Up in smoke: Analyzing the risk of illicit drug exposure and the harms of exposure misinformation

Now more than ever it is important to prioritize evidence-informed practices to shape the future of the Canadian healthcare system. Fear-based and reactionary approaches and policies towards drug use are aging poorly in Canada’s current state of public health, putting patients and healthcare workers at risk. It is time that we prioritize the protection of healthcare workers, communities, and people who use drugs (PWUD) without perpetuating the harms of stigma and bias. We must correct our current course to stay true to the values and ethical commitments we hold sacred as healthcare providers: safety, respect, autonomy, and justice.

There is uncertainty about the safety risks to healthcare workers in BC and Canada associated with secondary exposure to illicit drugs and the smoke they produce. Everyone has the right to a safe workplace and to exist safely in public spaces, however, our perception of what is safe or unsafe is often influenced by the amplified uninformed opinions of influencers and lobbyists, and media misinformation. Evidence-informed policies that reflect actual, rather than perceived risks, are essential for mitigating this bias.

The question of whether secondary exposure to illicit drugs is safe has received widespread attention in BC (British Columbia Government News, 2024a). These stories and subsequent media attention led the BC government to frame this problem as one of “public safety” and subsequently to abandon their decriminalization pilot project to recriminalize drug possession in public spaces, such as hospitals (British Columbia Government News, 2024). Notably, decriminalization and exposure are two different problems, and while exposure was the purported issue, the BC government rescinded decriminalization. We know that criminalizing possession and use compels people to use drugs alone out of fear of being arrested (British Columbia Centre for Disease Control, n.d.), and is one factor that has contributed to overdose deaths of, on average, six people a day in BC since 2014 (BC Government News, 2024b).