Evidence map›Paper›PMID 41353135›Full record

ArticleBMC public health2025

Exploring the early impacts of drug decriminalization on harm reduction and opioid agonist treatment service operations and delivery in British Columbia: insights from key informant interviews.

Cayley Russell, Savannah Torres-Salbach, Laura MacKinnon, Rita Shahin, Dylan Griffith, Kate Hodgson, Charlene Burmeister, Courtney Amoraal, Frank Crichlow, Sameer Imtiaz and 2 more

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. What decriminalization in British Columbia could and could not achieve.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Cayley RussellInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 250 College St, Toronto, ON, M5T 1R8, Canada. Cayley.Russell@camh.ca.
Savannah Torres-SalbachInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 250 College St, Toronto, ON, M5T 1R8, Canada.
Laura MacKinnonDepartment of Family Practice, University of British Columbia, 5950 University Blvd, Vancouver, BC, V6T 1Z3, Canada.
Rita ShahinToronto Public Health, 55 John St, Toronto, ON, M5V 3C6, Canada.
Dylan GriffithKootenay Insurrection for Safe Supply, 40-622 Front St, Nelson, BC, V1L 4B7, Canada.
Kate HodgsonDepartment of Nurse Practitioners, Vancouver Coastal Health, 520 West 6th Ave, Vancouver, BC, Canada.
Charlene BurmeisterBritish Columbia Centre for Disease Control, Vancouver, BC, V5Z 4R4, Canada.
Courtney AmoraalCanadian Society of Addiction Medicine, 53 Sunlake Rd. SE, Calgary, AB, T2X 3G8, Canada.
Frank CrichlowCanadian Association of People Who Use Drugs (CAPUD), 68 Highfield Park Dr Suite 102, Dartmouth, NS, B3A 1X4 11, Canada.
Sameer ImtiazInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 250 College St, Toronto, ON, M5T 1R8, Canada.
Jürgen RehmInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 250 College St, Toronto, ON, M5T 1R8, Canada.
Farihah AliInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 250 College St, Toronto, ON, M5T 1R8, Canada.

Funding

CIHR FRN:184698
6 · The paper itself

Abstract

backgroundOn January 31, 2023, Health Canada granted British Columbia (BC) a three-year (2023-2026) exemption under the Controlled Drugs and Substances Act (CDSA), decriminalizing the personal possession of up to 2.5 g of certain unregulated drugs among adults (18+) without arrest, seizure of drugs, or criminal penalty. A key objective was to increase awareness, engagement, and retention in harm reduction (HR) and opioid agonist treatment (OAT) services by reducing stigma and enhancing service access. In May 2024, however, the policy was amended to re-criminalize drug use and possession in public spaces. This study examines how decriminalization and its subsequent amendment affected HR and OAT service operations from the perspective of service providers across BC.

methodsBetween October 23rd, 2024 and January 29th, 2025, 18 semi-structured virtual key informant interviews were conducted with HR and OAT service providers across BC. The interviews examined participants' experiences with decriminalization and its amendment, and how these policy changes impacted service operations and delivery. Thematic analysis was used to identify patterns across interview data.

resultsKey informants reported few operational changes following decriminalization, with no major adjustments to service delivery. Despite expectations of increased client engagement, sites received no additional funding and faced ongoing staffing and resource shortages. Informants emphasized that systemic issues-such as the toxic drug supply and rising homelessness-had a greater impact on service use than the policy itself. A lack of clear communication and site-specific training resulted in uncertainty and confusion, further limiting frontline staff's ability to respond effectively to policy changes.

conclusionKey informants perceived that decriminalization did not lead to immediate changes in HR and OAT site operations. Longstanding systemic barriers continued to limit service capacity and policy impact. Providers highlighted the need for sustained investment in housing, staffing, and supervised spaces to support meaningful engagement and reduce stigma. Addressing these foundational issues was seen as essential for realizing the policy's intended public health objectives.

Indexed as

Analgesics, OpioidDrug and Narcotic ControlHarm ReductionOpiate Substitution TreatmentOpioid-Related DisordersAdultBritish ColumbiaFemaleHumansIllicit DrugsInterviews as TopicMaleQualitative ResearchAnalgesics, OpioidIllicit DrugsDecriminalizationDrug policyHarm reductionOpioid agonist treatmentPeople who use drugsService provision: public health

Identifiers

PMID41353135
PMCPMC12798107

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.