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Decriminalization in B.C.

Information and frequently asked questions (FAQs) for local governments  on decriminalization of people who use drugs.

Local governments are important partners in the successful implementation of decriminalization. Since decriminalization came into effect in BC, some local governments have expressed interest in understanding the potential impacts of decriminalization on public substance use as they consider the needs of their communities.

About decriminalization

In BC, illicit drug toxicity death is the second-highest cause of years of potential life lost  (only cancer was higher), and the highest cause in the 19-39 year age group. Fentanyl and its analogues (similar substances) remain the main driver of illicit drug toxicity deaths. BC has undertaken a number of actions to support its response to the toxic drug supply, including the Take-Home Naloxone program, medication-assisted treatments, prescribed safer supply, overdose prevention and supervised consumption services, and broader treatment and recovery supports; more information can be found on Toward the Heart and in the Adult Substance Use System of Care Framework.

On May 31, 2022, the federal government approved an exemption to the Controlled Drugs and Substances Act to allow for the removal of criminal penalties for possession of small amounts of some illicit substances for personal use by people over 18 years old within British Columbia. This exemption is effective starting January 31, 2023 until January 31, 2026. The purpose of the exemption is to reduce the stigma associated with substance use and support people in accessing important health and social services. 

More information about the exemption is available on the Province of BC website Decriminalizing People who Use Drugs in BC.

What responsibilities do local governments have to engage with Medical Health Officers about matters that could have implications for public health, such as public substance use?

Medical Health Officers (MHOs) are mandated to provide expert advice to local governments on public health issues, including how to address concerns about public substance use. MHOs will work to support an outcome that is optimal for the health of the population, including people who use substances and people who do not use substances. 

Both the Public Health Act and Community Charter describe duties of local governments when dealing with matters concerning public health. 

Section 83 of the Public Health Act requires local governments to: 
  • Consider advice provided by a Medical Health Officer such as if they are considering a bylaw with a public health implications (e.g., a bylaw that prohibits public consumption of decriminalized drugs)
  • Designate an official to act as a liaison between the local government and the health authority on matters of public health ((section 83(1)(c)) 
Section 2 of the Public Health Bylaws Regulation (Community Charter) requires a local government to consult with the regional health board or Medical Health Officer in the development of bylaws under concurrent authority regarding public health. Bylaws relating to the protection, promotion or preservation of the health of individuals, or the maintenance of sanitary conditions must be deposited with the Minister of Health. A bylaw that restricts or has the potential to restrict an individual’s access to health services or that may impact health authority resources will require the Minister of Health’s approval.

Key messages

As indicated by the Ministry of Mental Health and Addictions in the FAQ for local governments, the Government of BC is mindful that enforcement activities can drive people to use drugs alone and can elevate risk of death. Local governments are encouraged to take an education and engagement approach, including supporting referrals to services such as: overdose prevention sites or supervised consumption sites, primary care and health authority delivered mental health and substance use services, and treatment and recovery services. Information about and a listing of mental health and substance use services can be found at:

These key messages have been developed by the BC Centre for Disease Control (BCCDC) to support local governments’ knowledge, decision making, and communications about public use of illicit substances (public substance use). These key messages have been developed following a review of the available evidence and application of public health knowledge about substance use and in consultation with public health, local governments, and people with lived and living experience of substance use.

The information provided here does not replace consultation with the local Medical Health Officer who can provide further information specific to an individual community.  A current list of local Medical Health Officers is available online

MHOs will consider local factors and provide advice tailored to a specific community. In some instances, the advice of the local MHO may differ from the information here, based on local conditions.

A common reason to use drugs in public is homelessness or housing instability. Not being able to access overdose prevention services is another reason. Some people use in public because they don’t have access to any other spaces where they can have another person nearby in case they need help.  Regardless of where people use substances, using alone is a significant risk factor for death.


Substance use occurs along a continuum from helpful to harmful, and what is observed in public spaces is only one aspect of substance use in a community. A holistic response should therefore focus on the entire spectrum of substance use, including promotion of physical, social, and emotional well-being of all community members. Action on the social determinants of health is essential as a complement to programs that focus specifically on prevention and treatment of mental health and substance use concerns.


There is no evidence that decriminalization has led to a population-level increase in public use in other jurisdictions. As such, there are no grounds to assume that public use will increase in BC as a result of decriminalization. However, the potential for unintended consequences – including any potential impacts on public use – is included in provincial monitoring and evaluation activities.‎

There is a high risk of overdose death for anyone using the substances that are accessed from the street drug market because of the toxic and unpredictable nature of the drug supply. Opioid overdose is reversible and survivable if quickly recognized and treated with naloxone. 

