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Drug Policy

Drug policy at every level – global, national and local – has a profound effect on the health of individuals and communities. Canada’s new National Anti-Drug Strategy takes a strong law enforcement approach and focuses primarily on reducing the supply of and demand for illicit drugs and the crime associated with illicit drug use. The government hopes this new strategy will lead to safer and healthier communities by means of three action plans: preventing illicit drug use, treating those with illicit drug dependencies, and combating the production and distribution of illicit drugs.

At the local level, the Four Pillars Drug Strategy is a comprehensive approach adopted by the City of Vancouver in 2001 to address the city's open drug scene, particularly in the Downtown Eastside, and to reduce drug-related harm in Vancouver communities. The Four Pillars of the strategy are prevention, treatment, harm reduction and enforcement. The most controversial of these pillars, and the one that is missing from Canada's current national drug strategy, is harm reduction.

The principle of harm reduction recognizes that abstinence is not always a viable option for every person who is addicted to drugs. The main objective of harm reduction in the context of illicit drug use is to eliminate or at least minimize the dangers and risks, to the individual as well as to the public, of the use of illicit drugs. Needle exchanges and supervised injecting facilities are two examples of interventions based on the principle of harm reduction that have been shown to improve the health of injection drug users by reducing the harms associated with the use of illicit drugs.


  • Werb D, Kazatchkine M, Kerr T, Nutt D, Strathdee S, Hankins C, Hayashi K, Montaner J, Des Jarlais D, Maghsoudi N, Wood E. A call to reprioritise metrics to evaluate illicit drug policy. Lancet, 2016; 387(10026): 1371. PubMed
  • Ti L, Kerr T. The impact of harm reduction on HIV and illicit drug use. Harm Reduction Journal, 2014; 11(1): 7. PubMed
  • Werb D, Kerr T, Nosyk B, Strathdee S, Montaner J, Wood E. The temporal relationship between drug supply indicators: An audit of international government surveillance systems. BMJ Open, 2013; 3(9): e003077. PubMed
  • Zlotorzynska M, Wood E, Montaner JS, Kerr T. Supervised injection sites: Prejudice should not trump evidence of benefit. Canadian Medical Association Journal, 2013; 185(15): 1303-1304. PubMed
  • Wood E, Kerr T. Commentary on Des Jarlais et al. (2012): Are ethnic disparities in drug policy-related harms relevant to the addiction medicine community? Addiction, 2012; 107(12): 2096-2098. PubMed
  • Nosyk B, Wood E. Evidence-based drug policy: It starts with good evidence and ends with policy reform. International Journal of Drug Policy, 2012; 23(6): 423-425. PubMed
  • Werb D, Nosyk B, Kerr T, Fischer B, Montaner J, Wood E. Estimating the economic value of British Columbia’s domestic cannabis market: Implications for provincial cannabis policy. International Journal of Drug Policy, 2012; 23(6): 436-441. PubMed
  • Hadland SE, Marshall BDL, Kerr T, Lai C, Montaner JS, Wood E. Ready access to illicit drugs among youth and adult users. American Journal on Addictions, 2012; 21(5): 488-490. PubMed
  • Wood E, McKinnon M, Strang R, Kendall PR. Improving community health and safety in Canada through evidence-based policies on illegal drugs. Open Medicine, 2012: 6(1): e35-40. PubMed
  • Hyshka E, Butler-McPhee J, Elliott R, Wood E, Kerr T. Canada moving backwards on illegal drugs. Canadian Journal of Public Health, 2012; 103(2): 125-127. PubMed
  • Werb D, Mills EJ, DeBeck K, Kerr T, Montaner JS, Wood E. The effectiveness of anti-illicit-drug public-service announcements: A systematic review and meta-analysis. Journal of Epidemiology and Community Health, 2011; 65(10): 834-840. PubMed Summary
  • Werb D, Rowell G, Guyatt GH, Kerr T, Montaner JSG, Wood E. Effect of drug law enforcement on drug market violence: A systematic review. International Journal of Drug Policy, 2011; 22(2): 87-94. PubMed Summary
  • DeBeck K, Kerr T. The use of knowledge translation and legal proceedings to support evidence-based drug policy in Canada: Opportunities and ongoing challenges. Open Medicine, 2010; 4(3): 167-170.
