NANAIMO'S HIDDEN ADDICTION PROBLEM

 

Nanaimo’s Hidden Substance Problem — Part One

Does Nanaimo Have a Substance-Use Problem Beyond the Street?

Street overdoses are the most visible evidence of Nanaimo’s substance crisis. Alcohol sales and hospital records suggest the problem reaches much further—into ordinary homes and neighbourhoods.

A friend of mine once took a job at a Nanaimo bottle-return warehouse.

After the first weekend, they were stunned.

They had no idea Nanaimo drank that much.

The endless stream of returned beer cans, wine bottles and liquor containers offered a glimpse of something most of us never see gathered in one place: the accumulated evidence of alcohol being consumed quietly throughout the community.

When Nanaimo’s substance problem makes the news, the focus is usually downtown. We see people overdosing on sidewalks, emergency vehicles responding to drug-poisoning calls and Community Safety Officers administering naloxone.

That crisis is real, tragic and impossible to ignore.

But is it the whole story—or does Nanaimo have a much broader drug and alcohol problem taking place behind the closed doors of ordinary homes?

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Alcohol Sales Tell a Different Story

In 2022, alcohol sold in the Greater Nanaimo health area amounted to 10.9 litres of pure alcohol for every resident aged 15 and older. The provincial figure was 8.9 litres.

Greater Nanaimo’s recorded alcohol sales per person were therefore approximately 22 per cent above the B.C. level.

The phrase “10.9 litres” can be misleading. It does not mean 10.9 litres of beer, wine or liquor. It means the amount of pure alcohol contained in all the different alcoholic beverages sold.

One litre of pure alcohol represents approximately 58.6 Canadian standard drinks. Nanaimo’s figure therefore equals approximately 639 standard drinks per person in one year.

That is the alcohol equivalent of approximately 27 cases of 24 regular-strength beer for every resident aged 15 and older.

That does not mean everyone drank 27 cases of beer. The alcohol may have been consumed as beer, wine, spirits, coolers or drinks served in restaurants and pubs.

More importantly, the calculation includes people who did not drink at all.

If a substantial share of the population consumed little or no alcohol, those who did drink accounted for more than the population-wide average of roughly 12 standard drinks per week.

Alcohol consumption is also not spread evenly. Some people may have an occasional glass of wine, while others consume considerably more.

UPDATE — August 2026

New figures supplied by the University of Victoria’s Canadian Institute for Substance Use Research show that during fiscal 2024–25, alcohol sales in Greater Nanaimo amounted to 9.61 litres of pure alcohol per resident aged 15 and older, equivalent to 564 standard drinks.

The matching B.C. figure was 7.42 litres, or 435 standard drinks.

That places Greater Nanaimo approximately 30 per cent above the provincial rate.

Although Greater Nanaimo’s per-capita sales have declined from the earlier figures cited in this article, the provincial rate has fallen more sharply. The gap between Greater Nanaimo and B.C. has therefore widened.

The figures are based on recorded alcohol sales and include residents who do not drink. They should not be interpreted as the amount consumed by the average drinker.

The Hospital Numbers Add Weight

Sales figures alone do not prove that a community has a substance-use problem. People may purchase alcohol in Nanaimo while living elsewhere, and Nanaimo residents may buy it outside the area.

Hospital statistics provide another indication of harm.

The most recent comparable local hospital figures published in Island Health’s Greater Nanaimo profile are from 2019. They should not be presented as current conditions, but they remain difficult to dismiss.

Greater Nanaimo recorded an age-standardized rate of 481.4 alcohol-related hospital admissions per 100,000 people, compared with 352 across B.C.

That placed Greater Nanaimo approximately 37 per cent above the provincial rate.

Cannabis-related hospital admissions were 54.1 per 100,000 people, compared with 25 provincially—more than twice the B.C. rate.

These numbers do not prove that every admission involved addiction. Nor do they establish that liquor stores or legal cannabis shops caused the hospitalizations.

Storefronts Do Not Tell the Whole Story

The number of liquor stores or cannabis shops tells us primarily about convenience and availability.

Another store may simply divide an existing market among more retailers. People who want alcohol or cannabis will often travel across town to obtain it.

Total sales, frequency of use and resulting health consequences are much more meaningful than the number of storefronts.

