Addressing Opioid Use in Indigenous Communities

Opioids are a class of drugs that can help relieve pain, with the most common being morphine, fentanyl, and oxycodone (Health Canada, 2022). Although they can be obtained legally, there have been many deaths resulting from the illegal use of opioids, especially during the Covid-19 pandemic (Public Health Agency of Canada, 2022). Interestingly, there have been studies reporting that Indigenous Peoples are more likely to die from an opioid overdose compared with non-Indigenous people. In one article by Charlebois (2021), it was stated that “Indigenous People are five times more likely to experience an overdose and three times more likely to die than other residents.” So, I wanted to explore the reason for this, and have found several studies that provide some explanation why opioid overdose deaths are higher in Indigenous communities.

Lavalley et al. (2018) explored the reasons for the high use of illegal opioids amongst Indigenous Peoples, which included factors such as the historical trauma they experienced during colonization, and the poverty and difficulty in accessing healthcare services that they experience today. The article speaks to the importance of drug policy reform that considers the trauma and systemic racism that can drive the high rates of overdose, along with issues relating to family, housing, and healthcare access (Lavalley, 2018). In a news video by CityNews (2021), they discuss how the mortality rate for opioid-related deaths was much higher than non-Indigenous, particularly during the Covid-19 epidemic, when harm reduction sites were closed.

https://www.youtube.com/watch?v=pRqwyXpHLUw

So, what is the Government of Canada doing in terms of policies and programs to help reduce the illegal use of opioids amongst Indigenous Peoples? In a study by Maar & Manitowabi (2022), they recommend that “Indigenous led, culturally safe treatment approaches are urgently required to support the health, well-being, and recovery of Indigenous people living with opioid use disorder.” Rowan et al. (2014) identified seven types of cultural interventions that have been effective in reducing or eliminating substance abuse, with Sweat Lodge Ceremonies being the most frequent (68%), followed by smudging with sage, cedar, and sweetgrass (63%), and social, cultural, and family-based activities (58%). The Canadian Research Initiative in Substance Misuse (CRISM) also provided a list of interventions that were effective in addressing opioid addiction and treatment for Indigenous Peoples. They explained that methadone maintenance therapy (MMT) has been the “gold standard” for treatment of opioid use disorders, but this treatment is not easily accessible in the remote First Nations and Northern communities (CRISM, 2016). It was suggested that Suboxone, a combination of buprenorphine and naloxone, is a better alternative for doctors to prescribe in these remote communities, as it can be dispensed in multiple doses at once, whereas methadone requires daily dispensation (CRISM, 2016).

Fortunately, the impact of opioid-use on Indigenous Peoples has prompted the Government of Canada to invest money in developing culturally appropriate treatment interventions. This year, Health Canada announced an investment of 10 million dollars to support Indigenous communities in addressing substance related abuse (Health Canada, 2023). With this funding, there are 16 community-led projects being implemented, which focus on opioid use amongst Indigenous Peoples. One example is a program in Alberta, which is providing staff training so healthcare professionals are better equipped to support Indigenous youth (12-18 years) and their families (Health Canada, 2023). In Ohsweken, Ontario, over $400,000 will be invested to provide harm reduction education, supplies, and outreach services (Health Canada, 2023). These are just a few examples of how the Government of Canada is addressing the opioid use in Indigenous communities, and I am eager to see the expansion of more culturally specific treatment programs that incorporate traditional Indigenous healing practices to prevent and treat substance abuse disorders.

WORKS CITED

Charlebois, B. (2021, December 14). Opioid crisis: Indigenous people far more likely to die from overdose, experts warn. British Columbia. https://bc.ctvnews.ca/opioid-crisis-indigenous-people-far-more-likely-to-die-from-overdose-experts-warn-1.5706533

CityNews. (2021, November 28). Opioid deaths double among First Nations people in Ontario [Video]. YouTube. https://www.youtube.com/watch?v=pRqwyXpHLUw

CRISM Ontario. (2016). Topic summary: Prescription opioid misuse and interventions in Northern Ontario and First Nations communities [Topic Summary]. http://crismontario.ca/SiteAssets/topic-summaries/PO_misuse_in_Ontario.pdf

Health Canada. (2023b, January 11). Health Canada announces nearly $10 million to support Indigenous communities across Canada to address substance related harms. https://www.canada.ca/en/health-canada/news/2022/12/health-canada-announces-nearly-10-million-to-support-indigenous-communities-across-canada-to-address-substance-related-harms.html

Health Canada. (2020, March 19). Opioids: What Are They? (fact sheet). Canada.ca. https://www.canada.ca/en/health-canada/services/publications/healthy-living/opioids-what-are-they-fact-sheet.html

Lavalley, J., Kastor, S., Valleriani, J., & McNeil, R. (2018). Reconciliation and Canada’s overdose crisis: responding to the needs of Indigenous Peoples. Canadian Medical Association Journal, 190(50), E1466–E1467. https://doi.org/10.1503/cmaj.181093

Maar, M., Ominika, T., & Manitowabi, D. (2022). Community-led recovery from the opioid crisis through culturally-based programs and community-based data governance. The International Indigenous Policy Journal, 13(2). https://doi.org/10.18584/iipj.2022.13.2.13792

Public Health Agency of Canada. (2022, September 27). Substance use and harms during the COVID-19 pandemic and approaches to federal surveillance and response: Canada-U.S. joint white paper. Canada.ca. https://www.canada.ca/en/public-health/services/publications/healthy-living/canada-us-white-paper-substance-use-harms-during-covid-19-pandemic-approaches-federal-surveillance-response.html

Rowan, M., Poole, N., Shea, B., Gone, J. P., Mykota, D., Farag, M., Hopkins, C. A., Hall, L. J., Mushquash, C., & Dell, C. A. (2014). Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study. Substance Abuse Treatment, Prevention, and Policy, 9(1). https://doi.org/10.1186/1747-597x-9-34