Indigenous communities take lead on tackling overdose crisis

Saskatchewan’s overdose crisis has disproportionately affected First Nations and Métis communities, spurring Indigenous leaders and health care providers to break new ground to prevent deaths.

In 2016, First Nations and Métis people accounted for 36 of the province’s 76 accidental overdose deaths while Statistics Canada reported they made up 16.3 per cent of the overall population.

That disparity predates the rise in the overall number of overdoses, a nationwide phenomenon largely driven by the growing prevalence of the extremely powerful opioid fentanyl and its analogs.

Ray Laliberte, executive director of the Métis Addictions Council of Saskatchewan, said it reflects the impact of colonization, the residential school system and unequal treatment in the foster care system for First Nations and Metis people.

“A lot of it stems from historical trauma,” he said. “There’s a definite connection between trauma and substance abuse.”

Laliberte said organizations like his are on the front lines of the crisis — which has also made them leaders in finding solutions.

The Saskatoon Tribal Council Health Centre, for example, serves more than 300 clients per day and exchanges roughly a million needles per year in an effort to reduce the spread of blood-borne diseases like HIV.

Tribal Chief Mark Arcand said those numbers reflect the centre’s reputation for highquality care, which has allowed it to connect many clients to further addictions treatment services.

“We pass no judgment,” he said. “We just want to help people.”

Both the STC and the Métis Addictions Council serve all clients, but they say providing on-site cultural supports, like Elders at the STC’s Health Centre, helps build trust with Indigenous clients and improves the quality of care.

“I think we have success because it’s a First Nations organization that is dealing with First Nations clients,” Arcand said.

Kathy Willerth, director of mental health and addictions for the Ministry of Health, said the government is aware of the crisis’s impact on both rural and urban First Nations and Metis populations and has partnered with organizations to make their services more culturally accessible and incorporate traditional healing practices.

“We have some centres that have really made changes and been able to have programs that are experienced by the Indigenous population of Saskatchewan as being very affirming,” she said.

Last year, the Ministry of Health committed $825,000 over five years to the STC centre. That funding was matched by Indigenous Services Canada, the federal department responsible for health services on First Nations.

Spokesperson William Olscamp wrote in a statement that the department supports and is investing in “comprehensive programming such as on-theland components, prevention, case management, counselling, and aftercare in addition to the pharmacotherapy for specific substance use issues, including opioid use disorder.”

The department has also distributed 1,500 naloxone kits, which can temporarily reverse the effects of an overdose, to First Nations in Saskatchewan since 2017 and trained more than 3,000 people how to use them, Olscamp said.

First Nations people who have Indian Status can receive a nasal naloxone spray for free under Indigenous Services Canada’s Non-Insured Health Benefits Program, although those without status do not have access to this service.

Willerth said the provincial government has also invested $450,000 into harm reduction resources and $1.8 million into three rapid-access medicine clinics for addictions treatment in Prince Albert, Regina and Saskatoon, which she said would help meet the needs of urban Indigenous populations in those cities.

“It’s an expectation that they’re able to address the needs of any population that comes through their door,” she said.

Saskatchewan is not the only province where Indigenous peoples are disproportionately affected by the overdose crisis.

In B.C., a report from the First Nations Health Authority this year said First Nations people were more than four times more likely to die of an overdose than other members of the population.

There are also internal demographic differences. In both B.C. and Saskatchewan, men are much more likely to die from an overdose than women. But among First Nations people in the two provinces, women are almost as likely as men to overdose.

Arcand said his advice for higher governments is to invest in proven models of care and preventative measures like early intervention to prevent addiction — and follow the example set by First Nations organizations.

“We don’t need to reinvent the wheel. We need something that works,” Arcand said. “We have a model of care I believe that can work for everybody in the province.”

Laliberte said the impact of the overdose crisis extends well beyond First Nations and Metis people and that tailoring supports is a proven way to improve care.

He added it was important to focus on addressing the underlying causes of addiction to prevent recidivism and encourage overall wellness.

“You have to deal with the root,” he said. “You have to deal with the historical trauma while trying to address the addiction and make is sustainable.”