Unfortunately, no comparable public figure appears to show how much legal cannabis is sold or consumed specifically in Greater Nanaimo. That leaves hospital admissions as one of the few locally available measures of cannabis-related harm.

Not Just a Downtown Problem

The street-level crisis understandably commands attention because it is visible. The rest of Nanaimo’s substance use is scattered among thousands of homes, apartments, restaurants, pubs and private gatherings.

It does not generate a police report simply because someone drinks heavily at home.

It may not generate a hospital record until health deteriorates.

It may not become a housing statistic until the rent can no longer be paid.

And it may never appear in a news photograph.

The available numbers do not justify declaring that everyone in Nanaimo has a drinking or drug problem.

They do justify asking why alcohol sales per person are substantially above the provincial level and why the available alcohol- and cannabis-related hospital-admission rates were also higher.

The people visibly struggling on Nanaimo’s streets represent the most urgent and tragic end of the substance crisis.

They may not represent its full extent.

The street crisis grabs the headlines. The bottles returning to the depot and the hospital admissions occurring behind closed doors may tell the deeper story.

This is Part One of Nanaimo’s Hidden Substance Problem. Part Two will examine how long a private substance problem can remain hidden—and how it eventually becomes an emergency, housing or street-level statistic.

Sources

Island Health: Greater Nanaimo Local Health Area Profile . Alcohol-sales figures are from 2022. Hospital-admission figures are from 2019.

University of Victoria: Canadian Institute for Substance Use Research—Alcohol Sales Methodology .

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Nanaimo’s Hidden Substance Problem — Part Two

Why Does Greater Nanaimo Drink More Than B.C.?

The sales figures reveal a substantial gap. They do not tell us whether it is driven by stress, culture, isolation, economic pressure—or a complicated mixture of them all.

Greater Nanaimo’s alcohol numbers raise an obvious question.

Why are recorded alcohol sales per person so much higher than the provincial level?

In 2022, alcohol sold in the Greater Nanaimo health area was equivalent to 10.9 litres of pure alcohol for every resident aged 15 and older, compared with 8.9 litres across British Columbia.

That placed Greater Nanaimo approximately 22 per cent above the provincial figure—the equivalent of about 639 standard drinks, or roughly 27 cases of 24 regular-strength beer, per person over the course of the year.

The number includes people who do not drink, as well as residents aged 15 to 18. It is not an estimate of what the average legal-age drinker personally consumed.

The number tells us how much alcohol entered the local market. It does not tell us why Greater Nanaimo remains so far above the B.C. level.

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The figure is based on alcohol sold in the area, not a survey asking Nanaimo residents how much they personally drank.

Nevertheless, the same basic method is applied across B.C., making the comparison difficult to ignore.

What the number does not tell us is why the difference exists.

Not Necessarily an Increasing Problem

The first caution is important: Greater Nanaimo’s alcohol consumption was not rising steadily.

Sales increased during the pandemic, reaching approximately 11.6 litres per person in 2020 and 2021, before falling to 10.9 litres in 2022.

Greater Nanaimo remained well above the B.C. level, but it was slightly below the Island Health average.

That suggests pandemic conditions may have intensified existing drinking habits. It also suggests Nanaimo may be part of a broader Vancouver Island pattern rather than a complete provincial outlier.

The question is not why Nanaimo is drinking more and more. It is why Greater Nanaimo continues to record substantially higher alcohol sales than B.C. overall.

Stress, Boredom and Isolation

During the pandemic, Canadians who increased their alcohol or cannabis use frequently cited stress, boredom and loneliness.

Spending more time at home and losing normal routines also made private consumption easier to conceal and normalize.

Greater Nanaimo’s health profile provides another piece of context. In 2022–23, mood and anxiety disorders affected an estimated 367.5 people per 1,000 in Greater Nanaimo.

That was below the Island Health rate but above the B.C. rate of 322.6 per 1,000.

This does not prove anxiety caused Nanaimo’s alcohol sales. The relationship can run in both directions.

People may use alcohol or cannabis to cope with stress, sleeplessness, loneliness or depression. Sustained heavy use can then worsen mental health, finances, relationships and physical health.

What begins as relief can become another source of pressure.

