Decriminalization of drug possession in British Columbia and hospitalizations for opioid poisoning

Objectives

In January of 2023, the provincial government of British Columbia, Canada, received federal approval to decriminalize the personal possession of certain illegal drugs. The policy had multiple aims, including a long-term goal of reducing drug-related overdoses by decreasing stigma associated with drug use and promoting health service and treatment engagement. In May of 2024, the policy was amended to recriminalize drug possession in public spaces. We evaluated the association between the implementation of British Columbia's drug decriminalization policy, including both the initial enactment and the May 2024 amendment, and opioid-related poisoning hospitalizations.

Study design

We conducted interrupted time series analyses using quarterly data on opioid-related poisonings leading to hospitalization.

Methods

The study period spanned from the first quarter of 2016 to the third quarter of 2024, inclusively. Data were sourced from British Columbia and other Canadian provinces without decriminalization (excluding Quebec, Newfoundland and Labrador, and Prince Edward Island). Two intervention time points were assessed: January 31, 2023, marking the implementation of the initial decriminalization exemption, and May 7, 2024, when a substantial amendment to the exemption was enacted. Data were analyzed using generalized additive models.

Results

We found no association between the slope of opioid-related poisoning hospitalization rates associated with the original enactment of the decriminalization legislation, and also no associations with this indicator after the May 7th amendment either in level or slope.

Conclusions

Our findings indicate that decriminalization was not associated with increases in opioid-related poisoning hospitalizations.