Vancouver plebiscite this October on hard drug use in public, new treatment facility | Daily Hive

Vancouver plebiscite this October to ask voters about public use of hard drugs and turning the old St. Paul's Hospital into a major addictions and mental health treatment facility

The old St. Paul's Hospital campus on Burrard Street in Downtown Vancouver's West End. (Jeff Whyte/Shutterstock)

Vancouver voters could be asked to weigh in on two major changes to the municipal government’s approach to the drug and mental health crisis: stronger restrictions on the open use of hard drugs in public spaces, and a push to turn part of the existing St. Paul’s Hospital campus on Burrard Street into a secure treatment and stabilization facility.

A policy paper by Mayor Ken Sim’s ABC Vancouver party proposes putting two advisory questions onto the ballot form of the civic election scheduled for Oct. 17, 2026, asserting that the City of Vancouver should seek a direct public mandate on issues that largely span municipal and provincial responsibilities.

Under the proposal, the first public safety plebiscite question would ask voters: “Are you in favour of the City of Vancouver strengthening its laws to forbid open-air hard (Heroin, Meth, Fentanyl, and Crack) drug use in public spaces?”

The second public safety plebiscite question would ask: “Should the City of Vancouver formally ask the Province of B.C. to convert portions of the old St. Paul’s Hospital, or another site, into a secure medical facility that provides acute voluntary and 100-plus involuntary care beds for individuals posing a serious risk to themselves or others due to severe substance use and mental health disorders?”

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Although Vancouver City Council is currently in the midst of its summer break, a notice of a Special Council meeting was provided this morning, Thursday, Aug. 13. During the meeting now scheduled for the morning of Friday, Aug. 14, City Council will consider ABC’s motion to add both questions to the ballot form.

That same ballot form will include not only the candidate lists for mayor, City Council, the Vancouver Park Board, and the Vancouver School Board, but also — as Daily Hive Urbanized previously reported in July — plebiscite questions seeking voter approval for the City to borrow up to $790 million to fund new and improved community centres and other infrastructure under the 2027–2030 capital plan.

If approved this Friday — which is expected given ABC’s majority on City Council — the plebiscite would set the stage for public safety to emerge as the defining issue on the civic election campaign trail over the next two months.

However, the plebiscite’s two questions relating to new strategies for public safety would be advisory rather than legally binding. A “Yes” vote would give the next makeup of City Council a clear mandate to pursue new municipal bylaws and pressure the BC NDP-led provincial government for major new additional treatment capacity.

Plebiscite questions have long been a feature of the ballot forms of each Vancouver civic election to seek voter approval for borrowing to fund capital plans.

While not legally binding, this historic public safety plebiscite would be among the most consequential put before Vancouver voters in decades. The last non-capital-plan plebiscites were held in 2003, when voters were asked whether Vancouver should bid for the 2010 Winter Olympics, and in 2004, when they were asked whether the City should switch to a ward system for electing city councillors or retain its longstanding at-large system. Before that, there was the 1994 referendum that led to the closure of the Stanley Park Zoo, instead of making the major investments needed to modernize the longtime attraction.

“The proposed plebiscite would therefore: provide Vancouver residents with a direct voice on two of the city’s most significant public policy issues; establish a clear democratic mandate for future municipal bylaws and advocacy; strengthen the City’s ability to hold the Province accountable for delivering healthcare infrastructure and treatment capacity within Vancouver; improve transparency by ensuring that future policy decisions reflect the expressed will of the electorate; increase public confidence in both municipal decision-making and intergovernmental advocacy; and reinforce democratic accountability by ensuring that long-term policy direction is shaped directly by Vancouver voters rather than by elected officials alone,” reads ABC’s policy paper explaining the rationale.

The public safety plebiscite frames the two questions as complementary rather than competing approaches, combining greater enforcement of public space rules and social norms with more specialized health-care services for people experiencing severe addiction and/or mental health issues.

New measures to deter hard drug use in public spaces and reduce public disorder

Under the first question, ABC proposes creating or strengthening municipal bylaws that would restrict one of the most common types of public disorder — the consumption of hard drugs in public spaces. It suggests this could give police another enforcement option, potentially including municipal penalties, rather than leaving officers with a choice between taking no action and pursuing criminal charges.

The document compares such restrictions with existing Vancouver health bylaws governing activities such as smoking, public urination, defecation, and other antisocial behaviour and conduct in public spaces. For instance, smoking is already prohibited near bus stops and onboard public transit, and near building entrances, windows, and air intakes, as well as in restaurant patios and other customer service areas.

