Background: The escalating crisis of toxic drug deaths in Canada has prompted a significant increase in substance use focused anti-stigma campaigns. This onslaught of novel, and mostly government-produced, anti-stigma campaigns has received little scrutiny. Objectives: This paper explores how Canadian substance use anti-stigma campaigns 1) construct the problem of “stigma” 2) represent the identities of PWUD. Methods: Study 1 used a systematic review to identify patterns in representations of PWUD and constructions of stigma across 134 examples of Canadian anti-stigma campaigns (2009-2020). Study 2 asked 8 focus groups with 41 marginalized PWUD to respond to two mainstream anti-stigma campaigns. Results: Study 1 found that campaigns frequently constructed stigma as an individual rather than structural problem, and rarely mentioned the intersections of racism, classism and substance use stigma. Nearly 75% of PWUD represented appeared to be White and Middle-Upper class. In Study 2, participants critiqued campaign framing of stigma as an individual problem affecting White Middle Class PWUD, decrying a double standard that ignored their intersectional stigma experiences as mostly racialized and low-income PWUD. Participants also expressed resistance to their exclusion from these campaigns. Implications: Both studies suggest that many anti-stigma campaigns in Canada have seemingly attempted to rescue only privileged PWUD from stigma, whilst potentially deepening the societal exclusion of marginalized PWUD.