Background: Due to inequities fuelled by racism and classism, substance use stigma and overdose death disproportionately impact those from non-White, low-income groups. In response, government and public health organizations across Canada have released anti-stigma campaigns featuring images of people who use drugs (PWUD). Ironically, the majority of these images appear to be of PWUD belonging to White, middle-class groups. This effectively ignores intersecting roles of racism and classism in the experience of stigma, shifting attention away from those worst affected by the drug toxicity crisis.
Objective: To better understand this troubling trend, we examined the development process of the BC Government's high-profile Stop Overdose campaign. We aimed to identify key factors that explained how and why White, middle-class PWUD came to dominate the campaigns’ imagery and messaging.
Methods: Through a Freedom of Information (FOI) request we obtained 320 pages of government documents outlining the real-time development, testing and evaluation of the Stop Overdose campaign. These documents were analyzed using reflective thematic analysis.
Results: We identified that campaign developers’ goal of shifting the focus away from the “stereotypical” marginalized drug user, and the prioritization of campaign “relevance” can explain the Stop Overdose campaign’s focus on White, middle-class PWUD.
Implications: This analysis highlights wider social implications of anti-stigma messages that under-represent PWUD most affected by overdose mortality. It also provides a critical perspective on using campaigns to address substance use stigma, and by extension, the drug toxicity crisis.