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Metrics details. In January , British Columbia implemented a three-year exemption to Controlled Drugs and Substances Act , as granted by the federal government of Canada, to decriminalize the personal possession of small amounts of certain illegal drugs. This decriminalization policy, the first in Canada, was announced in response to the overdose emergency in British Columbia as a public health intervention that could help curb overdose deaths by reducing the impact of criminalization and increasing access to health and social services through stigma reduction. The qualitative findings suggest that people who use drugs misunderstood the details of the provincial decriminalization model and often conflated it with regulation. Results suggest that information sharing about decriminalization were minimal pre-implementation, highlighting areas for knowledge dissemination about people who use drugs' rights under this policy. Given that decriminalization in British Columbia is a new and landmark reform, and that the success of decriminalization and its benefits may be undermined by poor awareness and knowledge of it, efforts to share information, increase understanding, and empower the community, may be required to promote its implementation and benefits for the community. Peer Review reports. In , the Government of British Columbia BC announced that it received approval from the Canadian federal government to decriminalize the personal possession of illicit drugs for adults in the province \[ 1 \]. Drug decriminalization in BC is planned as a three-year trial under an exemption from Sect. The BC decriminalization model formally eliminates criminal penalties for the possession of drugs under certain parameters. The exemption only applies to adults over the age of 18 in BC and to possession of 2. Possession of substances not mentioned above, including novel psychoactive substances, remains illegal in BC. It is a no-sanction model; alternative penalties, such as fines or mandatory treatment, are not included. However, police officers can provide health and social service information cards to individuals who request them. The exemption also does not apply to certain circumstances, such as at schools, airports, and parks, as well as in vehicles and for individuals with drug-related court conditions. The initial exemption for this decriminalization model will be piloted in BC for three years, from January 31, to , when internal and external groups will evaluate it \[ 2 \]. Drug decriminalization in BC follows years of advocacy by public health experts, police officers, people who use drugs PWUD , and other drug policy advocates to staggering drug toxicity death rates \[ 3 , 4 , 5 , 6 \]. BC, like other parts of Canada and the United States, has been experiencing unprecedented drug-related death rates that are linked to drug toxicity in the unregulated and illicit market \[ 7 \]. Since a public health emergency was declared by the provincial government in , BC Corners Service has recorded nearly 13, drug toxicity deaths \[ 8 \]. In response to this crisis, a host of policy interventions have been introduced, including the expansion of take-home naloxone and drug treatment, and the establishment of overdose prevention sites, anti-stigma campaigns, and drug checking programs \[ 9 , 10 \]. However, as drug toxicity deaths have not waned in recent years, alternative drug policies remained a priority. Nevertheless, the provincial and federal governments intend to reframe drug use from a criminal issue to a health issue to promote greater dialogue about drug use, supports, and not using drugs in isolation \[ 13 , 17 \]. This aim follows research showing that criminal drug laws and policing exacerbate social and health risks, including overdose risk, due to fear of police, social stigma, and isolation risk \[ 18 , 19 , 20 , 21 , 22 \]. While introducing decriminalization can be viewed as responsive to the drug toxicity crisis, its impacts are not necessarily automatic. Evidence shows that drug policy objectives can be thwarted by poor implementation efforts and a lack of knowledge among those it is meant for \[ 23 , 24 , 25 , 26 , 27 \]. For instance, details on how police officers will assess the content of drugs remains unclear. Therefore, key to the implementation of decriminalization in BC is promoting awareness and knowledge of the policy itself among the groups it is intended for. To promote the uptake and benefits of decriminalization, knowledge sharing among PWUD, police officers, and the public about the existence and details of the policy is required. In recent years, the prohibition of drugs and criminalization of people who use them have been under a spotlight given the related harms from policing. A large body of evidence suggests that policing is a determinant of health for PWUD, and that police harassment has resulted in negative health outcomes for them. For example, police presence in drug markets results in rushed injections and increased overdose risk \[ 28 , 29 , 30 , 31 , 32 , 33 \]. Both policing and the stigma associated with criminalization and drug use also negatively impacts people accessing health and harm reduction services, including syringe programs, overdose prevention sites, opioid substitution therapy and HIV medication \[ 34 , 35 , 36 , 37 , 38 \]. A growing body of research also suggests that criminalization and policing is related to increased overdose risk. Fear of arrest is a barrier to people seeking emergency medical services or calling 9— during overdose events \[ 39 , 40 , 41 , 42 , 43 \]. Specific police practices are also associated with greater overdose risk. For instance, in a recent retrospective