Background:
The ongoing unregulated drug poisoning (overdose) public health emergency in North America is the second leading cause of years of life lost in British Columbia (BC), Canada. There is growing interest in the intersections of overdose and the criminal legal system. The purpose of this analysis was to describe the frequency and composition of charges for people who have and have not had an illicit drug poisoning event.

Methods:
Population-based health and corrections data were retrieved from a 20% random population sample of BC residents (N=878,246), and from people with healthcare records for drug poisoning (N=33,882). Charging data represented persons who spent at least one day in custody with a release date between January 1, 2016 - December 31, 2020. The total number of charges and the most common charges (i.e. drug-related, crimes against person, traffic, property, and other) were reported among people with 10+ charges in a calendar year, by year and overall.

Results:
People with 10+ charges in a calendar year make up a very small proportion of the Reference Sample (<0.01%) (N=1044) and Overdose Cohort (<5%) (n=1652). Drug-related charges were uncommon. Charges for crimes against person were similar in the Overdose Cohort and Reference Sample, 17% and 20% of all charges, respectively. Property-related charges, which likely reflect survival crime, were the most common in both groups; however, the Overdose Cohort (52%) had a higher frequency than the Reference Sample (38%).

Conclusions:
Few people who had an illicit drug poisoning event have been charged with an offense and fewer were charged 10+ times in a calendar year. In the context of growing media and public concern about public safety, efforts must focus on increasing access to social supports and reducing stigma for people with living experience of substance use, incarceration, and criminalization.