What's a policy without trust? How the legacy of policing shapes experiences of drug decriminalization in British Columbia

Historically, coercive and distrustful relations between police and people who use drugs have contributed to profound and enduring health harms. British Columbia's drug decriminalization policy, introduced in 2023, aimed to shift these dynamics and promote health and wellbeing by reducing criminalization and improving interactions with police. Drawing on qualitative interviews with 38 people who use drugs with diverse and intersecting structural vulnerabilities, including Indigeneity, racialization, and economic and housing precarity, we examine perceptions and experiences of policing and policy during the first year of decriminalization. Participants described a persistent legacy of police violence, including physical, psychological, and symbolic harms, that shaped enduring mistrust toward both policing and the policy itself. This mistrust constrained the perceived legitimacy of decriminalization, with participants questioning whether the policy meaningfully altered entrenched institutional practices, culture, or power relations. Past and present policing also remained a structuring force of social marginalization, shaping the everyday realities of people who use drugs. Rather than a departure from previous enforcement regimes, the legacies of policing overshadowed the potential benefits of decriminalization. These findings demonstrate how historical harms and institutional legacies mediate health-oriented policy reforms through fear, mistrust, and constrained legitimacy. Drug decriminalization is not implemented in a vacuum; its capacity to improve health and wellbeing depends on the sociohistorical contexts and legacies that structure how people engage with police, institutions, and health policy.