cohort study of administrative data following drug market disruption attempts by policing, researchers found that increased drug confiscations by police officers were significantly associated with a two-fold increase in fatal overdoses in surrounding neighborhoods in the three weeks following enforcement \[ 21 \]. In response to the overdose crisis and evidence of the impact of criminalization on overdose, several jurisdictions, including in Canada, passed drug-related good Samaritan laws, which decriminalizes personal drug possession at the scene of an overdose. However, recent studies show limited effectiveness of such policies on willingness to call 9— and overdose risk due to a lack of knowledge and awareness of the policy itself \[ 25 , 27 , 41 , 48 \], although there are differences in the populations who are knowledgeable on this Act \[ 49 \]. Similar results are found in other jurisdictions, including several states in the United States with drug-related good Samaritan laws \[ 26 , 39 , 50 , 51 , 52 \]. Subsequently, PWUD express ongoing fear of arrest and police intervention at overdose events, undermining drug-related good Samaritan laws achieving desired benefits. In other decriminalized jurisdictions such as Portugal and Oregon, there is only a small body of literature on the impact and implementation of reforms, although some research points to the importance of knowledge and awareness of reforms among both people impacted by decriminalization i. This study and others also suggest that lack of knowledge and awareness of decriminalization can undermine its benefits or impact \[ 23 , 24 , 25 , 26 , 27 \]. To our knowledge, however, no studies have been conducted on knowledge and awareness of drug decriminalization prior to its implementation in any jurisdiction with such a reform. Data collection took place between September and January , immediately after the exemption was announced May 31, and before its inception January 31, In this study, we draw on two different sources of data — one quantitative and one qualitative — that were collected concurrently but independently. Data collection for both data sources took place between September and January , immediately prior to the implementation of decriminalization, across the province of BC. While data were collected separately and independently, each research team, qualitative and quantitative, informed both data collection instruments to ensure corroboration of data across methods and findings. Conversely, the survey provided an opportunity to understand predictors of knowledge and awareness, such as regional and socioeconomic differences, which pointed to areas of further examination in the qualitative data. The interview guide revisions also included asking about public drug consumption in a way that complemented the survey questions. The current study leverages the complementary natures of these two data sources. To triangulate findings, the investigators met to compare, examine, and discuss the findings on outcomes related to awareness and knowledge of decriminalization in BC. Following data collection and preliminary analysis, the investigators met to triangulate findings by examining and comparing findings on outcomes related to awareness and knowledge of decriminalization in BC. Findings from both the quantitative and qualitative data are grouped under four topic domains: 1 awareness of decriminalization; 2 understanding of decriminalization; 3 knowledge of decriminalization; and 4 sources of information about decriminalization. For each topic domain below, we provide a description of the survey and interview findings, considering how the qualitative can complement and help explain the quantitative findings. This group was comprised of six people with past or present experience of illegal drug use who were well-connected with other networks and groups of PWUD across BC. Members were compensated for their involvement at a rate that aligned with local standards. For data collection, the group advised on study recruitment and sampling strategy, and the questions asked in the data collection instruments. Members also assisted in participant recruitment for the qualitative study by sharing the study flier, helping with scheduling interviews, and distributing the consent form and honorarium to participants. After the data were analyzed, the study findings were presented back to the group for additional feedback, discussion, and validation. Sampling, Recruitment, and Data Collection: Quantitative data was collected through the Harm Reduction Client Survey which is a long-running survey of clients at harm reduction supply distribution sites across BC. Methods for the survey have previously been described in depth \[ 54 \]. In brief, harm reduction distribution sites are sampled annually from diverse sizes of communities across BC. At participating sites, a paper-based survey instrument was used to collect data. Data collection was supported by site staff or peer workers who explained the survey to clients, offered the opportunity to participate, and obtained verbal informed consent while reassuring individuals that participation was voluntary and anonymous. Inclusion criteria were being at least 19 years of age and reporting use of a drug that is illegal, opioid agonist therapy, or prescribed safer supply in the previous six months. Participants were recruited from 29 harm reduction supply sites located in a range of large, medium, and small communities across BC. Data collection occurred between November and mid-January The Harm Reduction Client Survey addresses a variety of other topics, including harm reduction service needs, in keeping with its purpose as a surveillance and quality improvement initiative of the