Cost of Living and Insecure Employment

Housing costs, food prices and employment uncertainty are also reasonable suspects—but the timing matters.

Nanaimo’s 2025 unemployment rate was reported at 7.3 per cent. Average monthly apartment rent reached approximately $1,685, while the rental vacancy rate stood at 2.2 per cent.

Those current pressures cannot be blamed for alcohol sales recorded in 2022.

They can, however, create conditions in which harmful substance use grows privately before it appears in future health, housing or emergency statistics.

Financial stress does not affect everyone in the same way. Some people buy less alcohol because money is tight. Indeed, B.C. alcohol sales have recently declined, with researchers identifying inflation and cost pressures as possible contributing factors.

For others, unemployment or financial insecurity can bring a loss of routine, purpose and hope. Alcohol or cannabis may become a comparatively accessible escape, even as the money spent makes the financial problem worse.

Economic pressure may reduce overall alcohol sales while increasing dangerous use among some of the people least able to afford the consequences.

Culture and Convenience

Nanaimo has long had a reputation for pubs and drinking establishments. Whether that reputation is fully deserved is another question, but alcohol has been woven into social life for generations.

A large number of liquor outlets and licensed establishments makes alcohol convenient. Legal cannabis stores now make cannabis similarly accessible.

Convenience may influence where and how often people buy. It does not necessarily increase the total amount consumed.

A new liquor store may simply divide an existing market among more retailers. Someone who wants alcohol may drive across town if the nearest store closes.

That is why sales and health outcomes matter more than counting storefronts.

The regional figures raise several questions the available data cannot answer:

• Does Vancouver Island have a more permissive drinking culture?
• Does Nanaimo’s role as a regional shopping centre increase recorded sales?
• How much is purchased by tourists or residents of surrounding communities?
• Did pandemic-era drinking at home become a permanent habit for some people?
• Are loneliness, mental-health pressures and financial insecurity contributing to harmful use among particular groups?

Each explanation is plausible. None has been proven to be the single cause.

Government Knows What Is Sold—Not Who Drinks It

Almost all legal commercial alcohol sold through B.C. liquor stores, restaurants, pubs, breweries, wineries and brewpubs is captured through the province’s wholesale or sales-reporting system.

That makes the recorded sales volume reasonably strong.

What it cannot show is who purchased the alcohol, where it was ultimately consumed or how evenly consumption was distributed.

A visitor may buy alcohol in Nanaimo and drink it elsewhere. A Nanaimo resident may purchase alcohol in another community. Homemade alcohol and personal imports may escape the local count.

Those limitations add some haze around the edges. They do not erase a persistent gap between Greater Nanaimo and B.C.

No Single, Comfortable Explanation

It would be convenient to blame Nanaimo’s numbers on one cause: unemployment, high rent, too many liquor stores, the pandemic or an Island drinking culture.

The evidence does not allow that.

The most likely explanation is a mixture of habit, social acceptance, convenience, stress, isolation, mental health, regional shopping and personal circumstances.

The sales figure tells us how much alcohol entered the local market.

It does not tell us why one person has a glass of wine with dinner while another drinks until the rent, the job or the family begins to disappear.

A private substance problem can remain invisible for years. It becomes a public statistic only when something finally breaks.

This is Part Two of Nanaimo’s Hidden Substance Problem. Part Three will examine what may happen behind closed doors before substance use becomes an ambulance call, housing crisis or visible street-level emergency.

Sources

Island Health: Greater Nanaimo Local Health Area Profile .

Statistics Canada: Alcohol and cannabis use during the COVID-19 pandemic .

City of Nanaimo: 2026 State of the Nanaimo Economy .

University of Victoria: Canadian Institute for Substance Use Research .

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Nanaimo’s Hidden Substance Problem — Part Three

How Many Street Crises Began Behind Closed Doors?

By the time substance use produces an ambulance call, an eviction or an overdose on a sidewalk, the problem may have been developing privately for years.

The overdose on the sidewalk is impossible to miss.

The ambulance arrives. Firefighters or paramedics attempt to revive someone. Community Safety Officers administer naloxone. Bystanders watch, and another incident is added to Nanaimo’s street-level statistics.

What we do not see is everything that may have happened before that moment.

