Daphne Bramham: More needed to redress the tragic fact that Indigenous people are disproportionately victims of opioid crisis
Last year, Indigenous people accounted for 13 per cent of opioid deaths in B.C.
Overdose deaths linked to illicit fentanyl-laced drugs rose 21 per cent last year among First Nations people in B.C. even as there was a glimmer of hope that the crisis may have peaked among the general population.
Since the crisis began four years ago, B.C. Indigenous people have been overrepresented in the deadly count. Last year, they accounted for 13 per cent of the deaths, while making up 3.4 per cent of the provincial population.
Put another way, First Nations people were 4.2 times more likely to suffer a fatal overdose and six times more likely to suffer a non-fatal overdose than other British Columbians.
No one is suffering more than First Nations women and girls, who already have the worst health outcomes in Canada because of violence, exploitation and poverty.
They are unique in this epidemic where 80 per cent of the victims in the general population are men. Women, by contrast, account for 39 per cent of First Nations’ overdose fatalities last year and 46 per cent of the non-fatal ones.
They are bearing the brunt of marginalization, says Dr. Evan Adams, chief medical health officer at the First Nations Health Authority. Another measure of that is expected to come next week in the report of the murdered and missing women’s inquiry.
Among the reasons that he suggests for the widening gap between First Nations’ and the general population’s statistics are the effects of colonization including residential schools, the lack of social supports, childhood experiences and limited access to safe spaces and services.
The litany of dreadful statistics compiled by the provincial coroner’s office was read out Monday against the backdrop of a quilt with the names of some of the hundreds who have died. Among those names was Max, the son of the health authority’s knowledge keeper, Syexwaliya. Max died 12 days before his 41st birthday in March 2018.
“My son was just too lost,” she said. “I couldn’t do anything for him. I had to love and accept him as he was.”
Still, Syexwaliya takes heart from the statistics.
“The statistics make me feel that Indigenous people aren’t invisible and what’s brought out in the statistics and in the reports means that work is being done,” she said.
Addiction is a disease of pain — physical, emotional, mental and spiritual. Addiction piles tragedy on tragedy.
“It’s a journey of pain, a journey of suffering and a journey of seeking health services that couldn’t be found,” said the chair of the health authority, Grand Chief Doug Kelly.
Too many Canadians, too many British Columbians and too many First Nations people have already died, but Kelly said that for Indigenous people, things are not getting better. They’re getting worse, especially for those living in cities and most especially for women.
Overdose hot spots include the usual ones: Vancouver’s Downtown Eastside, the Fraser Valley, Chilliwack, Nanaimo, Victoria and Prince George. But for First Nations people, there’s also Campbell River and Kamloops.
Those stark differences mean distinct and targeted solutions are required. As Canada’s first Indigenous health authority, the First Nations authority (with its unofficial motto of “no decisions about us, without us”) is well positioned to do that.
With a goal of addressing causes of addiction, it has its own four pillars approach: preventing people from dying, reducing the harm of those who are using, creating a range of accessible treatments and supporting people on their healing journey.
The authority also strongly supports the call from B.C.’s chief medical health officer to decriminalize possession of all drugs for personal use as has been done in Portugal. (The suggestion was quickly shot down by the B.C. government, which says that could only be accomplished with federal legislation.)
Among the reasons Kelly cites are yet more terrible statistics.
Of Canada’s female offenders in federal prisons, Public Safety Canada reported last summer that 43 per cent are Indigenous. In youth detention, Indigenous kids account for 46 per cent of all admissions — a jump of 25 per cent in a decade.
Addiction is often contributing factor in the crimes committed, as is fetal alcohol spectrum disorder (although the report said there is no evidence that FASD is more prevalent among First Nations than other populations).
Because so many First Nations women are incarcerated, it means their children often end up in government care or with relatives, which only exacerbates the cycle of childhood trauma, loss and addiction.
So far, the First Nations Health Authority has spent $2.4 million on harm-reduction programs. It’s trained more than 2,430 people in 180 communities how to use naloxone to reverse fentanyl overdoses, has 180 “harm-reduction champions” and peer coordinators in all five regions.
But the biggest barrier is the one that led to Max’s death — lack of accessible treatment.
Last week, FNHA and the B.C. government committed $20 million each to build treatment centres in Vancouver and Surrey and promised to upgrade six existing ones. Kelly says that’s great. But it’s not enough. They’re still waiting for another $20 million from the federal government for construction.
Still, where will the operating money come from? That’s the next multi-million-dollar question. But it must be found.
Now that there is evidence that First Nations communities — and women in particularly — are suffering so disproportionately, ignoring them is unconscionable.