Provincial Harm Reduction Supply Program. Questions about decriminalization were added to the survey in following the announcement that the BC government would be implementing this policy in \[ 55 \]. Survey questions specifically about decriminalization assessed: a knowledge and awareness; b drug purchasing patterns; c experiences with police and health services; d barriers to accessing supportive services. We also included questions on demographic characteristics, substance use patterns, internet access, and housing concerns. The quantitative study was granted ethics approval from the University of British Columbia H To support consistency and quality, clear guidelines were developed and shared with staff engaged before data entry began, and small modifications were made and communicated to account for variations in question completion. Responses were entered into a REDCap database and extracted after data entry completion. Data cleaning included grouping write-in responses with existing categories and creation of new categories if necessary. The analytic sample was selected based on the outcome variable and complete responses to the predictor variables. There were no significant differences in the sociodemographic factors between the full and analytic sample. Responses to each question were scored as correct 1 vs incorrect or not sure 0. To assess a greater understanding of decriminalization, participants were scored on getting both questions correct 1 vs one or zero correct 0. Table 1 summarizes the demographic characteristics of the sample, also considered as predictor variables. Gender identities were cis man, cis woman, and gender expansive or transgender, which included gender non-conforming, trans-man, trans-woman, or other identities. Due to small counts, the latter category was not included in the multivariate analysis. Participants reported their age in years, which was categorized into 19—39 years and 40 years or older. BC has five regional health authorities that deliver health services Fraser, Interior, Island, Northern, and Vancouver Coastal ; the health authority the survey was completed in was used to categorize participants. Concern about losing housing in the last 6 months, internet access, opioid use in the last three days, and stimulant use in the last three days were all as categorized yes or no according to survey responses. All quantitative analyses were conducted in R version 4. To assess predictors of a person being aware of decriminalization a multivariate log binomial model was fitted with participant characteristics. A log binomial model was chosen as awareness of decriminalization is binomial outcome that is not rare. To assess predictors of a participant correctly answering each true or false question and getting both questions correct, three multivariate log binomial models were fitted with participant characteristics. For each of the five drugs included in decriminalization, we examined if people used the drug were more likely to be aware of its inclusion in decriminalization. To recruit interview participants, CAB members and peer workers distributed recruitment fliers through their networks of PWUD that spanned the same regions sampled for the Harm Reduction Client Survey. These individuals also facilitated scheduling and honorarium payment. In some cases, provided telephones for the interview itself. To reduce bias and gain diversity in perspectives, we also purposefully sampled certain groups to ensure diverse perspectives were captured, such as unhoused, racialized, and gender diverse individuals. The qualitative sample characteristics are in Table 2. Inclusion criteria were: a 19 years or older, b self-identify as someone who has used illegal drugs e. Prior to the interview, participants provided informed consent. Eligible and interested participants were provided with a consent form that explained the purpose of the study and the requirements of participation. Verbally and through the consent form participants were informed that their participation was voluntary and confidential. The consent process and interviews were conducted by a trained research assistant or coordinator. All interviews were conducted over the phone or in person and digitically audio recorded following informed consent. We conducted a total of 38 qualitative interviews — a sample size that was guided by informational saturation, meaning that the data were rich enough to produce meaningful patterns and findings \[ 56 \]. Initially, we felt that we obtained a sense of richness in the data at 32 interviews, but conducted an additonal six to ensure fullness in the dataset and confidence that we achieved a high degree of depth and richness in the data pertaining to the study aims. The interivews were directed by a question guide organized around three main topics: a personal experiences with police officers around drugs, b awareness and knowledge of decriminalization, c relationship between police and PWUD. The questions asked were developed in collaboration with the research team, community advisory group, and other collaborators and researchers to promote relevance and validity. As well, our team held regular meetings to discuss the quality and relevance of data. From these meetings, we revised some questions to ensure we generated a depth in responses, by adding probing questions, and breadth of information, by adding new topics, that were relevant to our study aims. Revised topics in the question guide received ethical approval before proceeding with additional data collection. After each interview was completed, the audio recording was transcribed verbatim and verified by multiple researchers. Any personally identifying information was removed or anonymized during the