Decriminalization supporters question B.C. drug study that links policy to overdoses

British Columbia’s former chief coroner is cautioning against a “jump to conclusions” after a new study found safer supply and drug decriminalization policies were associated with significant increases in opioid overdose hospitalizations in the province.

Lisa Lapointe, who retired from the post last year, said in an interview Wednesday that the study published in JAMA Health Forum last Friday did not provide the full picture on the effectiveness of the province’s drug policies, since it used data up to the end of 2023 and did not capture the “significant” decrease in toxic drug deaths in B.C. reported in 2024.

Toxic drug deaths last year fell 13 per cent from the year before, with the annual death toll lower than any year since 2020. Decriminalization of opioid possession was introduced in B.C. in January 2023 then heavily curtailed in May 2024. The ongoing safer supply program providing pharmaceutical-grade opioids to people at risk of overdosing was introduced in 2020.

“It would be interesting to see that study redone with the 2024 data,” said Lapointe, whose tenure as chief coroner put her on the forefront of B.C.’s fight against the opioid crisis that has claimed more than 16,000 lives since being declared a health emergency in 2016.

“We know that the crisis started under a criminalization program. We know that the number of deaths grew exponentially under the criminalization program … I don’t think this report indicates that the safer supply program is not working. It doesn’t indicate that decriminalization is not working.”

The new peer-reviewed study by researchers from Memorial University in St. John’s, as well as the University of Manitoba and Weill Cornell Medicine in New York, says that neither the safer supply of opioids nor the decriminalization of opioid possession in B.C. appeared to mitigate the opioid crisis.

The research found safer supply alone was associated with a 33 per cent increase in opioid hospitalizations, while the addition of decriminalization was associated with a further spike for an overall increase of 58 per cent, compared with before the safer supply program was introduced.

It says there was no change in overdose deaths associated with safer supply, and “insufficient evidence to conclusively attribute an increase in opioid overdose deaths to (either of) these policy changes.”

The researchers reached their conclusions after comparing outcomes in B.C. against those in other provinces over the same period.

Former Vancouver mayor Kennedy Stewart — a strong proponent of decriminalization — said while he isn’t as familiar with the safer supply program, the study’s findings of increased hospitalization actually validated the decriminalized model in removing stigma from drug use.

It allowed people suffering from overdoses to be more comfortable seeking medical help, which Stewart said was reflected in the rise in hospitalizations.

“That’s all decriminalization was ever meant to do,” he said. “Those of us who still support it are interested in reducing the stigma and lowering the barriers to people accessing health care and when they have a substance use issue … it’s not the magic cure, but it really is performing how we thought it would perform.”

The study’s authors said the increase in hospitalizations could be due to destigmatization in seeking treatment, or because “reduced stigma and removal of criminal penalties facilitated the diversion of safer opioids.”

Stewart said there were “growing pains with any policies.”

“And I think instead of just chucking these things out we need to think, how can we get more people from the criminal justice system into health care?”

The provincial Ministry of Health said in a statement that it “continues to carefully examine all emerging evidence to inform policy” but adds that a number of health professionals, researchers and academics have raised concerns about the latest study.

The ministry said those concerns include the toxicity of B.C.’s drug supply during the study’s data period from the beginning of 2016 to the end of 2023, which increased when the border was closed during the COVID-19 pandemic leading to criminal organizations “mixing in new drugs like benzodiazepines that do not respond to naloxone.”

“Both of these factors would logically drive increased hospitalizations,” the statement said. “Policy impacts on health outcomes take time to fully emerge. The study only covers 2016 to 2023 and may not capture the full impact of the policies.”

Critics say the onus is on the government implementing a policy to prove that it works before putting it in place.

B.C. Conservative Opposition public safety critic Elenore Sturko said the study’s data covers the period coinciding with both the onset of decriminalization in the province and “the deadliest period of time that we had in the province’s history in terms of overdose deaths.”

The BC Coroners Service said at least 2,511 people died from toxic drugs in 2023, the deadliest year on record.

“Looking at the study that has come out from JAMA, I think that is just proof of what we’ve been saying all along,” Sturko said.

“And you don’t really need to have this study. If you live in British Columbia, you just have to open your eyes and look around you and see what’s happened in community.

“We all know someone who has been affected either by an overdose or a fatal overdose. You didn’t need the study to know that we’ve been taking the wrong path here.”

She said she and others in the Opposition will continue to put pressure about the issue on the New Democrat government, noting that the province has rolled back parts of the policies.

“I think it’s actually really sad and disgusting that we would be in a position where we’re looking to try to disprove something that the government had every responsibility to make sure was safe in the first place, and they didn’t do that,” Sturko said.

This report by The Canadian Press was first published March 26, 2025.

Chuck Chiang, The Canadian Press