Priority setting for the overdose crisis: Challenges and opportunities for peer engagement in British Columbia

In recent years, decision-makers in BC have engaged people who use(d) drugs (PWUD) and the general public for their input on strategic directions regarding the overdose crisis. Given the oft-politicized nature of substance use, it is important for the response to centre around people with lived experience and to be grounded by the best available evidence. By engaging PWUD or "peers" as essential partners, the resulting policies and services may better reflect the community's needs. Meaningful engagement can be challenging due to stigma and a multitude of systemic barriers. Special considerations must be taken to ensure participatory processes are inclusive and ethical. BC's worsening overdose crisis demands that we reevaluate our drug policies and spending priorities across health and other social sectors. PWUD have identified several key priority areas, including expansion of harm reduction, controlled pharmaceutical prescribing, and drug decriminalization, some of which have ignited considerable debate among stakeholders.