transcription process. The anonymization process included removing participant identifiers from data, including names, ages, ethnicity, as well as any identifying experiences, such as details of events. The de-identified transcripts were uploaded to NVivo a qualitative data coding organization software to be organized and analyzed \[ 57 \]. Bi-weekly research team meetings were held to develop a coding framework and included a member of the community advisory board who expressed interest in being involved in the coding and analysis process. A preliminary framework was applied to five transcripts to ensure that participant perspectives were encapsulated by the codes, and revisions to the framework were made when necessary. Then, the coding framework was applied to all transcripts. Regular meetings were held amongst coders to ensure consistency and reliability and any necessary revisions to the framework and coding were made. To analyze the data, we engaged in a qualitative descriptive approach guided by the study aims \[ 58 \]. Qualitative descriptive approaches are often undertaken in mixed- and multi-methods studies, such as ours, to provide descriptions of experiences and perceptions that corroborate and expand quantitative findings — thus making findings overall more meaningful \[ 59 \]. The analysis process continued into writing and comparing the quantitative results with the qualitative findings to provide a better understanding of knowledge gaps and informational needs of PWUD. Individuals with access to the internet, those who were concerned about losing housing, and those who participated at sites in Vancouver Coastal were significantly more likely to be aware of decriminalization. In the qualitative interviews, most had heard of decriminalization in BC; but variations in the depth of knowledge were also found; qualitative analysis revealed possible reasons for these variations. It was evident that some PWUD who were actively involved in decriminalization reforms and advocacy were especially knowledgeable, whereas a few had never heard of it. For participants, a lack of knowledge amongst PWUD in their social circles was linked to the view that PWUD did not talk about drug policy reforms in their community; for them, discourse and information exchange about decriminalization was minimal. Some participants indicated that discussions of drug policy changes, including decriminalization, was not necessarily a top priority or topic for PWUD. One person said:. No participants stated that they learned about the exemption from government-provided materials or campaigns about the incoming decriminalization policy. The combination of limited discourse with minimal information about drug policy reforms, PWUD expressed a burden of responsibility to seek out and acquire such information. The idea of decriminalization itself was obscure and many were unsure of some or all its features. One feature identified by several participants was the threshold quantity whereas other features, such as possession and trafficking, were unclear:. That they would have to give it back to you. The extent to which PWUD understood decriminalization was also articulated through questions they posed to the interviewer. Some asked for clarification on what it was or details of the policy itself. Conversely, among those who seemed to understand decriminalization, most participants knowledge was based on their experiences. Some participants had observed a reduction in criminal penalties and policing in BC already. Here, they focused on the removal of criminal penalties that comes with decriminalization, including de facto decriminalization which according to many was already in place:. Decriminalization was about reducing or removing arrest for simple possession — something they witnessed in BC prior to the policy change — thus, underscoring the importance of personal experience shaping their knowledge of what decriminalization meant. Participants often conflated or confused drug decriminalization with other laws and policy frameworks, highlighting a misunderstanding of what decriminalization was. Participants also reported that such confusion or conflation was common amongst other PWUD in their community. Knowledge about the decriminalization model in BC was a key concern for PWUD in terms of their rights and empowerment. Several participants expressed fear around the perceived lack of knowledge that PWUD had surrounding BCs model of decriminalization and the disadvantage that this placed on them. Such unknowns left PWUD feeling vulnerable to ongoing criminalization or police harassment. Participants were worried that poor understanding of the decriminalization policy would limit its effectiveness or benefits, as it may make them vulnerable to policing. Another person said:. Lacking knowledge of the details of decriminalization were a point of disempowerment or vulnerability in police encounters. The details themselves were important; for participants, there were risks in knowing about decriminalization generally, but not knowing its bounds or details specifically. Other people similarly expressed concerns that misinformation or misunderstanding could also leave people vulnerable to other abuses of authority or misuse of the law:. PWUD continued to mistrust the law and enforcement despite knowing about decriminalization, assuming that they would be caught up in the finer details and penalized when given the chance. Lack of knowledge about decriminalization was a point of vulnerability for them in this arrangement. Similarly, conflating decriminalization with other policy models falsely produced high expectations that decriminalization in BC was a drug market intervention or that it granted greater protections