Lay Perspectives on Drug (De)Criminalization and the (De)Stigmatization of People Who Use Illicit Drugs

Abstract

Background: Substance use stigma has been framed as contributing to the drug toxicity crisis. We theorize the political function of drug criminalization as contributing to a system of stigma that exerts social control over people who use illicit drugs (PWUID). Consequently, drug decriminalization may be a potential destigmatizing solution. Since decriminalization is often positioned as an antistigma intervention targeting the public, it is important to understand how laypeople conceptualize decriminalization. Methods: We acquired, via a Freedom of Information request, 221 deputations sent to the City of Vancouver regarding Motion B.4, which would advance decriminalization. We used reflexive thematic analysis to explore: (1) how laypeople conceptualized drug (de)criminalization and its relation to the (de)stigmatization of PWUID; and (2) the potential implications of the various conceptualizations of (de)criminalization for the autonomy of PWUID. Results: Supporters of Motion B.4 commonly assumed decriminalization would destigmatize PWUID. Supporters also often argue that the drug toxicity crisis is a public health problem, not a criminal one. However, the public health model of decriminalization advocated by some supporters still limited the autonomy of PWUID. Meanwhile, those opposed commonly positioned social control of PWUID as necessary, including opponents who argued that decriminalization was a form of systemic neglect that abandons PWUID. This view was echoed by some proponents, notably those who argued for a public health model of decriminalization. Finally, some proponents asserted that PWUID should be included in the policymaking process, though few deputations came from self-identified PWUID. All PWUID argued that decriminalization must exclude the police. Conclusion: Our analysis of lay perspectives on decriminalization highlights the importance of models that adequately address all levels of stigma for PWUID. Models that fail to preserve the autonomy of PWUID are likely to reproduce their stigmatization.