A substance problem can remain hidden while someone still has a home, holds a job and manages to pay the bills. The drinking or drug use occurs behind a closed door. Family members may know something is wrong, but public agencies may know nothing about it.

There is no government statistic for someone who is barely holding everything together. The official record begins only when something breaks.

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The Street May Be the End of the Story

It would be wrong to assume that everyone who drinks heavily or uses drugs will lose their home. It would be equally wrong to suggest that everyone experiencing homelessness has a substance-use problem.

People lose housing for many reasons, including inadequate income, unaffordable rent, illness, relationship breakdown, eviction and loss of employment.

But these pressures can overlap.

In B.C.’s 2023 homeless counts, 37 per cent of respondents identified insufficient income as one reason for their most recent housing loss, while 25 per cent identified addiction or substance use.

Respondents could identify more than one reason. Financial pressure and substance use may therefore operate together rather than as competing explanations.

These are province-wide findings, not Nanaimo-specific results, but the connection is important.

A person may still be paying rent, but spending on alcohol or drugs can make an already strained household budget even more fragile. At the same time, unemployment, high housing costs, loneliness or mental-health struggles may encourage greater use.

Substance use can worsen the financial problem. Financial stress can worsen the substance use.

Eventually, something gives way.

By the time someone appears in an encampment or is revived on a sidewalk, the substance problem may not be new. What is new is that it can no longer remain private.

More Than Three Ambulance Responses Every Day

BC Emergency Health Services recorded 1,287 overdose or drug-poisoning patient events in Nanaimo during 2025.

That was down from 1,525 in 2024 and the extraordinary peak of 2,136 in 2023.

It still amounted to an average of approximately three and a half paramedic responses every day.

The longer comparison is even more revealing. In 2016, BCEHS recorded 512 overdose events in Nanaimo. The 2025 total was therefore approximately two and a half times the level recorded when B.C.’s toxic-drug public-health emergency was declared.

These are patient events, not necessarily different people. One person may require emergency assistance more than once.

The figures also do not tell us how many incidents occurred downtown, in parks, inside apartments or in family homes.

BCEHS has emphasized that overdoses occur throughout communities, both inside and outside homes. The highly visible downtown incident is only one part of the emergency-response picture.

Naloxone Measures the Rescue

Nanaimo’s Community Safety Officers provide another indication of the intensity of the crisis.

The City reported that CSOs administered 1,292 doses of naloxone during 2024. Between 2022 and 2024, they also conducted more than 6,500 wellness checks involving people affected by substance use.

These figures require careful interpretation.

A dose of naloxone is not necessarily a separate overdose. One person may require several doses during a single incident, and the same individual may be revived on more than one occasion.

Nor should the CSO total be added to the ambulance numbers. Community Safety Officers, firefighters and paramedics may all attend the same emergency.

The figures measure responses by different agencies. They are not a clean count of unique incidents or individuals.

Naloxone records the rescue. It tells us very little about how the person arrived at that point.

What Is Nanaimo Fire Rescue Seeing?

Nanaimo Fire Rescue responds to medical emergencies and participates in the Take Home Naloxone program.

Its publicly available business plans do not provide a clear annual breakdown of:

• Suspected overdose or drug-poisoning calls
• Naloxone administrations
• Incidents occurring in private residences
• Incidents occurring in public locations
• Repeated responses involving the same address or individual

Those numbers should be available.

A useful request to Nanaimo Fire Rescue would ask:

How many suspected overdose or drug-poisoning incidents did NFR attend in each year from 2018 through 2025? How many involved naloxone, and how many occurred inside private residences rather than in public places?

The location breakdown could be one of the most revealing pieces of this series.

It would help show whether Nanaimo’s emergency statistics are primarily a downtown street crisis—or whether a substantial number originate behind apartment doors, inside houses and throughout the wider community.

The Invisible Stage

Before the ambulance call, there may be months or years during which the consequences remain largely private.

Bills begin arriving late.

Workdays are missed.

Relationships become strained.

Food, utilities and rent compete with the cost of alcohol or drugs.

The person withdraws from friends and family. Health deteriorates. Employment becomes less secure.

None of these developments necessarily produces a substance-use statistic.

Instead, they may appear separately as missed work, unpaid rent, family conflict, anxiety, depression, an emergency-room visit, an eviction, a police complaint or a request for shelter.

