Regulation on the rocks: Community-directed appraisal on the projected harms of reform to alcohol pricing in the Downtown Eastside of Vancouver

Minimum Unit Pricing (MUP) is one regulatory approach to alcohol pricing in regions around the world. Broadly, MUP establishes a lowest price threshold for retail per a standardized unit of ethanol in a beverage alcohol product. Illicit drinkers are people whose drinking is often criminalized (i.e., people who drink in public and are subject to harassment or sanctions from law enforcement) and/or people who consume non-beverage alcohol (e.g., hand sanitizer, rubbing alcohol, mouthwash). The provincial government of British Columbia, Canada has proposed reforms to the existing framework for MUP, which is likely to disproportionately impact illicit drinkers. These reforms to MUP would increase the price of the lowest cost, high alcohol-level drinks. We draw from a community dialogue facilitated by the local Eastside Illicit Drinkers Group for Education (EIDGE) to critically examine these proposed reforms. Through a narrative review of recent international research, we describe some projected negative impacts of BC's proposed reforms, which intend to reduce access to low-cost alcohol beverages. We outline how this is likely to - paradoxically and systematically - push some drinkers, particularly those most disenfranchised by the intersecting social relations of racial capitalism and settler colonization, toward more harmful modes of alcohol consumption, including the use of unregulated alcohol and/or non-beverage alcohol. Likewise, the reforms are likely to unevenly target local Indigenous populations, who experience disproportionate criminalization; and for whom accessing consumable alcohol, healthcare services, and places to drink safely is more fraught than for non-Indigenous drinkers. Ultimately, our essay provides critical considerations for the implementation of MUP in BC that could inform alternative models/options in place of blanket increases in unit pricing.