than it offered:. Such expectations produced a false sense of security or safety that could potentially introduce greater risks for PWUD, both in terms of criminalization and drug toxicity. Specific elements examined in the quantitative and qualitative arms included the substances covered by the exemption, threshold quantity, drug seizures, and trafficking circumstances. Quantitative and qualitative outcomes of knowledge of exemption details were largely similar across demographic stratifications. People who used methamphetamine, powder cocaine, and opioids were significantly more likely to know whether the drug they used was included in decriminalization Table 4. In the qualitative interviews, participants did not talk about the substances included at length but seemed confident in their knowledge about the substances included. Some participants recalled and listed them accurately with no hesitations. However, we did not specifically interrogate them more on this topic. Interestingly, excluded substances from decriminalization, including hallucinogens and benzodiazepines, were also not raised by or discussed among any participants, despite being present in the illegal market — potentially highlighting a knowledge gap or area for future investigation. While the median estimate was 2. However, it was unclear whether respondents believed the possession limit was above 2. In the qualitative interviews, many of the participants who had heard of decriminalization understood that BC was introducing a model with a threshold amount. This topic was talked about it at length by most participants, indicating a clear discourse that was present amongst their communities, although their knowledge about it varied. Overall, many participants accurately stated a threshold amount of 2. As well, it was mostly unclear whether PWUD understood that the 2. But a grand total of it. In the survey, participants responded to true and false statements about drug confiscation and drug trafficking Table 5 and 6. The belief that police could seize drugs under the threshold was significantly associated with participating at a site in Interior or Northern health authority compared to Fraser health and being from a medium sized community compared to a large community Table 6. In the interviews, similar variations in knowledge about drug confiscation were reported, although most were aware that it was a feature of the exemption. In introducing this topic to interview participants, most were quick to express skepticism that decriminalization would reduce drug confiscation at all. This skepticism was based on a sense of deep distrust towards the law and officer. On this topic, many reported that drug confiscation was a regular and frequent occurrence. Their distrust was reinforced by the belief that decriminalization lacked any measures or plans to hold police officers accountable or monitor their practices. Knowledge and understanding of drug trafficking laws was talked about at length in the qualitative interviews; how drug trafficking charges would be handled by police officers and the courts was one of the most confusing details of decriminalization for participants. Some believed even drug trafficking offences under 2. Participants were especially unclear on how drug trafficking and possession charges would be delineated from each other — a piece of information that was especially important for PWUD who felt vulnerable to policing otherwise. You know, there is still some grey areas. The possibility of arrest or charges for drug trafficking still left uncertainty in police interactions where, in lieu of specific details and parameters for drug trafficking, they were not confident in the outcomes. It was unclear whether respondents endorsed sources of information they had used, preferred sources of information, or whether some may have received the decriminalization handout before they completed the survey. It was clear from the qualitative interviews that information about decriminalization, both in terms of availability and depth of information, was scarce or lacking at the time of data collection — immediately before the inception of decriminalization. Some participants thought that information about decriminalization was largely limited to social media or news outlets — avenues that made some PWUD aware but not overly knowledgeable about the policy. In other words, participants questioned who decriminalization benefited if it was not known among equity-deserving groups. Examples provided by participants of such groups included people who are unhoused or precariously housed or who had visual impairments. Even if it changes tomorrow, it will still be the same pretty much. We need to make people more aware. For them, peer workers who had strong relationships to the community were well positioned to engage in accurate knowledge sharing. In addition to accuracy and being well-connected, they talked about peer workers having first-hand experience with the legal system that they believed was valued by other PWUD. PWUD often did not understand the parameters of the decriminalization model, including the drugs, amounts, and circumstances in which it applies. As discussed below, participants offered several recommendations for increasing awareness and understanding of decriminalization in the community. Awareness of other drug policies among PWUD globally are considerably lower. We expect that as decriminalization in BC is implemented, awareness may increase; however, it is unclear how knowledge and information about the model may evolve. Future iterations of the Harm Reduction Client Survey and qualitative research by our teams are planned to assess ongoing awareness, understanding, and knowledge of decriminalization