Health care providers encourage people who use substances to use with someone else nearby, stagger use, and have naloxone on hand. Many people prefer to use indoors, but the option of an indoor private space in which to follow health guidance is not available to everyone, for example people who are homeless or live in a place that has visitor restrictions. For some, the safety, support, and connection that is available to them through use in a public space can be lifesaving.

Restricting public consumption can add to stigma and displace people who use substances to places where they are less likely to be noticed and responded to if they overdose. This may also lead to people using alone without supports, increasing the risk of fatal overdoses. 

Decriminalization has been undertaken in part out of recognition that some groups have been more harmed by the criminalization of drugs than others, including but not limited to Indigenous, Black, and other racialized communities who experience increased police interactions. To support achieving the aims of decriminalization (including decreased stigma and increased connection to services), it is important that restrictions to public substance use not result in “recriminalization” and thereby undermine this equity-promoting intervention.

The high risk of drug toxicity and fatal overdose is not present with legal substances (alcohol, tobacco, cannabis) because they come from a regulated and predictable supply, and are much less likely to lead to poisoning and death. The toxic and unpredictable nature of the illicit drug supply is a main reason why a different approach to legal versus decriminalized substances is needed at this time.

A range of strategies, programs and partnerships are needed to take a health- and equity- promoting approach to addressing concerns about public substance use in communities across BC. Through support and connection with people who use drugs, many community concerns about substance use can begin to be addressed. For example:   

Build relationships to address substance use in health promoting ways  

Local governments and health authorities can continue to build their relationships with each other on these topics. Within the health authorities there are a number of staff positions that can help, including regional harm reduction coordinators, decriminalization leads, and Medical Health Officers. 
Community organizations serving people who use substances are also important resources. Communities that have been hardest hit by the overdose crisis may also have Community Actions Teams that bring together partners to provide focused, action-oriented strategies to address the overdose crisis at the local level. The Community Action Initiative shares information and lessons from these teams.

Engage with people with lived and living experience of substance use  

Local governments can create healthier and safer communities for everyone by engaging people with lived and living experience of substance use at all stages of planning. 

Drug user groups are an important resource as they carry practical knowledge and resources to support people who use substances, and work to improve the relationships between people who use substances and their communities.

Support initiatives for affordable, accessible, and low barrier housing   

People without homes or who are precariously housed are more likely to use substances in public. Housing is more than an alternative to public substance use – it improves people’s health and allows them to make healthier choices. As well, offering substance use and harm reduction services within supportive housing protects people who use substances while addressing concerns from other community members. It is important that housing be inclusive of youth and pregnant and parenting people. Connect with BC Housing for more information.

Support implementation of Overdose Prevention Services

Overdose prevention services are evidence-based health care services that decrease the risk of fatal overdose and connect people who use drugs to social and medical supports. Local governments can help reduce public use of drugs and encourage safer use by working with health authorities and community organizations to implement of overdose prevention services (e.g. by identifying facilities, supporting zoning changes or exemptions as necessary, and conducting outreach to increase stakeholder support).
The impacts of decriminalization will be monitored by the Province of BC and through a federally funded evaluation. More information can be found on the  Province of BC’s decriminalization webpage

FAQs on public substance use
A: The risk of infection from a community-acquired needlestick injury is extremely low
People may be worried about blood-borne infections from inappropriately discarded syringes. However, the risk of infection from community-acquired needle stick injuries is extremely low. A review of 14 studies of children with accidental needlestick injuries found no cases of transmission of blood-borne infection. 
Safe syringe disposal practices greatly reduce the risk of a community needlestick injury occurring in the first place. Improper syringe disposal can be a reaction to the presence of police and concerns about syringes being used as evidence of illegal drug use. Under decriminalization, people who inject substances can store syringes for safe disposal without the risk of criminalization, meaning fewer inappropriately discarded syringes.

Use of illicit drugs by injection is decreasing in British Columbia, while smoking is increasing, which may also impact how frequently inappropriately discarded syringes are present in the community. 

The BC Centre for Disease Control has produced fact sheets on community syringe distribution, responding to discarded syringes, and community needlestick injuries which may be used by local governments in public communication; these are available on

Local governments can take the following actions to reduce the number of improperly discarded syringes, including: installing sharps disposal boxes, recruiting pharmacies to participate in disposal programs, supporting syringe-pick up programs (“rig digs” or “needle hunters”), and support health authority-led harm reduction services (including overdose prevention sites). Including people who use substances at the outset of a program significantly impacts its future success. Drug paraphernalia bylaws, syringe buy-back, or requiring return of used syringes to access additional supplies (“1-1 exchange”) are not recommended because these approaches can increase unsafe practices, including syringe re-use, which can increase risk of HIV and hepatitis C transmission.

