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Access to health and harm reduction services during drug decriminalization in British Columbia, Canada: a mixed-method study
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Access to health and harm reduction services during drug decriminalization in British Columbia, Canada: a mixed-method study
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Access to health and harm reduction services during drug decriminalization in British Columbia, Canada: a mixed-method study
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Journal Article
Access to health and harm reduction services during drug decriminalization in British Columbia, Canada: a mixed-method study
2026
Overview
Background
On January 31
st
2023, the Canadian province of British Columbia temporarily decriminalized the personal possession of certain illegal drugs up to 2.5 g, cumulatively, for adults. A stated aim of this policy directive was to reduce the stigmatization of people who use drugs and increase access to health and harm reduction services. The aim of this study was to capture the prevalence and nature of potential barriers to such services under drug decriminalization.
Methods
We employed a mixed-methods study design, triangulating survey data from harm reduction service users in 2022 (
n
= 503) and 2023 (
n
= 433) alongside qualitative interviews with people who use drugs in British Columbia (
n
= 78) collected in 2023. Qualitative and quantitative findings were analysed convergently.
Results
Findings across both datasets suggest that reported barriers to health and harm reduction services persisted during British Columbia’s decriminalization pilot. Quantitative and qualitative data reflecting these barriers are presented in parallel under four themes: (1) stigma and fear of substance use disclosure, (2) stigma and access to services, (3) service-specific barriers, and (4) police-related barriers.
Conclusion
Decriminalization alone may be insufficient to address and/or mitigate the barriers that continue to constrain people who use drugs’ access to care. If the policy goal is to reduce barriers to health and harm reduction services, additional structural and institutional supports may be required.
Highlights
Barriers to accessing health and harm reduction services persisted during BC’s decriminalization pilot.
Perceived stigma limited access to health and harm reduction services.
Inhalation services remain limited at observed consumption sites across BC.
Despite the legal reform, policing practices discouraged health service attendance.
Decriminalization alone may be insufficient in eliminating service barriers.
