Do British Columbians Support Harm Reduction?

Harm Reduction is a public health response to substance use that minimizes death, disease, and injury from drug use by promoting safer drug use practices. However, the media regularly publishes articles about harm reduction in a negative light – we  hear controversies about harm reduction services in the political arena, and passionately discuss the topic around the dinner table. But are we, the public, really that spilt in our opinions about harm reduction? A recent public attitudes study found the majority of the public in BC supports harm reduction services.

In December 2013, the BC Centre for Disease Control published a research article on the attitudes of British Columbian’s towards harm reduction strategies and services in the Journal of Substance Abuse Treatment Prevention and Policy. The study found over three quarters of British Columbians surveyed support harm reduction. Of those surveyed 72% support needle distribution and 65% support needle distribution in their own community. These results are encouraging for those working in harm reduction roles, whose work supports and promotes harm reduction activities in BC, and for those whose lives depend on harm reduction services.

The BC survey found that people who were younger, female and had completed at least a high school education were more likely to support harm reduction. Those who resided in the Fraser Health region were less likely to support harm reduction but even here 69% supported it. Targeting messages towards segments of the population who may have misconceptions about harm reduction may help gain further support for services that improve the health of, and reduce stigma towards, people who use drugs. Messages should inform the public that harm reduction has economic and health benefits and helps individuals, families and communities to be safer and healthier. Studies and experience has repeatedly found harm reduction programs do not promote illegal drug use but, in fact, decrease use and increase access to drug treatment programs. Platforms such as the media, city council meetings, and community forums should be utilized to share this information and bring awareness of the benefits of harm reduction services to all British Columbians.

It is important to note that regardless of some vocal media and local municipality opposition, British Columbians care about people with substance use issues and support harm reduction services. This brings into question why some policies are in place in BC that contradicts the benefits of harm reduction services and the public’s support. Are city councillors being swayed by a vocal minority? Or, are decisions being made for reasons that are not evidence-based? In the light of BC’s recent public attitudes survey, we encourage all policy-makers to re-evaluate their harm reduction policies in order to meet best practice recommendations, save people’s lives, and represent the public’s support for harm reduction services across the province.



Authors: Despina Tzemis (left), Harm Reduction, Health Promoter, and Jane Buxton, Harm Reduction Lead, BC Centre for Disease Control (right)

Public opinion and alcohol policy in BC

As the BC government’s public consultation on liquor control and licensing laws draws to a close at the end of this month we wish to highlight findings from a province-wide opinion survey conducted last month for MADD Canada and CARBC. While telephone surveys have their limitations we believe the results are indicative of broad support across BC for some fundamental principles: that a major purpose of liquor laws should be to reduce alcohol-related harm (84% support); that consumers need to be better informed about risks, e.g. through labeling (71%); and that some kinds of pricing can be used to reduce harm (62% to 65%).

In this blog, we will mainly address the issue of public support for alcohol pricing policies because the strong evidence behind this approach is not widely known. The scientific evidence shows that alcohol consumption decreases when alcohol prices increase – and, more importantly, there are associated reductions in premature deaths, admissions to hospital and accidents on our roads. However, opinion research has found that most people do not believe heavy drinkers will reduce their drinking if prices are increased.

Furthermore, in the many hundred comments on the public consultation website and the blog series from the parliamentary secretary for the review, John Yap, a common sentiment is expressed: why punish the responsible majority for the behaviour of a small minority who misuse alcohol? While this viewpoint overlooks the existence of risks from moderate drinking (e.g. cancers), widespread occasional heavy consumption and harm from others drinking, this is a critical objection to address in discussions of policies like pricing.

Setting a minimum or floor price on alcoholic beverages is a policy that the BC government has implemented for the last 25 years, though BC minimum prices tend to be lower than most other provinces and are considerably lower than some (e.g. Saskatchewan). This type of policy is well targeted towards heavier drinkers as several studies have shown that those who drink low cost alcohol tend to consume higher amounts.

So do BC minimum prices provide any public health or safety benefit? Using BC hospital data, a recent study published in the American Journal Public Health found that for every 10% increase in minimum prices there was an immediate 9% reduction in hospital admissions for injuries and poisonings ‒ and a similar reduction in serious illnesses caused by alcohol (e.g., liver cirrhosis, cancers) 2 to 3 years later. Similarly, we have found immediate and delayed effects from minimum price increases on alcohol-related deaths.

Thus, there is strong evidence that minimum alcohol pricing avoids punishing the majority of responsible drinkers while having the greatest impact on the behaviour and the health of those most at-risk. We would love to know how public opinion would change if these facts were more widely known. We believe British Columbians would tolerate price increases on the very cheapest, often high strength alcohol products if they actually believed this would prevent fellow citizens becoming seriously ill, injured or dying from the effects of alcohol.

Because minimum prices here are relatively low and, unlike in Saskatchewan, they are not adjusted to reflect alcoholic strength, there are some products that cost less than 75 cents per “standard drink” (i.e., 17.05 mL ethanol or the amount of alcohol in a 12oz can of 5%beer). This makes it possible to exceed Canada’s Low-Risk Drinking Guidelines while spending less than three dollars per day – usually less than a loaf of bread.

Would you accept increasing the price of the cheapest alcohol to $1.50 per standard drink if you knew that it would save a few lives each year and reduce health care costs?


Author: Tim Stockwell, Director, CARBC


Author: Gina Martin


Author: Andy Murie, CEO MADD Canada