A: There is no risk of overdose from touching fentanyl  
There has been widespread inaccurate information on dermal (through the skin) fentanyl exposure risk. There is no risk to the public of overdose from accidentally touching fentanyl. Further, there are no recorded overdoses in BC from anyone touching fentanyl. Accidental or incidental dermal illicit fentanyl exposure (i.e., touching fentanyl on bare skin) for a short duration does not present a health risk. For more information on what to do if someone touches an unknown substance, review this one-pager (i.e. wash your hands with soap and water and avoid touching the eyes, nose, and mouth). More information can be found in this position statement from the American College of Medical Toxicology (ACMT) and American Academy of Clinical Toxicology (AACT).

A: Accidental, short-term exposure to smoke or vapour from illicit substances is not a significant health risk 

There are no recorded overdoses in BC from accidental second-hand exposure to smoke or vapour from illicit substances.  Exposure to smoke and vapour from an illicit substance is different than experiencing toxicity.  With fresh air, any mild symptoms, such as light-headedness, will dissipate. For more information on what to do if someone was accidentally exposed to smoke or vapour from an illicit substance, review this one-pager

Burning of any substance produces vapours and small particles that are harmful to the airways and lungs with repeated, long-term exposure. People generally have substantially lower second-hand smoke exposure outdoors than indoors. Outdoors, smoke accumulates much less because there is no enclosure, there is natural ventilation, people are further apart, and smoke disperses quickly with distance. Risks are higher with indoor, long-term, repeated exposure to smoke. Accidental, short-term exposures to second-hand smoke are of much lower concern. In addition, illicit substances, such as crack, fentanyl, and heroin are generally burned for a shorter duration than cannabis and tobacco, meaning there is less time for smoke or vapour to accumulate. 

In additional to the strategies described above (which include supporting the expansion of supportive housing), communities can help reduce public smoking of illicit drugs and encourage safer use by working with health authorities to implement inhalation overdose prevention services (e.g. by identifying facilities, supporting zoning changes or exemptions as necessary, and conducting outreach to increase stakeholder support). Guidelines for safe operation of outdoor inhalation OPS is available in the provincial Overdose Prevention Services Guide. Guidelines for indoor inhalation OPS are forthcoming from the BC Centre for Disease Control. 

A: Witnessing peers, parents, and caregivers using substances are more significant factors that influence youth initiation into substance use 

One concern from the public regarding public consumption is the possible impact witnessing public use will have on youth. Youth are most at risk of starting substance use when witnessing use or offered substances in the home or within their peer group – i.e. risk is increased when witnessing use by people they know and trust. The potential impacts on decriminalization on youth are part of the provincial monitoring and evaluation plan for decriminalization.

A: A continuum of supports at the local level are important for youth to develop healthy relationships with substances.

Local governments already have a range of initiatives that can support youth to have a healthy relationship to substance use and promote mental health. Some examples of these types of local government activities include: local government support for youth recreational, leadership and employment opportunities; local government support to school-based programs that aim to prevent substance use harms; local government support to community spaces that foster community connectedness and strengthen supports for families and caregivers; investing in food security initiatives; and including social and affordable low-barrier housing in community planning. 

A: Substance use is not more likely to take place in playgrounds than in other public settings

Public substance use occurred in BC before decriminalization and has not historically been concentrated in playgrounds during daytime hours. The available evidence does not suggest that playgrounds are a venue that is more likely than other public spaces to lead to substance-related harm. Some of the most commonly cited concerns about use in playgrounds include the above regarding community needlestick injury, inappropriately discarded syringes, touching drugs and whether seeing people use drugs will cause youth to initiate substance use. Each of these concerns is addressed above. 

A:  Witnessing public substance use is not a significant trigger for relapse. 

Some people choose abstinence from specific substances following a history of problematic use or for other reasons. People with a past history of problematic use may still experience cravings for the substance, and may have concerns that witnessing public use will trigger those cravings and potentially a return to use of the substance.

Relapses are common in the recovery journey of people experiencing substance use. Some important circumstances that do increase the likelihood of relapse are negative life events (e.g. recent unemployment, child apprehension, etc.); conflict with family, caregivers, and friends; lack of follow-up from health services; stigma and discrimination against people who use substances; and lack of engaging recreational activities. Unstable housing, lack of supportive social networks, lack of programs or supports to maintain recovery, and the cost of recovery services may increase the likelihood of relapse. 
Local governments can support their residents in recovery through evidence-based strategies. They can leverage existing programs that provide meaningful volunteer and paid employment opportunities; provide opportunities to build social connections among community members; and support health authority-led substance use prevention, treatment, and harm reduction initiatives.

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