The party argues that the City already regulates activities that can pose health or safety risks to other people using shared public spaces.

“A favourable result would provide City Council with a clear democratic mandate to strengthen municipal bylaws where authority exists, advocate for additional legislative authority from the Province where required, and reaffirm the principle that Vancouver’s public spaces should be managed first and foremost for the safe use and enjoyment of the public as a whole,” reads the policy paper.

Over the past decade, concerns have grown across Vancouver about increasingly visible hard drug use, overdose deaths, street disorder, and the number of people living with serious untreated mental illness and addictions disorders. Public drug consumption has become a more common sight in parks, on sidewalks, in retail districts, onboard SkyTrain and buses, and near schools and playgrounds, while overdoses and mental health crisis incidents have become more frequent and visible in neighbourhoods throughout the city.

The results-driven proposal also explicitly notes that enforcement measures would not be sufficient on its own.

“Importantly, the proposed approach would not rely on enforcement alone. It would be paired with expanded stabilization, treatment, recovery, and involuntary care services, recognizing that lasting improvements in community safety depend on improving outcomes for those living with severe addiction and mental illness as much as they do on protecting the public realm,” states the policy paper.

Turning the old St. Paul’s Hospital campus into an addictions and mental health treatment facility, as a years-long temporary use before Concord Pacific’s redevelopment

The plebiscite’s second major component would have the City formally lobby the provincial government to establish what the document calls a new “Tertiary Care Centre” at the old St. Paul’s Hospital site.

In 2020, Providence Health Care reached a deal to sell the 6.6-acre existing St. Paul’s Hospital site in Downtown Vancouver’s West End to local developer Concord Pacific. Once the brand-new, expanded replacement St. Paul’s Hospital campus in the False Creek Flats — just north of SkyTrain’s Main Street-Science World Station, and just south of Chinatown and the Downtown Eastside — opens and begins serving patients in Spring 2027, hospital operations and staff will vacate the Burrard Street property, clearing the way for Concord Pacific to eventually pursue a high-density, mixed-use redevelopment.

However, any redevelopment is likely still years away. Concord Pacific has not submitted a rezoning application, and a project of this scale would likely first be subject to a master planning exercise — specifically, the City’s policy statement process — to establish the framework for future rezoning applications and the likely phased redevelopment of the large and prominent site. The current market conditions are likely another major factor for the likely timeline before any new construction begins.

According to the party, Concord Pacific has confirmed that redevelopment of the old hospital site is up to 10 years away and has tentatively agreed to allow addiction and mental health treatment uses on the property in the interim, until it is ready to move ahead with redevelopment.

“At this point, we do not have sufficient details to take a position or comment on the matter. We are happy to work with the appropriate levels of government on any plans they may put forward,” Matt Meehan, the vice president of planning for Concord Pacific, told Daily Hive Urbanized upon inquiry.

The old St. Paul’s Hospital campus on Burrard Street in Downtown Vancouver’s West End. (Adam Melnyk/Shutterstock)

The existing St. Paul’s Hospital already contains extensive addiction and mental health facilities, including psychiatric units. As the hospital that is currently the closest to the Downtown Eastside, as many as 29 of its 30 emergency department beds can be occupied by patients with mental illnesses on an average weekday, according to St. Paul’s Foundation. The hospital already treats thousands of patients with mental health issues each year, with 70 per cent of those receiving mental health care also experiencing an addiction issue.

The general idea is that the old hospital’s existing addiction and mental health facilities — along with other areas of the sprawling campus with acute care spaces that could be relatively easily converted — could provide an unusually close-to-turnkey opportunity for an interim, semi-permanent large secure medical facility offering voluntary and involuntary care. Otherwise, the functional major hospital could sit vacant for years awaiting redevelopment, even as demand for specialized treatment remains acute amid the ongoing mental health and addictions crisis.

There is precedent for this type of approach. The provincial government previously announced that two new involuntary care facilities would be created by repurposing existing secure buildings: a former long-term residential addiction recovery facility in Surrey and a former youth corrections facility in Prince George. The proposal to reuse portions of St. Paul’s Hospital would follow a similar model.

