The picture is particularly dismal on Vancouver Island where, unlike some other areas of the province, the number of alcohol-related deaths is increasing, said CARBC director Tim Stockwell.

"There are considerable regional variations in trends. ...Vancouver Island has shown an upward trend," he said.

The report estimates that between 2002 and 2006 in B.C, 4,431 deaths were caused by alcohol, 1,814 were caused by illicit drugs and 22,972 by tobacco.

Between 2003 and 2007 there were 89,065 hospitalizations caused by alcohol, 22,381 by illicit drugs and 134,441 by tobacco. That shows a 36.6 per cent increase over the period in people taken to hospital because of illicit drugs, 3.4 per cent increase for alcohol and 7.8 per cent decrease for tobacco-related hospital visits.

Victoria is also singled out as the centre where illegal drug use is more likely to be cocaine and crack cocaine, compared to Vancouver where amphetamines, crystal meth, heroin and magic mushrooms are more popular. High-risk groups surveyed in all areas of the province-- such as intravenous drug users and recreational club drug users -- said most drugs were easy to obtain, the report says.

Cocaine use is a problem for users and for the health-care system, especially when mixed with alcohol, Stockwell said.

"It can trigger psychotic episodes when people go on a binge," he said.

The combination tends to "completely mess up" the nervous system, Stockwell said.

"They complement each other so beautifully and so disastrously and people end up using more of both."

But, while figures of illicit drug use are eye-catching and alarming, Stockwell does not want anyone to lose sight of the alcohol-related figures.

Those ending up in hospital are not the traditional street alcoholics with liver failure, he said.

"Most of the deaths would not be people you would recognize as alcoholics. There are 60 different ways in which alcohol can kill you, even at a relatively low level," he said.

Almost a dozen types of cancer are linked to alcohol and half a bottle of wine a day should be regarded as risky, Stockwell said.

On Vancouver Island in 2007, the report estimates 410 people per 100,000 were hospitalized because of alcohol use.

Alan Campbell, Vancouver Island Health Authority director for mental health and addictions services, said the study, unfortunately, does not contain many surprises.

"We have been aware for some time of the trend in the increase in legal and illegal drugs. It is part of the health burden," he said.

Campbell would like to see more education around the risks of alcohol use.

"Even moderate alcohol use is a problem, and our society has not really looked at it," he said.

Since the study was completed last year, VIHA has been putting its energy into groups at high risk of illicit drug use and outreach teams are working with the street population, Campbell said.

"We are certainly aware that psychotic episodes can be triggered by drug use," he said.

Another problem in which people are ending up in local hospitals comes from the increasing purity of some illegal drugs, Campbell said.