That fragmentation makes the full progression difficult to see.

One agency records the medical emergency. Another records the housing loss. Another records public disorder. Another pays for the ambulance.

No single ledger tells the whole story.

Not Everyone on the Street Started There

Public discussion often divides Nanaimo into two groups: ordinary residents and “street people.”

Reality is not that tidy.

Someone living outside today may once have had a home, a job, a vehicle and a family.

The slide into crisis may have involved substance use, but also unemployment, trauma, mental illness, physical disability, an unaffordable rent increase or the loss of someone who had been providing support.

The point is not to assign one simple cause.

It is to recognize that the visible street population did not appear from nowhere.

Nanaimo’s street-level statistics may include people whose problems spent years incubating behind closed doors—until the rent could no longer be paid, the family could no longer cope or someone finally called 911.

The Question Nanaimo Is Not Yet Answering

The City can count naloxone doses.

Paramedics can count overdose responses.

Housing agencies can count people in shelters or encampments.

Hospitals can count admissions.

What remains largely unmeasured is the path connecting them.

• How often did the overdose problem begin while the person was housed?
• How many emergency responses occur in private residences?
• How often does substance use contribute to an eviction or job loss?
• How many families are quietly keeping someone housed and alive?
• How many people behind a closed door are moving toward becoming next year’s street-level statistic?

The overdose on the sidewalk is not necessarily where the crisis began. It may simply be where the rest of the community finally noticed it.

This is Part Three of Nanaimo’s Hidden Substance Problem. Part Four will examine the uncomfortable financial question: government sells alcohol and cannabis, collects the revenue—and then pays part of the health, housing and emergency-response bill.

Sources

BC Housing: 2023 Report on Homeless Counts in B.C.

BC Emergency Health Services: Overdose and Drug-Poisoning Data

City of Nanaimo: Community Safety Officer overdose-response information

Nanaimo Fire Rescue: Nanaimo Fire Rescue information

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Nanaimo’s Hidden Substance Problem — Part Four

Government Sells It—Then the Public Pays the Bill

B.C. controls the alcohol and cannabis supply chains, collects the revenue and promotes higher prices as a health measure. The resulting costs are scattered across a much larger collection of public ledgers.

Why did government make selling alcohol and cannabis without its permission a criminal offence?

Because it hates competition.

That is the mischievous answer.

The serious answer is that government regulates these substances to control product quality, restrict youth access and keep sales within a monitored legal system.

Those are legitimate responsibilities.

But government does considerably more than regulate.

In British Columbia, the Liquor Distribution Branch controls the wholesale system for beverage alcohol and non-medical cannabis. It also operates government liquor and cannabis stores.

The province is wholesaler, retailer, regulator, tax collector and revenue beneficiary. Then, through hospitals, ambulances, policing and social services, it becomes part of the cleanup crew.

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Private retailers may compete for customers, but they do so inside a system licensed, supplied and financially controlled by government.

The province is therefore not a financially disinterested referee.

A Billion-Dollar Return

In 2024–25, the Liquor Distribution Branch recorded almost $3.9 billion in alcohol and cannabis revenue and contributed $1.094 billion in net income to the province.

Cannabis accounted for only $23.9 million of that net income. The great majority came from alcohol.

That is not incidental revenue.

The LDB describes its net income as a significant source of provincial government revenue. Its financial performance is measured against annual net-income targets.

There is nothing improper about government operating its distribution and retail system efficiently.

The uncomfortable question is whether government can become financially dependent on the continued sale of substances it simultaneously urges people to consume less often.

Revenue Is Not the Same as Public Profit

The familiar defence is that liquor revenue helps pay for hospitals, schools and other public services.

That is true—but it tells only one side of the story.

A 2026 Provincial Health Officer report calculated that governments received approximately $2.04 billion in alcohol-related income connected with B.C. in 2020.

That broader amount included liquor-authority income, federal excise duties and sales taxes.

Alcohol-related health, justice, lost-productivity and other societal costs were estimated at $2.81 billion.

That left an estimated public deficit of approximately $768 million.

Alcohol generated billions in government income while costing society substantially more than government received.

The years and accounting categories should not be mixed with the LDB’s more recent results. The $1.094-billion figure is current LDB net income. The $2.04-billion figure is an older and broader calculation covering several sources of government income.