However, that recent announcement of such involuntary care facilities in other parts of B.C. — rather than within Vancouver, where the epicentre of the provincial and national crisis is located — has drawn the ire of Mayor Sim. He has publicly addressed Premier Eby and provincial cabinet ministers twice over the past month, including in his latest formal letter on Aug. 6, which called for at least 100 new involuntary care beds to be created in Vancouver as quickly as possible. In the initial July 13 public statement, Sim warned that the City of Vancouver will be “forced to act in unprecedented ways” if the provincial government continues to refuse to take meaningful action. This plebiscite now appears to be the clearest indication yet of what he meant.

This second plebiscite question specifically calls for the creation of at least 100 involuntary care beds at the old St. Paul’s Hospital, along with an undetermined number of voluntary care beds.

The envisioned 24/7 facility at the old St. Paul’s Hospital would provide medical stabilization for people experiencing severe drug intoxication and connect patients with detoxification, addiction medicine, psychiatric treatment, and other services. Voluntary treatment would be offered, while people who meet the legal requirements for involuntary care could undergo a separate assessment and potentially be transferred into secure treatment beds on the same campus.

The old St. Paul’s Hospital campus on Burrard Street in Downtown Vancouver’s West End. (CBRE)

This proposed interim treatment centre at the old St. Paul’s Hospital campus would be the most significant physical component of the ABC plan.

According to the paper, people brought there while severely intoxicated would receive immediate medical assessment and stabilization, monitoring for overdose and withdrawal, psychiatric assessment where appropriate, and access to addiction and mental health services.

Patients would first be assessed for voluntary treatment. Only those who declined voluntary treatment and met the legal criteria for involuntary admission would move into a separate involuntary care assessment process.

The policy paper describes the concept as a way of reducing the cycle in which some people repeatedly move through hospital emergency departments, shelters, emergency services, supportive housing, and police interactions without receiving sustained treatment.

It proposes that appropriate patients could be transferred from overcrowded hospital emergency departments to the specialized Tertiary Care Centre, where they could receive medical monitoring and assessments before being connected with longer-term services.

“Vancouver cannot continue to function as the province’s default service provider for addiction, mental illness, and homelessness”

The policy paper highlights that many of the services needed to address severe addiction and mental illness fall under the direct jurisdiction of the provincial government, rather than the jurisdiction of any municipal government. It contends that Vancouver’s municipal government has been left dealing with many of the downstream consequences through policing, firefighting, sanitation, park maintenance, bylaw enforcement, and other municipal services.

It is estimated the City of Vancouver now spends approximately $100 million each year on municipal services related to public disorder and the concentration of provincially-funded services within the city, especially in and near the Downtown Eastside.

“The proposed plebiscite is therefore about more than public safety and public health. It is also about restoring accountability between orders of government. Vancouver cannot continue to function as the province’s default service provider for addiction, mental illness, and homelessness while local taxpayers bear the financial burden of responsibilities that properly belong to the Province of British Columbia,” reads the policy paper.

“A clear expression of support from Vancouver voters would strengthen City Council’s mandate to insist that provincial commitments be matched by provincial investment, and that the costs of provincial policy no longer be disproportionately downloaded onto Vancouver residents and businesses.”

ABC paints a picture that it is highly unfair for Vancouver property taxpayers to shoulder a significant share of costs tied to provincial health-care responsibilities and the resulting public safety pressures, rather than having those municipal tax dollars directed toward new and improved community centres, parks, infrastructure, and other City services — as would typically be expected of a municipal government.

ABC is also sharply critical of what it characterizes as an imbalance in the provincial government’s response to the addiction crisis.

It invokes the City’s longstanding Four Pillars model of prevention, treatment, harm reduction, and enforcement, arguing that harm reduction remains necessary but should operate alongside significantly greater investment in treatment, recovery, prevention, and enforcement.

“An effective public policy framework cannot rely on a single pillar in isolation. Harm reduction has an important role in reducing immediate risks of death and disease and will continue to remain an essential component of any comprehensive strategy. However, harm reduction alone cannot substitute for preventing addiction, expanding treatment capacity, supporting recovery, or maintaining safe public spaces through appropriate enforcement,” reads the policy paper.

“Lasting success requires that all four pillars operate together: preventing people from falling into addiction, intervening early when problems emerge, ensuring timely access to evidence-based treatment and recovery services, reducing immediate harms, and maintaining public confidence through safe, accessible, and well-managed public spaces.”

Among the examples cited is the proposal by the provincial government and Vancouver Coastal Health (VCH) for an overdose prevention site (OPS) at 900 Helmcken St., directly across from the Sheraton Wall Centre Hotel and near the Granville Entertainment District. The latest proposed relocation of the facility, which was previously informally known as the Yaletown OPS, has generated significant opposition from nearby businesses, residents, and ABC elected officials.

