficult, if not even (impossible) to attribute certain changes or increases directly to decriminalization,” including the number of people who sought treatment.
The shifts in policy — off-again, on-again criminalization — allowed researchers to look at different outcomes using data that captured police-recorded drug incidents nationally, and drug-related hospitalizations and deaths in B.C., Alberta and Ontario.
They compared monthly changes in B.C. to the rest of the country between August 2020 and March 2025.
Over the five-year study period, researchers counted a total of 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 in B.C., Ontario and Alberta.
As predicted, B.C. saw a significant (39 per cent) drop in monthly rates of police-reported drug possession incidents after decriminalization, followed by a rapid uptick (68 per cent increase) following partial re-criminalization in public spaces.
But after decriminalization, B.C. didn’t differ significantly from other provinces and territories for changes in opioid-related hospitalizations or deaths, according to the study.
Hospitalizations and deaths fell during partial re-criminalization in B.C., but, again, similar declines occurred across the rest of Canada, as well as the U.S, and were more likely driven by “broader factors” such as changes in the drug supply and its toxicity, Myran and his co-authors wrote.
“It is important to recognize plausible reasons behind these non-effects; crucially, the decriminalization policy was not combined with additional interventions or services that could have effectively reduced exposure to toxic drugs or related risk behaviours to improve drug-related mortality and morbidity outcomes for people who use drugs,” the researchers wrote.
There are compelling reasons to decriminalize minor drug possession and increase support for people who use drugs, Myran said. A criminal record carries implications for education, housing and employment “and it’s not necessarily the case that it’s helping someone to enter recovery or use fewer drugs,” he said.
Decriminalization was associated with a large fall-off in both police encounters and police charges for minor drug possession. From that perspective, the policy worked, he said.
“The problem was that there was a promise saying that we’re going to do this, and it’s going to have these criminal justice benefits, but it’s also going to have major health benefits. We are going to see these big reductions in overdoses. And the data are not supporting that.”
Officials risk eroding public trust “if the thing you promised doesn’t materialize.”
The study wasn’t designed to look at other outcomes, like public drug use or community safety.
But Myran isn’t convinced that the criminal status of minor drug possession is a major driver of the overdose crisis. “There are other very meaningful drivers that are worth understanding and acting on. But it doesn’t seem to be the criminal status.”
Declining opioid-related deaths in Canada and the U.S. may be partly down to tightened controls on China’s export of fentanyl “precursors,” disrupting fentanyl production in North America, and fewer young people using opioids, Dr. Alexis Crabtree, of the BC Centre for Disease Control, wrote in an accompanying commentary.
National Post
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