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Criminalization Causes The Stigma : Perspectives From People Who Use Drugs

In Canada, and elsewhere around the world, the primary approach to addressing drug use and drug possession has been through punitive drug laws, prohibition, and policing. Yet, this draconian approach has failed to produce any substantive reduction in the number of people who use drugs (World Drug Report, 2021) and aggressive policing tactics are well documented to exacerbate the multiplicity of social, health, legal, and environmental issues experienced by people who use drugs (Cooper et al., 2005; Jensen et al., 2004; Nelson, 2018; Sarang et al., 2010). Since 2016, while people who use drugs have continued to be criminalized in Canada, 34,355 people have died from opioid-related over- doses—more than all major causes of accidental death combined (Fischer, 2023; Government of

Canada, 2023). The inadequacy of a solely policing response opened the door for the introduction of low-cost public health responses centered on harm reduction (Hyshka et al., 2017 ; Wild et al., 2017). Despite these innovations, in recent years, academic, public health, community activist groups, and even some branches of law enforcement (Canadian Association of Police Chiefs, 2020; Zimonjic, 2020), have called for more robust policy reform such as the decriminalization of illegal drugs and the implementation of wide-reaching safe supply programs (Bonn et al., 2020; CAPUD, 2019; Ivsins et al., 2020).

The involvement of people with lived or living experience of drug use as a valued resource in democratic drug policy processes is increasingly recognized within research as critical to the success (e.g., applicability, accessibility, relevance) of drug policy reforms (Madden et al., 2021). While the majority of such studies have explored the perspectives of people who use drugs in relation to cannabis regulation (Hathaway et al., 2011; Osborne & Fogel, 2017), some researchers have recently begun to examine people who use drugs’ policy preferences toward the regulation of criminalized drugs (Greer & Ritter, 2019; Greer & Ritter, 2020). This study contributes to a small body of research on views of people who use drugs toward drug law reform and is the first of which to focus specifically on decriminalization in the Canadian context. With this gap and the evolving context in mind, our qualitative study captures the opinions, ideas, and attitudes of people who use drugs to elucidate their views on the impacts of criminalization and potential drug liberalization policies. Building on the work of stigma theorists such as Fraser et al. (2017) and Seear et al. (2017), who employ a poststructuralist lens to understand how stigma is both performative and produced, our paper adopts a critical realist approach to our data and analysis.

More specifically, in analyzing the experiences of participants, we suggest that public attitudes toward people who use drugs may be in part produced by Canada’s criminal drug laws and explore what consequences the resulting stigma has on the lives of people who use drugs. Based on our findings, we recommend that to truly combat structural, social and self stigma, alternatives to criminalization and a move toward the liberalization of drug policies (e.g., decriminalization, legalization, regulation, and safer supply) should be considered.