The planned OPS next to B.C.’s largest hotel was first announced in early May 2026, and at the time it was initially expected to open as early as just before or during the FIFA World Cup. Following an initial public backlash, the provincial government and VCH put the opening on “pause.” However, some nearby businesses and residents remain concerned that the OPS could still open at this location after the civic election, depending on the outcome.

A survey conducted last month by polling firm Ipsos found that 62 per cent of B.C. residents disagree with the notion that “drug consumption sites are a good use of taxpayer money,” while only 26 per cent agree. Moreover, 73 per cent agree that “the money spent on drug consumption sites would be better spent on treatment and recovery services,” compared with just 15 per cent who disagree.

The same survey found that 58 per cent of respondents believe drug consumption sites have worsened the overall addiction crisis, while 57 per cent believe they have worsened visible public drug use in surrounding areas. Another 57 per cent believe they have worsened crime and public disorder in surrounding areas, while 54 per cent believe they have worsened community safety. As well, 70 per cent of B.C. residents would oppose having a facility such as an OPS in their neighbourhood, including 52 per cent who would strongly oppose it.

Only 19 per cent agree with the notion that “I think the provincial government is doing a good job addressing the addiction and overdose crisis,” while 71 per cent disagree. Moreover, 69 per cent disagree that they are seeing real improvements as a result of the money the provincial government is spending on the crisis. This survey had a sample size of over 800 B.C. adults and a margin of error of plus or minus four per cent, 19 times out of 20.

900 helmcken street vancouver coastal health ops

Proposed new OPS location at 900 Helmcken St., Vancouver, directly across from the Sheraton Wall Centre Hotel. (Kenneth Chan)

ABC also raised concerns about the continued concentration of aging single-room occupancy (SRO) hotels and supportive housing in and around the Granville Entertainment District, arguing that the provincial government should develop a plan to transition those properties toward other forms of housing and care.

The provincial government has committed to closing three problematic SROs along the Granville Strip, beginning with the highly controversial Luugat Hotel SRO — the former Howard Johnson hotel — by June 2026. More recently, however, there has been sharp criticism of the provincial government’s progress in meeting its commitments. It was reported this week that the 110-room Luugat remains open for a single resident, at a provincial operating cost of more than $100,000 per month, even though that resident is also reportedly absent from the property for days at a time.

If voters support the second plebiscite question, the document notes that the City would press the provincial government to prioritize Vancouver for future involuntary care investments, establish a timeline for secure treatment capacity, develop a strategy for replacing aging SROs in poor condition and/or located in unsuitable areas, and work more closely with the municipal government before opening new provincially-funded facilities with significant neighbourhood impacts.

ABC’s proposal ultimately argues that putting the two plebiscite questions directly to voters would give future City Council decisions greater democratic legitimacy, while strengthening the hand of Vancouver’s municipal government in negotiations with the provincial government.

Conversely, the proposal is also likely to become a major political lightning rod, with opposition parties and candidates and activist groups expected to challenge both the two plebiscite questions themselves and ABC’s decision to put them directly to voters.

The plebiscite would likely further widen an already significant political fault line that has developed between the municipal government and the provincial government over much of the past year.

Tensions between Mayor Sim and Premier Eby’s administration grew considerably last fall, when the provincial government effectively halted Sim’s plan to abolish the Vancouver Park Board and transfer its responsibilities to the mayor and City Council.

That dispute intensified after B.C. Minister of Housing and Municipal Affairs Christine Boyle — previously a OneCity Vancouver city councillor who frequently clashed with Sim at Vancouver City Hall — imposed a condition that any future transfers of parkland to First Nations would not be subject to a referendum for final voter approval. Sim and ABC strongly disagreed with that approach, maintaining that any transfer of parkland — regardless of the circumstances — should be subject to a public vote. ABC no longer has plans to pursue the Park Board’s abolition, and will be fielding their own Park Board commissioner candidates for the upcoming civic election.

Against that backdrop, the public safety plebiscite would open another major front in the Sim-Eby relationship, this time over addictions and mental health treatment and acceptable social conduct in public spaces.

howard johnson supportive housing granville vancouver police crime businesses

A police incident at the Luugat (former Howard Johnson hotel), turned into a supportive housing site, at the Granville Entertainment District in downtown Vancouver on July 25, 2025. (Kenneth Chan)

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