post-implementation. While over half of participants were aware of decriminalization in BC, understanding the model and details of decriminalization among PWUD was highly variable. The qualitative findings provide nuance as to where discrepancies exist. Interview participants often conflated decriminalization with other legal frameworks i. As noted in previous work, the details of a decriminalization model can be complex and therefore obscure \[ 65 \]. Findings underscore the need to clearly define and articulate this legal parameters among target audiences, including the goal or what the policy is intended for. Concerns for the impact of knowledge disparities has been echoed in other studies where legal protections from drug policies were limited. Ample research demonstrates the impact of misunderstanding drug-related good Samaritan laws include ongoing hesitation to calling 9— in the event of an overdose, and an ongoing fear and distrust towards police, the legal system, and government in general \[ 39 , 60 , 66 \]. In previous studies, PWUD have reported violence, abuses of power, misconduct, discrimination, and a lack of procedural justice contribute to this mistrust \[ 30 , 38 , 67 , 68 , 69 , 70 , 71 \]. These factors are often linked to intersecting structural vulnerabilities that position some PWUD at greater risk of police contact and negative outcomes \[ 69 , 70 , 72 \]. It is therefore important to ensure decriminalization in BC is effectively implemented in a way that promotes structural change whereby policing is decoupled from the lives of PWUD and healthcare. Conversely, participants in our study suggested that increasing knowledge about their rights under decriminalization has the potential to empower PWUD in police interactions and promote the benefits of policy change, including de-stigmatization and a sense of social inclusion. In addition to structural changes that are needed, additional knowledge sharing with police officers, training, and accountability measures that promote procedural justice may need to be in place and communicated to PWUD to promote trust and legitimacy of the policy itself. Effective health communication strategies have been shown to be a key element of health policy implementation. The strategies suggested by participants in the current study, including leveraging peer networks and technology, are shown to be effective in the health communication literature. Knowledge of the policy considerably varied by region, such as in rural and remote areas where misconceptions of the policy existed e. This finding aligns with health communication findings across a range of health issues showing that reaching groups in rural regions is significantly more challenging than urban populations \[ 74 , 75 \], due to infrastructure, the cultural environment, information sources, and fiscal costs \[ 75 , 76 , 77 , 78 , 79 \]. Innovative health communication interventions, such as the use of technology and social media, could promote health literacy in rural communities, although connectivity and accessibility may need to be addressed \[ 75 , 80 , 81 \]. Groups from rural areas should be engaged in the design and delivery of such campaigns as they understand the rural context and culture in which people live \[ 74 , 79 \]. Other studies in BC show that communication about drug alerts occurred mainly through friends or peers in rural communities \[ 82 \] — therefore, networks of PWUD may be important to connect with and distribute health information through. Information sharing should consider barriers that PWUD may face to accessing online information, including limited cell phone ownership \[ 84 \]. As participants in our study noted, PWUD are a diverse population with differing knowledge sharing needs. Participants strongly suggested that multiple and diverse avenues for information sharing are needed, including through social media, harm reduction sites, and peer networks. To ensure that the exemption can equitably reduce criminalization, education efforts should be targeted to people with lower awareness of the policy and its components, including women, younger people, people without access to the internet, people with visual impairments, and people who live in rural and remote communities. Previous research has shown that particular forms of knowledge sharing work well with this community, including from peers and other PWUD \[ 85 , 86 \]. Since collecting data in our study, some community groups have acted in attempts to increase knowledge and awareness among PWUD, including Pivot Legal Society know your rights training and information cards \[ 87 \]. These data were collected as a pre-implementation baseline. Results may have been different in the period after data collection but before implementation November January Research with more hidden, precarious, or less connected PWUD may produce different findings and is an area of future research. Decriminalization in BC is a historic policy change and pilot reform that will be in place for three years, from January — The success of this reform will be judged on multiple outcomes, including reducing criminal penalties, stigma, and increasing access to health and harm reduction services. These benefits of decriminalization may hinge on awareness, understanding, and knowledge of decriminalization among impacted groups. Findings from our pre-implementation multi-methods study suggests that these factors may be deficient among PWUD in BC — the very community that decriminalization is intended to have a positively impact. Considering that the success of decriminalization and its benefits may be undermined by poor awareness and knowledge of it, efforts to share information, increase understanding, and empower the community, are a key part of its implementation. Ministry of Mental Health and Addiction. Decriminalization in BC: S. Government of Canada. List of class exemptions and related guidance. Exemption from Controlled Drugs and Substances Act: Personal possession of small amounts of certain illegal drugs in British Columbia January 31, to January 31, British Columbia Association of Chiefs of Police. Drug Decriminalization: An integrated approach to improve health and safety outcomes. Canadian Drug Policy Coalition. Office of the Provincial Health Officer. 