An Indigenous man addresses an audience from a podium. Five other Indigenous people, sitting at a table beside him, are watching

Indigenous People Bare the Brunt of the Toxic Drug Crisis

 The Tyee, Local Journalism Initiative Reporter

The B.C. First Nations Health Authority opened its gathering to present a grim report on toxic drug toxic deaths in 2022 with a song, a prayer of hope and  unity for the families and friends affected by toxic drugs. 

The report found toxic  drugs have been taken a disproportionate toll on First Nations members,  who were almost five times as likely to die of drug poisoning in 2022  than non-Indigenous B.C. residents. Although representing only 3.3 per  cent of the province’s population, Indigenous people represented 16.4  per cent of toxic drug poisoning deaths in 2021.

The numbers are also dire for women. In  2022, 36.5 per cent of the First Nations people who died were women,  twice the rate for non-Indigenous people.

“When I think about toxic drug deaths, I  think about pain. I think about self-medication. I think about the  causes of that pain. I think about systemic failure to look after those  in pain,” said Stó:lō Grand Chief Doug Kelly.

Dr. Kelsey Louie of the  Tla’amin Nation, the authority’s acting deputy chief medical officer,  said First Nation individuals and communities have been “particularly,  disproportionately impacted by the toxic drug supply — with a loss of  life that is unacceptable.” 

Louie said the authority’s  approach begins with listening to communities and families who had lost  loved ones to learn how to expand “our role in preventing toxic drug  poisonings. And stop the harm being done today.”

Kelly said the crisis requires a broad response.

“Our children are vulnerable. Parents,  families, communities, teachers, schools, coaches, everyone that comes  into contact with children have an opportunity to support them, grow  them, develop them, heal them,” he said.

Health authority CEO Richard Jock, a member  of Mohawks of Akwesasne, said the COVID-19 response has dominated  public health, and the authority knew mental health would be the next  challenge. 

“We certainly didn’t anticipate the level of effects from toxic drugs that we’re seeing today.”

The level and nature of drugs are changing,  he said, and partnerships with First Nations communities and provincial  and federal governments also need to change.  

Jock said the toxic drug emergency is now  the First Nations Health Authority’s top priority and it was “gearing up  our response for deploying and redeploying resources, both human and  financial, to meet these emerging and changing needs.”

Part of the work is tackling barriers and  obstacles in the health system, said Jock, recognizing intergenerational  trauma. “We need to acknowledge that the trauma is a key element and  underlies much of the issues that we’re facing today, including toxic  drugs.” 

Acting chief medical officer Dr. Nel  Wieman, of Little Grand Rapids First Nation, said action is needed on a  public health emergency entering its eighth year. “It starts to feel  more like the status quo, and we cannot accept this. We have to treat  this for what it is — a public health emergency.”

“First Nations communities across B.C. have  lost too many loved ones to an increasingly toxic drug supply. And that  loss of life is now more than 1,000 family members and friends,” Wieman  said. “It gives me great sadness to report that in 2022, there were 373  deaths among First Nations people.”  That is a 6.3-per-cent increase  over 2021.

Wieman said the disproportionate impact on  Indigenous people is linked to the history of trauma in people’s lives,  along with intergenerational trauma. 

And First Nations people report less access  to mental health, wellness and substance use treatment that is  culturally safe and appropriate, she said. “Systemic racism toward First  Nations is a barrier to health care.”

First Nations are also are  more likely to face poverty and housing challenges, which are among the  social determinants of health. “These are also predictors of substance  use disorders,” Wieman said.

Wieman said the health authority recognized  the disproportionate on First Nations women. It has “pivoted our toxic  drug crisis response to have a greater focus on First Nations women, and  has dedicated a portion of our harm reduction outreach and engagement  programs to support women, especially in urban areas.”

The speakers agreed on the need to build hope and address the causes of toxic drug deaths.

Wieman said there’s a need to “change our  understanding of the root causes of substance use and addiction, and  work together to address the stigmas surrounding drug use and the people  who use drugs.”

Katie Hughes, the health authority’s vice  president for public health response, says “Our strategy is to build on  First Nations people’s strengths and resilience, address root causes,  and provide holistic healing and wellness supports to First Nations  people regardless of where they live.”

Hughes also outlined new  initiatives. The authority will meet people where they are in their  wellness journeys, she said. Treatment centres will move to a healing  and wellness approach, and will expand to regions that are underserved.  The authority is investing in  land-based healing initiatives and expanding healing pathways for those  who have lost a loved one to this crisis.  

It’s also focused on “efforts and  investment in additional areas, including securing new funds to enhance  wraparound services directly in communities,” said Hughes. That includes  First Nations-led overdose prevention and mobile harm reduction  services and working with the province to provide detox and treatment  beds specifically for First Nations people. 

“We’ve recently utilized one-time funding  to partner with eight treatment centres across the province that provide  withdrawal management and treatment services to support individuals at  higher risk who require immediate access,” she said.

The health authority also wants to expand peer support networks.

Grand Chief Kelly has a deep connection to  the crisis. He lost his daughter during her healing journey of recovery  and shared what he had learned.

“Conditional love doesn’t work,” he said.  “Do not shame your child or your loved one. Do not judge. Simply be  there. Simply be there. Walk with them,” he said. 

Culture, language, spirituality can all  guide loved ones to wellness, he said, but if supports and resources are  offered conditionally, for example only if people attend abstinence  models of treatment, they are not meeting needs. 

Kelly spoke of Indigenous housing  organizations that kick out young women when they’re struggling. “We  have to create shelter that’s going to have that approach of  unconditional love,” he said. “Kicking ’em out puts them on the street,  and that’s a direct path to self-destruction and death. So I’m hopeful  that each and every one of you will raise the profile of these public  issues, — housing, safe shelter.”

“We have to work together to improve  services from all of the agencies that come into contact with children,”  said Kelly, “To make sure that the health-care system is providing  quality care each and every time they engage someone in pain, that they  look after them in a good way.”

Top image credit: Richard Jock, Chief Executive​ Officer of the First Nations Health Authority, speaking at the Apr 21, 2023 press conference. – FNHA press release

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