Alcohol is Canada’s biggest drug problem. So why aren’t people getting help?

Jordan Kawchuk didn’t imagine having a roommate at the age of 54, let alone more than a dozen of them.

But for six months at the start of 2026, his home was the Vancouver Island Therapeutic Community (VITC), a treatment centre for men in Nanaimo, B.C.

When Kawchuk, a writer and former TV producer, met with CBC’s Audio Documentary Unit during a visit to the treatment centre, he was wearing a blue, button-down shirt, his hair neatly coiffed. He said he often gets mistaken for a member of the staff.

But it was actually his second time at this facility and the fifth in-patient program he’s tried during his decades-long struggle with alcohol-use disorder.

Kawchuk has a long list of things he’s lost to alcohol over the years. He says he’s been fired from countless jobs; he’s lost a lot of money and trust. But he says the hardest part was losing his marriage and the opportunity to live full time with his daughters when they were growing up.

And he’s far from alone. Research shows that alcohol use costs Canadian society around $20 billion a year in health care, lost productivity and criminal justice costs.

Although consumption of alcohol is ticking down slightly overall, according to Statistics Canada, those who do drink are drinking more.

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A national study conducted by researchers from the Centre for Addiction and Mental Health (CAMH), published earlier this year in the Journal of Psychopharmacology, found that alcohol causes more harm overall than any other drug in the country, far more even than non-prescription opioids or tobacco.

The Canadian Institute for Health Information (CIHI) says around nine people die in Canadian hospitals each day from harm caused by alcohol. Daily hospitalizations for alcohol number 280, compared to 84 for opioids, it says. 

On top of that, nearly 18 per cent of people aged 15 years or older in Canada will meet the clinical criteria for an alcohol-use disorder in their lifetime. Still, some doctors and other advocates say people struggling with alcohol aren’t getting treatment options that are backed by science.

Dr. Evan Ailon is one of them. He runs the only dedicated practice on Vancouver Island for alcohol-use disorder (AUD).

And he says the patients are not usually the hardest part of his job. 

“The challenges that I have are with colleagues whose lack of information, lack of knowledge about this really gets in the way of the treatment of these patients.”

Ailon says people seeking help for a problem with alcohol often face stigma and marginalization. His patients tell him that family doctors have ignored their alcohol use or just advised them to cut down.

He says he’s also frustrated that patients are often advised to simply go to Alcoholics Anonymous. While support groups like that do work for some people, they shouldn’t be the only thing offered, he says.  

“Some of the most effective medications that have ever been invented in medicine, full-stop, are for alcohol-use disorder, but that is just something that’s not known by most providers and certainly not known by the average person.”

Naltrexone, for example, which was approved by Health Canada in 1997, affects the brain’s opioid reward centre, decreasing cravings. It helps people reduce consumption, and for those in recovery, reduces the chance of relapse.

Approved in 2007, Acamprosate improves withdrawal symptoms by restoring balance between the neurotransmitters that get out of whack with chronic alcohol use. It’s used to maintain abstinence . 

Ailon, who also works in hospitals, says the deaths he sees are often preventable. 

“I’ll see a patient who comes in with severe liver failure and I can see in the chart that they’ve had multiple admissions for liver failure…,” says Ailon. 

Yet he says he usually finds no mention of treatment for alcohol-use disorder. 

“If we as physicians had a patient who came into the hospital with numb feet and a heart attack from very poorly controlled diabetes and we wrote in our charts, ‘this patient continues to eat sugar, despite us telling them they need to stop eating sugar,’ but we’ve never started them on any of the medications that we have for diabetes, that would be unbelievably unacceptable. Yet for substance use, it’s completely normalized.”

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CAMH says it’s estimated that less than two per cent of people with AUD get appropriate medications. 

Jürgen Rehm, a CAMH senior scientist who in 2023 co-chaired a committee that developed new guidelines for treating high-risk drinking, says the condition usually goes unrecognized.

“Because neither the treating physician asks, nor the patient mentions alcohol problems …, overall high-risk drinking, or heavy drinking and alcohol-use disorders, are not being recognized early enough in our health-care system,” said Rehm, who is also a professor at the University of Toronto’s Dalla Lana School of Public Health. 

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Jordan Kawchuk has experienced that first hand. 

“I’ve been to emergency rooms where nurses or whoever gives me a stretcher or a bed has said, ‘well, we need this bed for people with more problems than you,’ or I overhear them saying, ‘another bed, another addict, another drunk.’ It’s hard even saying that alcohol-use disorder is a disease because I’ve seen people roll their eyes.”

CBC asked the Canadian Medical Association and the College of Family Physicians of Canada to comment on the state of alcohol treatment in this country, but both organizations declined.

Ailon says he also worries about patients being sent to expensive in-patient treatment programs. 

“When I see people who are dropping $40,000 on something that is no better than what they can do as an out-patient, it obviously makes me a little bit hesitant….” 

He says he does have patients who were helped by the programs, but it’s important to get to the root of what’s driving alcohol use. 

“You can put somebody in a three-month program … but if you, at the end of … those three months, put them back into exactly the same circumstances that they came from that were driving the issue, it’s not at all surprising that it doesn’t fix the problem.”

Chris Kinch says he agrees in-patient treatment isn’t for everyone. He’s a vice-president at Connective, the non-profit that runs VITC, where Kawchuk has been twice.

Treatment there is free, and he says it works for some people because it’s all about building community.

“So individuals have a highly structured day where they’re attending meetings, they’re working with each other, holding each other accountable,” Kinch said. 

“Community is the method of treatment that’s used.”

The men have access to counselling and group therapy. But it’s also about teaching them social skills so they can contribute to their communities when they leave treatment, he says.

For Jordan, being in treatment gives him the space he needs to rest, recover and work on himself, he says.

After almost six months at VITC, Jordan says he felt ready to go home in June. His first trip was to visit his daughters in the Okanagan region of B.C. 

“I don’t care about the careers or getting back to making television or getting rich or owning a home. That’s the only thing I want,” he says of fostering a relationship with his kids. “Now it’s time to get to know them as adults.” 

He says he’s taking his medication, going to AA meetings and writing a book about his struggle with alcohol-use disorder. 

“I just have to be diligent. I have to know that it is life and death because the disease is out to kill me.”