Content warning: mentions of substance use and death.
Across Canada, the toxic drug crisis persists as a social issue faced by thousands of citizens each year. In BC alone, over 14,500 people have died from toxic drug use since 2016. First Nations people bear the brunt of these casualties. From January to June 2024, they had 6.7 times the rate of death compared to other BC residents. At the same time, Canadian governments have historically outlawed or otherwise restricted First Nations’ health and wellness practices, with this disproportion and systemic racism applying to Indigenous Peoples in general.
Now, the First Nations Health Authority (FNHA) is working to combat the toxic drug crisis through an Indigenous approach to harm reduction. The BC-focused organization “works with First Nations, government partners, and others to support First Nations individuals, families, and communities to achieve the highest level of health and wellness.” In 2018, the FNHA initiated the “Indigenizing Harm Reduction” study. Partnering with SFU for funding, the project “seeks to determine the current community needs, priorities, and wise practices in harm reduction, with the goal of developing a provincial harm reduction framework specific to BC First Nations.” The Peak reached out to the FNHA for an interview, but did not hear back by the publication deadline.
Most recently, the FNHA released the first phase of their project. Researchers carried out a literature review of existing Indigenous harm reduction methods in the US, Canada, Australia, and Aotearoa (New Zealand). Then, they conducted interviews with “56 service providers and people with lived and/or living experience of substance use.” Four unique aspects of First Nations harm reduction emerged: relational practice, wholistic health, strengths-based approaches, and person-centred care.
Relational practice involves harm reduction that is “rooted in relationships, connection, and love.” The report noted First Nations harm reduction “acknowledges that a relational approach to care is foundational in building trust and creating a sense of safety for our relatives who use substances.”
Wholistic health involves “providing care that wraps around the person to support their physical, spiritual, mental, and emotional wellness on their healing journey.”
Additionally, strengths-based approaches “draw on the ancestral strengths of culture, community, and kinship to provide unconditional and inclusive care for all community members.”
And lastly, person-centred care “respects an individual’s needs, priorities, and autonomy in determining their care plan and allows for the flexibility to meet each individual’s unique needs.”
The study also asked First Nations communities, organizations, and agencies to analyze the FNHA’s “Framework for Action,” a four-pillar system for addressing the toxic drug crisis. The third pillar, “create an accessible range of treatment options,” was referenced by 68.6% of respondents as a priority.
“Participants often spoke of the need for a full spectrum of options, including culture and land-based programming, to tailor care to the individual”
— First Nations Health Authority
Moving forward, phase two of the study “will involve community-based research to assess the effectiveness of community-led interventions to reduce harm and promote healing.”
