In 2001, Portugal took a radical measure to combat its drug epidemic. It decriminalized all illicit drugs, choosing to treat addiction as a medical matter, not a criminal one.
Two decades later, facing a drug crisis of its own, the Canadian province of British Columbia chose to follow in Portugal’s footsteps. In January 2023, British Columbia temporarily removed criminal penalties for the possession of small amounts of cocaine, methamphetamine, MDMA, and opioids. The policy was implemented as a three-year pilot program, authorized by an exemption from the federal government’s Controlled Drugs and Substances Act.
While some politicians, including Conservative Leader Pierre Poillievre, have fiercely criticized the government’s more lax drug policies, the reality is that they have yet to be fully tested. We are only a few months into this experiment, and the province’s approach to drugs is still taking shape. B.C. still has decisions to make regarding mechanisms for diverting people toward support, the permissible quantities for personal possession, and expansions of safe supply programs.
What is Decriminalization?
Before providing an overview of the ongoing drug policy debates in B.C., let’s establish some basics. What is and isn’t allowed under a policy of decriminalization? What safety benefits might decriminalization achieve, and where might it fall short?
Under decriminalization, individuals aged 18 and up who possess under 2.5 grams of opioids, cocaine, methamphetamine, and MDMA for personal consumption will not be arrested or charged, and they will not have their drugs seized. Instead, they will be offered information about health and social services and helped with referrals if desired.
The case for decriminalization is simple. People with drug addictions will get their hands on drugs no matter what, so we should prioritize reducing harm when that happens. A policy of decriminalization ensures that people using drugs can call the ambulance without fear of prosecution. It can also reduce the stigma around drug consumption that prevents people from accessing critical services.
However, under a policy of decriminalization, these drugs remain illegal. Anyone selling or trafficking these drugs can still face criminal penalties, including prison time.
The main shortcoming of decriminalization is that it has little impact on the toxic drug supply. As long as selling drugs is illegal, and safe supply programs don’t entirely replace the black market supply, the content of the drugs will remain unregulated and dangerous. In 2022, over 70% of drugs seized by law enforcement across Canada contained fentanyl or fentanyl analogues. There is little reason to believe that decriminalization, on its own, will change this reality.
That said, no country in the world has gone beyond decriminalization to a policy of full legalization. And some, especially Portugal, seem to have achieved successes in reducing harm nonetheless. In the 1990s, roughly 1% of Portugal’s population was hooked on heroin, and the country had the highest HIV infection rate in the European Union. Since 2001, when Portugal decriminalized drugs, overdose deaths have decreased by 80%, and the number of new HIV infections among people who use drugs has plummeted. Moreover, the number of people receiving treatment increased by over 60% from 1998 to 2011.
More recently, Portugal’s success has been called into question. A Washington Post op-ed points out that the funding of rehabilitation services has declined, that waiting times have grown even though the number of people seeking treatment has fallen, and that there has recently been a substantial increase in visible urban drug use. Still, the early successes of Portugal’s policy in pulling the country out of a public health emergency cannot be ignored. Indeed, João Goulão, the head of Portugal’s Institute for Drugs and Drug Addiction, attributes Portugal’s recent struggles to dwindling funds, rather than the policy of decriminalization itself.
The Future of Decriminalization in B.C.
Decriminalization has yet to accomplish in B.C. what it accomplished in the early 2000s in Portugal, but it is far too early to rule it out. There are a few key policy areas that are subject to ongoing debate and that may shape the course of decriminalization in B.C.
First, B.C.’s approach to treatment has been called into question. In the early days of drug decriminalization, observers criticized provincial authorities for providing insufficient treatment resources and subjecting people to months-long waits. In response, the government has committed approximately $740 million to mental health and addiction services over the next three years, hoping to expand treatment options and shorten waitlists.
But some critics argue that the problem is not merely one of resources. Drug experts in Portugal have pointed out that B.C. lacks a formal mechanism to direct people toward support.
In Portugal, anyone caught with drugs for personal use can be ordered to appear before a “dissuasion commission,” a group composed of legal, health, and social work professionals who provide users with information about treatment options and access to health services. In a small subset of cases, the commission imposes mild administrative penalties, such as fines or community service, to deter further use, but these disciplinary actions remain outside the criminal justice system. This innovative approach has helped Portugal funnel large numbers of people into treatment. Oregon, in contrast, has not coupled its recent decriminalization policy with a system of diverting people toward support. The results of decriminalization in Oregon have been disappointing; overdose deaths rose 39.4% the year after the policy was enacted.
B.C. doesn’t need to copy Portugal’s dissuasion approach, but experts are saying it should think seriously about how to more effectively set people on a path to recovery.
Second, some advocates say that the 2.5 gram threshold for drug possession is far too low to have an impact. In a recent study that sourced opinions from people who use drugs in B.C., participants voiced the concern that they will still be vulnerable to criminalization if they continue to purchase drugs like cocaine and methamphetamine, which are typically sold in quantities larger than 2.5 grams. Many participants also pointed out that they will now simply have to make more frequent, smaller purchases, which are more likely than larger purchases to be laced with fentanyl.
In response, Carolyn Bennett, Federal Minister of Mental Health and Addictions, has said that the 2.5 gram threshold is a “starting point,” though it remains unclear how B.C. will balance its aim to achieve true decriminalization with its aim to reduce the quantities of drugs being consumed.
Third, B.C. will need to determine the boundaries of its safe supply program. The province already has a limited program that provides people with prescribed opioids or stimulants as they manage withdrawal symptoms, keeping them away from more dangerous, unregulated drugs. Some advocates argue that this program doesn’t go far enough, though. The Canadian Association of People Who Use Drugs has advocated for a more robust, free-of-charge safe supply that includes heroin and other opioids, cocaine, crystal methamphetamine, hallucinogens such as MDMA and LSD, and marijuana.
Meanwhile, Canada’s conservative wing has accused the safe supply program of fuelling a new opioid crisis, with government-provided drugs being resold on the streets, particularly among youth. Officials have responded that this claim is not backed by the evidence — that youth injuries and deaths are resulting from illicit supply, not a diverted safe supply.
B.C. will need to monitor these outcomes carefully, weighing the trade-off of increasing the supply of drugs — at the risk that they infiltrate the black market — while mitigating the damage that they do.
All Eyes on B.C.
As B.C.’s positions on treatment, the 2.5 gram threshold, and safe supply programs are debated and updated, we should hope the province serves as an example of how to approach drug legislation — both in how the province manages the fraught politics of substance use, and in the outcomes that its policy delivers.
On the political front, B.C. is doing a commendable job of treating substance use as a complex public health matter rather than an ideological debate. B.C. Premier David Eby of the left-wing New Democratic Party has emphasized that the policy is a pilot program that can be revisited if necessary and that the concerns being raised are worthy of attention. B.C.’s leaders should continue to carefully follow the evidence and be willing to shift course, either in scaling up or scaling down the decriminalization policy.
On the policy front, the outcome of B.C.’s drug experiment will prove significant for the rest of Canada. Canada is a country that isn’t afraid to lead the way on drugs; it was the second country in the world, after Uruguay, to legalize cannabis. We can expect that the Canadian federal government is closely watching the results in the jurisdiction of B.C., as the country considers potential shifts in drug policy at the federal level.
Other countries may be watching, too. With Oregon’s disappointing results, and emerging concerns in Portugal, the world awaits a fresh test case for decriminalization. As the drug policy debates unfold, Canadians must lead by example, putting policy over politics and carefully crafting an approach that saves lives.
Image by “Pretty DrugThings” is licensed under the Unsplash License.
