Too few resources, no easy solutions to address Nanaimo’s record drug toxicity issues

Dr. Shannon Waters, medical health officer, said rates of drug poisonings mirrored increases this year in fatalities with a rate of at least 906 incidents per 100,000 people recorded so far this year in Nanaimo, again about double the rest of Island Health.

“We use this type of data as our lab work for a population, versus when people might see others individually. This makes me think we’ve got to be looking at what we’re doing here in this region.”

Men, particularly those aged 25-44 were especially susceptible, with their poisoning and fatality rates upwards of 2.7 times higher than elsewhere on the Island.

Bigger spikes in drug poisonings and deaths were noted in the spring of 2023 with an average of 10 people have died per month this year alone, well up from averages of five or six in 2021, and seven or eight last year.

Waters also presented more localized data regarding drug toxicity poisonings and deaths, confirming Nanaimo’s downtown as the epicentre locally for the crisis, but indicating hot spots around Bowen Rd. and in the north end also exist.

An animation showing the scale of drug poisonings compared with fatalities in greater Nanaimo. Darker areas represent higher concentrations. (Island Health)

The need for housing
Multiple speakers pointed to a lack of available and affordable housing as a key driver behind the crisis.

Despite an increasingly tainted drug supply killing people, it was the stability of those affected which prevented many positive outcomes.

“For our outreach and healthcare teams, it’s so much more challenging and difficult to locate people when they don’t have a home or accessing a shelter,” Amanda Lemon, mental health and substance use services manager, said. “They don’t have phones, so some of that overdose follow-up from the emergency department…is a little more challenging.”

She added Nanaimo tracks well below other like-sized communities for shelter beds.

“In terms of supporting someone to have more positive health outcomes when they don’t have a basic need met, it becomes incredibly challenging. And what we’re expecting of people who are already very resilient but are struggling to meet their own basic needs, making huge life changes becomes virtually impossible.”

Dr. Roger Walmsley, an addiction medicine physician, echoed Lemon’s thoughts about the need for housing.

Many of those individuals are turning to addictions as a means to survive, not as a recreational option.

“They use drugs to stay up at night because they don’t have a warm place to go to. There’s not enough shelters in the city to go to to house all the people that we have.”

An increase in first-time users is also evident at local medical facilities, according to Walmsley.

“[Monday] morning I was in the hospital, I saw a young man who usually does not use illicit supply. He was smoking, using some cannabis with some friends, a friend passed him a joint and it ended up as an overdose of fentanyl.”

The need for additional services
Provincial health authorities continue to advocate the expansion and use of overdose prevention sites (OPS), where those using substances can do so safely and with proper medical help if needed.

Also available at the sites, including a recently expanded one on Albert St. in Nanaimo, are recovery options and connections to programs and supports.

Dana Leik, mental health and substance use director with Island Health, said the OPS on Albert St. is nearly one year old and has seen high volumes of visitors.

It’s a facility Island Health wants to expand, through the Canadian Mental Health Association who operate the site.

“Looking at how we can expand those hours is something we’ve been exploring with the operator…and we hope that we can be able to bolster that service up so there would be an increase in hours of operation, which is a service that is life saving.”

Adding other OPS’ was also asked, but Leik said it’s not as easy as pointing to a map and opening up.

She said it was a “very difficult service to operate” to find a willing service partner and adequate location.

More informal options, such as the now-closed NANDU (Nanaimo Area Network of Drug Users) site on Nicol St., was “something to consider” according to Leik.

NANDU was forced to close their downtown location due to repeated issues regarding public safety, according to nearby area residents.

“Is there a population that perhaps is not comfortable accessing the overdose prevention services that are contracted through Island Health, and whether there is room for considering what that other model of distribution and service intensity and availability might look like.”

Data from Island Health indicated a changing playing field regarding drug toxicity and related fatalities.

In the last two years, roughly 44 per cent of drug poisonings attended to by paramedics were outside, however, the number has increased to 56 per cent so far this year.

Corresponding drops were most notable among calls to private residences (36 and 32 per cent in 2021 and 2022, compared to 23 per cent this year) and “other inside” calls for service. (11 and 14 per cent, compared to 10 per cent.)

Fatalities linked to drug toxicity also followed a similar pattern.

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by Alex Rawnsley

Too few resources, no easy solutions to address Nanaimo’s record drug toxicity issues

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