But the larger point remains.

Alcohol revenue appears neatly on one government ledger.

The costs are spread among hospitals, ambulances, police, courts, employers, housing services and families.

The “Sin Tax” Contradiction

When alcohol taxes or prices increase, government often explains that the purpose is to discourage consumption and improve public health.

There is evidence that higher prices can reduce population-wide alcohol use and harm.

But the health message sits awkwardly beside the government’s financial objectives.

The public-health message:

We are increasing the price so people will buy less.

The government business objective:

Maintain a billion-dollar return.

The LDB reported that lower alcohol consumption caused reduced liquor sales and a revenue shortfall in 2024–25. It responded partly by reducing expenses to protect net income.

That exposes the conflict.

If people drink substantially less, the health policy succeeds—but government revenue falls.

If liquor income continues rising, the treasury benefits—but the claimed reduction in consumption may not have occurred.

A tax can reduce consumption and raise revenue at the same time. Those goals are not automatically incompatible.

But if public health is the primary purpose, government should answer several straightforward questions:

• How much is consumption expected to decline?
• How much additional money will be collected?
• How much will go to prevention, detoxification, treatment and mental-health care?
• Will declining liquor revenue be treated as a public-health success or a budget problem?

Without those answers, “we are raising the price for your own good” begins to sound less like medicine and more like a moral wrapper around another revenue increase.

A Price Signal Is Not Addiction Treatment

Higher prices may persuade an occasional consumer to skip a bottle, choose a cheaper brand or drink less often.

Dependence is different.

The need to become intoxicated—or to avoid withdrawal—does not disappear because government raises the price.

A dependent person with little money might reduce consumption. That person might also sacrifice food or rent, seek the strongest product at the lowest price, turn to unregulated alcohol or combine substances.

It would be irresponsible to claim that higher alcohol taxes broadly drive people toward fentanyl or methamphetamine. The evidence does not establish such a simple progression.

But the policy question remains:

What happens when government applies an ordinary consumer price signal to someone who is no longer behaving like an ordinary consumer?

A sin tax may discourage discretionary drinking. It is not addiction treatment.

Legal Sellers and Illegal Competitors

Government does not prohibit alcohol and cannabis sales altogether.

It prohibits sales outside the system it authorizes and financially benefits from.

A legal retailer receives government approval, obtains product through the authorized supply chain, keeps prescribed records and ensures government markup and taxes are paid.

An unauthorized seller is called a criminal.

There are sound reasons for the distinction: product testing, known strength, age restrictions, inspection and accountability.

Those protections matter—particularly in a toxic illegal-drug market where an unknown dose can kill.

Government controls the market, approves the competitors and ensures that it receives its share of every legal sale.

That does not make government identical to a street dealer.

It does mean government has a direct financial interest in the continued sale of substances capable of causing dependency, illness and social harm.

Put Nanaimo’s Ledgers Side by Side

The provincial government possesses detailed information about alcohol and cannabis moving through licensed outlets.

Yet Nanaimo residents cannot easily find one clear public account showing:

• The value of alcohol and cannabis sold locally
• The government income generated by those sales
• Local hospital and ambulance costs
• Policing, fire-response and housing costs
• Lost productivity and family consequences

That missing comparison matters.

Earlier parts of this series examined Greater Nanaimo’s comparatively high alcohol sales, elevated hospital-admission rates and the emergency interventions occurring at the sharpest end of the substance problem.

This final part asks where the money flows before and after the damage occurs.

Government can make a credible case for regulating alcohol and cannabis.

But regulation does not require pretending government has no financial conflict.

Until the revenue and cost ledgers are published together, government income from alcohol and cannabis should never be confused with public profit.

The province may not be a drug pusher in a nicer suit.

But it is the wholesaler, retailer, regulator, tax collector and revenue beneficiary.

And when the damage is done, the public still receives the bill.

This is Part Four of Nanaimo’s Hidden Substance Problem, examining the financial relationship between government revenue and the wider health and social costs of alcohol and cannabis.

Sources

BC Liquor Distribution Branch: 2024–25 Annual Service Plan Report

Office of the Provincial Health Officer: Living Well, Drinking Less

Province of British Columbia: Provincial Health Officer alcohol-policy release