Document Type
Working Paper
Publication Date
2025
Subjects
Addiction, Disease Model, Canada
Abstract
Over 50,000 Canadians have died of unregulated drug poisoning since 2016. And while the toxic drug crisis is the leading cause of death in British Columbia for people between the ages of 10 and 59, some British Columbians are at a higher risk than others. In 2023, First Nations people—who comprise 3.4% of BC’s population—accounted for 17.8% of its toxic drug deaths. Other marginalized communities are also at heightened risk: racialized people, young people, and people living in poverty or without shelter are all disproportionately impacted. These disparities reflect more than a public health crisis—they largely exist due to legal frameworks and policy choices that continue to pathologize and punish substance use, especially among marginalized communities.
This Article argues that the prevailing “disease model” of addiction has not disrupted punitive approaches to drug policy and has instead justified coercive legal interventions designed to treat the “disease of addiction.” While harm reduction is nominally a pillar of Canada’s drug policy, popular reforms like drug treatment courts and involuntary substance use treatment remain grounded in the disease model’s approach to the conceptualization and treatment of addiction, an approach that is inconsistent with harm reduction principals and fails to address the structural conditions that contribute to drug-related harms. Meaningful drug policy reform requires more than a simple shift from criminalization to medicalization; a true harm reduction framework must approach problematic drug use as a complex social and public health issue and not simply as a disease to be treated.
Citation Details
Sara Gordon, "The Damage Done: How the Disease Model of Addiction Harms Marginalized People in Canada" [forthcoming in 2025 in UBC Law Review].