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The details of decriminalization: Designing a non-criminal response to the possession of drugs for personal use. Subst Use Misuse. Police encounters and experiences among youths and adults who use drugs: Qualitative and quantitative findings of a cross-sectional study in Victoria, British Columbia. Can J Criminol Crim Justice. BMC Public Health. Strasser R. Rural health around the world: challenges and solutions. Fam Pract. A survey of health information source use in rural communities identifies complex health literacy barriers. Health Inf Libr J. Schiavo R. Health Communication: From Theory to Practice. San Franscisco: Wiley; J Prim Prev. J Rural Health. J Health Commun. J Racial Ethn Health Disparities. Awareness, predictors and outcomes of drug alerts among people who access harm reduction services in British Columbia, Canada: findings from a cross-sectional survey. BMJ Open. Subst Abuse. Communicating risk in the context of methadone formulation changes: A qualitative study of overdose warning posters in Vancouver. Drug quality assessment practices and communication of drug alerts among people who use drugs. Shane C. Download references. We would like to thank the advisors from the Professionals for the Ethical Engagement of Peers for their insights and assistance, and to PWUD who took the time to participate in this study. You can also search for this author in PubMed Google Scholar. AG wrote the manuscript, led the qualitative study conception and design, data analyses, and writing. JX coordinated qualitative data collection and contributed to the coding and analysis. OKL led the quantitative data analysis and writing of these findings. BK supported the study conception, analyses, and writing. AC led the quantitative study conception and design, data analyses, and writing. All authors contributed to and reviewed the final manuscript. All authors contributed to and reviewed the data collection instruments and final manuscript. Correspondence to Alissa Greer. All participants provided informed consent. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Reprints and permissions. Greer, A. Awareness and knowledge of drug decriminalization among people who use drugs in British Columbia: a multi-method pre-implementation study. BMC Public Health 24 , Download citation. Received : 18 October Accepted : 22 January Published : 08 February Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Research Open access Published: 08 February Awareness and knowledge of drug decriminalization among people who use drugs in British Columbia: a multi-method pre-implementation study Alissa Greer 1 , Jessica Xavier 1 , 2 , Olivia K. Abstract Background In January , British Columbia implemented a three-year exemption to Controlled Drugs and Substances Act , as granted by the federal government of Canada, to decriminalize the personal possession of small amounts of certain illegal drugs. Conclusions Given that decriminalization in British Columbia is a new and landmark reform, and that the success of decriminalization and its benefits may be undermined by poor awareness and knowledge of it, efforts to share information, increase understanding, and empower the community, may be required to promote its implementation and benefits for the community. Background In , the Government of British Columbia BC announced that it received approval from the Canadian federal government to decriminalize the personal possession of illicit drugs for adults in the province \[ 1 \]. Literature review In recent years, the prohibition of drugs and criminalization of people who use them have been under a spotlight given the related harms from policing. Methods In this study, we draw on two different sources of data — one quantitative and one qualitative — that were collected concurrently but independently. Quantitative methods Sampling, Recruitment, and Data Collection: Quantitative data was collected through the Harm Reduction Client Survey which is a long-running survey of clients at harm reduction supply distribution sites across BC. Data management and analysis To support consistency and quality, clear guidelines were developed and shared with staff engaged before data entry began, and small modifications were made and communicated to account for variations in question completion. Conclusion Decriminalization in BC is a historic policy change and pilot reform that will be in place for three years, from January — References Ministry of Mental Health and Addiction. Article Google Scholar Government of Canada. Article Google Scholar Schiavo R. Acknowledgements We would like to thank the advisors from the Professionals for the Ethical Engagement of Peers for their insights and assistance, and to PWUD who took the time to participate in this study. Loewen Authors Alissa Greer View author publications. View author publications. Consent for publication Not applicable. Competing interests The authors declare no competing interests. About this article. Cite this article Greer, A. Copy to clipboard. Contact us General enquiries: journalsubmissions springernature.
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