Cannabis as Harm Reduction: What Research from Vancouver’s Downtown Eastside Has Found
Last Updated: February 2026 | Reading Time: 5 minutes
Vancouver’s Downtown Eastside has been one of the most studied urban drug policy environments in the world. The concentration of harm reduction research, peer-led programming, and community-based health services in the DTES has produced a peer-reviewed literature that documents, with unusual specificity, what happens when people with severe substance use disorders gain access to regulated cannabis. This article reviews the evidence from that research — including studies that explicitly name High Hopes Research Society as a program under study.
High Hopes in the Published Literature
Two International Journal of Drug Policy papers published between 2020 and 2023 name High Hopes Foundation — the predecessor organization to High Hopes Research Society — directly in their peer-reviewed text.
The first, Valleriani, Haines-Saah, Capler, Bluthenthal & Socias (2020, IJDP, 79: 102737), is a qualitative study of cannabis distribution programs in Vancouver’s DTES. High Hopes Foundation is one of only two programs studied. Participants were recruited directly from High Hopes. The study documents the structural barriers that marginalized populations face in accessing regulated cannabis — cost, documentation requirements, geographic access, and stigma — and examines how peer-led distribution programs address those barriers. Cannabis was described by participants as a harm reduction tool for both opioid and stimulant use, used to manage withdrawal symptoms, reduce cravings, and substitute for more harmful substances.
The second, Reddon, Lake, Socias, Hayashi, DeBeck, Walsh & Milloy (2023, IJDP, PMC10817207), draws on three major longitudinal cohorts from the BC Centre on Substance Use — VIDUS, ACCESS, and ARYS. Among the 205 opioid users surveyed, 57.6% reported decreasing opioid use through cannabis. The study named High Hopes Foundation among the free cannabis distribution programs accessible to participants. In adjusted analysis, the significant predictors of self-reported opioid reduction were using cannabis specifically to manage opioid cravings (aOR=2.13, p=0.032) and daily cannabis use (aOR=3.87, p=0.028). Free program access was not independently statistically significant in the adjusted model.
High Hopes Research Society appears in both papers as a named research site, not merely a background reference — a distinction that matters for institutions evaluating organizational track record against published evidence.
Street-Involved Youth and Cannabis Harm Reduction
A 2020 open-access study by Paul, Thulien, Knight, Milloy, Howard, Nelson & Fast, published in PLOS ONE (15(7): e0236243), conducted qualitative interviews with 56 street-involved youth and 12 care providers in Vancouver’s DTES. The study examined the role of cannabis in this population’s substance use trajectories.
Youth described cannabis as a tool for managing the transition away from opioids and stimulants, for addressing chronic pain, PTSD symptoms, and anxiety, and for reducing the use of substances they identified as more harmful. Care providers, while acknowledging the complexity of cannabis use in adolescent populations, also described situations where cannabis appeared to function as a moderating influence on other substance use. The paper sits within the broader DTES harm reduction research network — same geographic setting, same structural context as the High Hopes programs — and reinforces the substitution pattern documented in the other studies.
What Structural Barriers the Research Documents
The Valleriani et al. (2020) paper is especially useful for institutional and clinical audiences because it is explicit about why regulated cannabis access fails for people who need it most. Cost was the primary barrier — at pre-legalization and early post-legalization prices, licensed cannabis was unaffordable for people living in deep poverty or on disability support. Documentation and registration requirements created administrative barriers that disproportionately affected those without stable housing, ID, or a regular healthcare provider. Stigma in clinical settings deterred some participants from seeking medical authorization at all.
The programs studied — including High Hopes — addressed these barriers by removing cost, removing administrative burden through peer researchers embedded in the community, and operating in settings where participants already had trust relationships. These are not incidental design features; they are the mechanism through which access becomes meaningful.
The CMAPS Funding Context
The Canadian Managed Alcohol Program Study (CMAPS), which ran cannabis substitution pilots in Ottawa, Victoria, and Vancouver between 2022 and 2024, was funded by Health Canada’s Substance Use and Addictions Program. The evaluation was conducted by the University of Victoria’s Canadian Institute for Substance Use Research. High Hopes Research Society served as program operator and community partner for the Vancouver site.
The Ottawa findings from CMAPS are now published in the International Journal of Drug Policy (Goulet-Stock et al., 2026). The Vancouver findings are in peer review at Drug & Alcohol Review.
For Institutional and Research Audiences
This research trail — from the Valleriani et al. (2020) qualitative documentation of High Hopes as a named DTES program, through the BCCSU cohort data naming High Hopes in quantitative opioid reduction findings, to the Health Canada-funded CMAPS evaluation with High Hopes as operator — represents an unusually complete institutional evidence chain for a community-based medical cannabis organization.
For healthcare institutions evaluating cannabis substitution as a service addition, for research programs seeking community partners with a documented research history, or for grant-making bodies assessing organizational track record, this literature provides a verifiable research basis rather than organizational self-description.
This article summarizes published peer-reviewed research for informational purposes. It does not constitute medical advice. Medical cannabis requires authorization from a qualified healthcare provider. The research cited represents the findings of independent investigators and does not constitute a health claim about any specific product.
References
- Paul, Thulien, Knight, Milloy, Howard, Nelson & Fast (2020). PLOS ONE, 15(7): e0236243. DOI: 10.1371/journal.pone.0236243
- Reddon, Lake, Socias, Hayashi, DeBeck, Walsh & Milloy (2023). International Journal of Drug Policy. PMC10817207
- Valleriani, Haines-Saah, Capler, Bluthenthal & Socias (2020). International Journal of Drug Policy, 79: 102737. DOI: 10.1016/j.drugpo.2020.102737