  • Wood E, Werb D, Kazatchkine M, Kerr T, Hankins C, Gorna R, Nutt D, Des Jarlais D, Barré-Sinoussi F, Montaner J. Vienna Declaration: a call for evidence-based drug policies. Lancet, 2010; 376(9738): 310-312. PubMed
  • Wood E. Evidence based policy for illicit drugs. British Medical Journal, 2010; 341: c3374. PubMed
  • Kerr T, Montaner JSG, Wood E. Science and politics of heroin prescription. Lancet, 2010; 375(9729): 1849-1850. PubMed
  • Werb D, Fischer B, Wood E. Cannabis policy: Time to move beyond the psychosis debate. International Journal of Drug Policy, 2010; 21(4): 261-264. PubMed
  • Wood E, Kerr T. Could a United Nations organisation lead to a worsening of drug-related harms? Drug and Alcohol Review, 2010; 29(1): 99-100. PubMed
  • Wood E, Werb D, Marshall BDL, Montaner JSG, Kerr T. The war on drugs: A devastating public-policy disaster. Lancet, 2009; 373(9668): 989-990. PubMed
  • DeBeck K, Kerr T, Li K, Milloy M, Montaner J, Wood E. Incarceration and drug use patterns among a cohort of injection drug users. Addiction, 2009; 104: 69-76. PubMed Summary
  • Werb D, Kerr T, Montaner J, Wood E. The need for an evidence-based approach to controlling opium production in Afghanistan. Journal of Public Health Policy, 2008; 29(4): 440-448. PubMed Summary
  • Wood E, Montaner J, Kerr T. Harm reduction drug policy – authors’ reply. Lancet Infectious Diseases, 2008; 8(9): 528-529. PubMed
  • Wood E, Kerr T. Methamphetamine strategy requires evaluation. Canadian Medical Association Journal, 2008; 179(7): 677. PubMed
  • DeBeck K, Wood E, Montaner JS, Kerr T. Canada’s new federal “national anti-drug strategy”: An informal audit of reported funding allocation. International Journal of Drug Policy, 2009; 20(2): 188-191. PubMed Summary
  • Kerr T, Small W, Johnston C, Li K, Montaner JSG, Wood E. Characteristics of injection drug users who participate in drug dealing: Implications for drug policy. Journal of Psychoactive Drugs, 2008; 40(2): 147-152. PubMed Summary
  • Wood E, Kerr T, Tyndall MW, Montaner JSG. The Canadian government’s treatment of scientific process and evidence: Inside the evaluation of North America’s first supervised injecting facility. International Journal of Drug Policy, 2008; 19(3): 220-225. PubMed Summary
  • Kerr T, Wood E. Misrepresentation of science undermines HIV prevention. Canadian Medical Association Journal, 2008; 178(7): 964. PubMed
  • DeBeck K, Wood E. Law enforcement and Australia’s 2001 heroin shortage: Evaluating the evidence. International Journal of Drug Policy, 2008; 19(4): 287-290. PubMed
  • Wood E, Montaner J, Kerr T. Illicit drug addiction, infectious disease spread, and the need for an evidence-based response. Lancet Infectious Diseases, 2008; 8(3): 142-143. PubMed
  • Kerr T, Wood E. Closing the gap between evidence and action: The need for knowledge translation in the field of drug policy research. International Journal of Drug Policy, 2008; 19(3): 233-234.
  • Kerr T, Montaner J, Wood E. Supervised injecting facilities: Time for scale up? Lancet, 2008; 372(9636): 354-355. PubMed
  • Small W, Wood E, Buchner C, Fair B, Kerr T. Decline in needle exchange use in Vancouver, Canada coincides with the Australian heroin shortage. International Journal of Drug Policy, 2008; 19(4): 291-2. PubMed
  • Small W, Kerr T, Wood E. HIV transmission as a result of drug market violence: A case report. Conflict and Health, 2008; 2: 8. PubMed
  • Wood E, Montaner JS. Antiretroviral therapy: A key part of the public health response to injection drug use. Addiction, 2008; 103(4): 660-661. PubMed
  • Kerr T, Kimber J, DeBeck K, Wood E. The role of safer injection facilities in the response to HIV/AIDS among injection drug users. Current HIV/AIDS Reports, 2007; 4(4): 158-164. PubMed
  • Werb D, Elliott R, Fischer B, Wood E, Montaner J, Kerr T. Drug treatment courts in Canada: An evidence-based review. HIV/AIDS Policy & Law Review, 2007; 12(2-3):12-17. PubMed
  • Wood E, Kerr T, Montaner JS. HIV treatment, injection drug use, and illicit drug policies. Lancet, 2007; 370(9581): 8-10. PubMed
  • Wood E, Kerr T. What do you do when you hit rock bottom? Responding to drugs in the city of Vancouver. International Journal of Drug Policy, 2006; 17(2): 55-60.
  • Kerr T. Reconsidering the public health failings of the criminal justice system: A reflection on the case of Scott Ortiz. Harm Reduction Journal, 2006; 3: 25. PubMed
  • Wood E, Stoltz J, Li K, Montaner JS, Kerr T. The cause of the Australian heroin shortage: Time to reconsider? Addiction, 2006; 101(5): 623-625.
