The morning mist hangs over Nanaimo’s harbor as I park across from the Wesley Street overdose prevention site. At 8:30 a.m., a small queue has already formed outside—individuals hovering close to the entrance, hands stuffed in pockets against the coastal chill. This humble storefront has become the epicenter of a heated community debate, one that pits public health priorities against neighborhood concerns in this Vancouver Island city of 100,000.
“I’ve reversed sixteen overdoses this year alone,” tells me Jamie, a peer worker who requested I use only his first name. His eyes, weathered but alert, scan the street as we speak. “Before we opened, people were using in alleys, in parkades. At least here, no one dies.”
Last week, tensions reached a breaking point when Island Health representatives appeared before Nanaimo City Council to defend the operation of the overdose prevention site. Their appearance came after months of escalating complaints from nearby businesses and residents about public disorder, discarded needles, and perceived safety concerns in the surrounding area.
The controversy reflects a pattern I’ve witnessed in communities across British Columbia—the challenging intersection of harm reduction services, public perception, and the ongoing toxic drug crisis that claimed 2,511 lives in British Columbia last year, according to the BC Coroners Service.
Dr. Sandra Allison, Island Health’s Medical Health Officer for Central Vancouver Island, presented data showing the site had recorded approximately 72,000 visits in 2023, with staff intervening in 221 overdoses. Not a single death has occurred at the facility since its opening.
“These are someone’s children, parents, siblings,” Dr. Allison emphasized to councilors. “The evidence is unequivocal that these services save lives.”
The overdose prevention site operates differently from supervised consumption sites. While both provide supervised spaces for people to use pre-obtained substances, overdose prevention sites emerged as an emergency response to the overdose crisis, operating under a provincial emergency order rather than federal exemptions.
Walking the surrounding blocks, I spoke with Lisa Chen, who owns a small boutique about 200 meters from the site. “I understand the necessity, but my business has suffered,” she says, gesturing toward her empty shop. “Customers tell me they don’t feel comfortable parking nearby anymore.”
This tension—between compassion for those struggling with addiction and concern for neighborhood livability—has split the community. At the council meeting, over a dozen delegates spoke, nearly evenly divided between those supporting and opposing the site’s current location.
A 2022 study published in the Canadian Medical Association Journal found that overdose prevention sites not only prevent fatal overdoses but also reduce ambulance calls and emergency room visits in their vicinity. The research, examining data from sites across British Columbia, estimated that these services have prevented hundreds of deaths provincially.
Yet for some Nanaimo residents, statistics offer little comfort when confronted with daily disorder.
“We’re not against harm reduction,” explains Michael Beaudry, spokesperson for a neighborhood coalition that has gathered over 800 signatures on a petition asking for the site to be relocated. “We just believe these services should be integrated into healthcare settings, not commercial districts.”
Navigating the alley behind the prevention site, I observe the complex reality. A staff member in a high-visibility vest carefully collects discarded needles, while nearby, a woman sweeps the sidewalk in front of her café. Both are part of this community, both trying to make it work.
The controversy in Nanaimo mirrors similar debates in communities from Victoria to Prince George. According to the BC Centre on Substance Use, communities with harm reduction services often experience initial resistance that sometimes—though not always—diminishes as the services become established and demonstrate their value.
Councillor Sheryl Armstrong, who has been vocal about her concerns regarding the site’s impacts, acknowledged the life-saving work happening inside but questioned whether the Wesley Street location was appropriate.
“We need to find solutions that work for everyone,” Armstrong said during the meeting. “The status quo isn’t working for many members of our community.”
Island Health officials countered that the current location was chosen specifically because it’s where the need exists—accessible to people who use drugs and central to the community it serves.
“Relocating to a less accessible area would mean fewer people accessing these life-saving services,” noted Erica Thomson, Executive Director of the BC and Yukon Association of Drug War Survivors, in a telephone interview after the meeting. “And that means more preventable deaths.”
As afternoon approaches, I watch the steady flow of clients entering and exiting the site. Some stop to chat with staff, others move quickly, heads down. Each represents a life potentially saved by this controversial service.
Dr. Bonnie Henry, BC’s Provincial Health Officer, has repeatedly emphasized that we cannot “treat our way out” of the toxic drug crisis. In her 2022 report “Stopping the Harm,” she noted that a comprehensive approach must include prevention, harm reduction, treatment, and recovery options.
For now, the Nanaimo site continues operations while the city considers next steps. Island Health has committed to increased cleanup efforts, security patrols, and better communication with neighbors.
As I prepare to leave, I notice a man pausing outside the facility. He hesitates, looks around, then walks through the door. Inside, regardless of the controversy swirling around this building, he’ll find something increasingly rare in the toxic drug crisis: a second chance.
Nanaimo’s struggle to balance compassion with community concerns represents a microcosm of our province’s larger challenge: how to save lives while addressing legitimate community impacts during an unprecedented public health emergency that shows no signs of abating.