  • Tyndall MW, Wood E, Zhang R, Lai C, Montaner JS, Kerr T. HIV seroprevalence among participants at a Supervised Injection Facility in Vancouver, Canada: Implications for prevention, care and treatment. Harm Reduction Journal, 2006; 3(1): 36. PubMed
  • Wood E, Stoltz JA, Li K, Montaner JS, Kerr T. Changes in Canadian heroin supply coinciding with the Australian heroin shortage. Addiction, 2006; 101(5): 689-695. PubMed
  • DeBeck K, Wood E, Montaner J, Kerr T. Canada’s 2003 renewed drug strategy: An evidence-based review. HIV/AIDS Policy & Law Review, 2006; 11(2/3); 5-12. PubMed
  • Elliott R, Csete J, Wood E, Kerr T. Harm reduction, HIV/AIDS, and the human rights challenge to global drug control policy. Health and Human Rights, 2005; 8(2): 104-138. PubMed
  • Kerr T, Walsh J, Lloyd-Smith E, Wood E. Measuring adherence to highly active antiretroviral therapy: Implications for research and practice. Current HIV/AIDS Reports, 2005; 2(4): 200-205. PubMed
  • Kerr T, Kaplan K, Suwannawong P, Wood E. Getting global funds to those most in need: The Thai Drug Users’ Network. Health and Human Rights, 2005; 8: 170-186. PubMed
  • Collins CL, Kerr T, Tyndall MW, Marsh DC, Kretz P, Montaner JS, Wood E. Rationale to evaluate medically supervised safer smoking facilities for non-injection illicit drug users. Canadian Journal of Public Health, 2005; 96(5): 344-347. PubMed
  • Wood E. The role of supply reduction in an evidence-based illicit drug strategy. Addiction, 2005; 100(8): 1194-1195. PubMed
  • Collins CLC, Kerr T, Kuyper LM, Li K, Tyndall MW, Marsh DC, Montaner JS, Wood E. Potential uptake and correlates of willingness to use a supervised smoking facility for noninjection illicit drug use. Journal of Urban Health, 2005; 82(2): 276-284. PubMed
  • Elliott R, Csete J, Palepu A, Kerr T. Reason and rights in global drug control policy. Canadian Medical Association Journal, 2005; 172(5): 655-656. PubMed
  • Kerr T, Wood E, Betteridge G, Lines R, Jürgens R. Harm reduction in prisons: A ‘rights based analysis’. Critical Public Health, 2004; 14(4): 345-360.
  • Kerr T, Wodak A, Elliott R, Montaner JS, Wood E. Opioid substitution and HIV/AIDS treatment and prevention. Lancet, 2004; 364(9449): 1918-1919. PubMed
  • Kerr T, Suwannawong P, Kaplan K, Wood E. The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Funding for unpopular public-health programmes. Lancet, 2004; 364(9428): 11-12. PubMed
  • Kuyper L, Hogg R, Montaner JS, Schechter MT, Wood E. The cost of inaction on HIV-transmission among injection drug users and the potential of effective interventions. Journal of Urban Health, 2004; 81(4): 655-660. PubMed
  • Wood E, Spittal P, Small, W. Li, K. Kerr T, Tyndall M, Hogg R, Montaner JS, Schechter M. Displacement of Canada’s largest public illicit drug market in response to a police crackdown. Canadian Medical Association Journal, 2004; 170(10): 1551-1556. PubMed
  • Wood E, Montaner JS, Braitstein P, Schechter M, O’Shaughnessy MV, Hogg R. Elevated rates of antiretroviral therapy discontinuation among injection drug users: Implications for drug policy and public health. International Journal of Drug Policy, 2004; 15(2): 133-138.
  • Wood E, Tyndall MW, Spittal PM, Li K, Anis AH, Hogg RS, Montaner JS, O’Shaughnessy MV, Schechter MT. Impact of supply-side policies for control of illicit drugs in the face of the AIDS and overdose epidemics: Investigation of a massive heroin seizure. Canadian Medical Association Journal, 2003; 168(2): 165-169. PubMed
  • Wood E, Spittal P. Maximising the effectiveness of harm reduction programmes. International Journal of Drug Policy, 2003; 14(4): 291-292.
  • Wood E, Tyndall M, Schechter M. Drug supply and drug abuse. Canadian Medical Association Journal, 2003; 168(9): 1113.
  • Wood E, Kerr T, Spittal PM, Tyndall MW, O’Shaughnessy MV, Schechter MT. The health care and fiscal costs of the illicit drug use epidemic: The impact of conventional drug control strategies, and the potential of a comprehensive approach. British Columbia Medical Journal, 2003; 45(3): 128-134.
  • Kerr T. North America’s first supervised injection site opens in Vancouver. Canadian HIV/AIDS Policy Law Review, 2003; 8(3): 24-25. PubMed
  • Kerr T, O’Briain W. Drug policy in Canada: The way forward. HIV/AIDS Policy & Law Review, 2002; 7(1): 27-32. PubMed
  • Kerr T. Drug treatment court opens in British Columbia. Canadian HIV/AIDS Policy Law Review, 2002; 6(3): 36-37. PubMed