Indigenous-informed treatments are needed to stop overdose deaths
Indigenous-informed treatments are needed to stop overdose deaths
Alberta addiction recovery programs rooted in Indigenous tradition offer a recovery-oriented alternative to current programs.
Some Indigenous communities in Alberta have developed a unique approach to addiction recovery that draws upon long-ignored cultural healing traditions.
As Canada confronts rising overdose rates and barriers to treatment, the insights from these communities could prove valuable to other provinces seeking solutions for Canadians of all ethnicities.
Indigenous communities have long contended with limited recovery services, scarce resources in remote areas, racism in the health-care system and intergenerational trauma. In the face of these barriers, some Indigenous communities have launched and expanded their own treatment services, which focus on sobriety, abstinence and cultural reintegration.
A particularly notable success story has been Kainai Healing Lodge Centre, situated on the Blood Tribe reserve in Alberta. The centre originally focused on alcohol treatment when established in 1977, but expanded its services to address drug addiction in the early 2000s amid the opioid crisis.
“The whole Blood Tribe went into an opioid crisis in 2015-2017, where in one month there were about 70 deaths,” said Leslie Wells, the program manager at Kainai Healing Lodge.
Wells adopts a “Two-Eyed Seeing approach” within the lodge’s addiction treatment programs that values both Indigenous and Western knowledge systems.
“It is my passion to help my people heal through our ways. But you have to have that balance of Indigenous healing methods as well as non-Indigenous methods,” said Wells, who has been through her own addiction recovery journey. “That’s how I healed.”
Kainai's intensive eight-week treatment program promotes Blackfoot traditional values and the “Soksipaitapiisin” lifestyle — an ethos encapsulating the Blackfoot tradition of living a good life.
The program includes all-night smoke rituals held in the centre’s tipi, hide-tanning sessions and workshops on traditional healing medicines, moccasin making and buckskin dress-making.
It also incorporates traditional sweat ceremonies, a longstanding tradition in many Indigenous cultures where community members pray with elders in a heated space. These ceremonies promote detoxification by mandating that participants be sober for several days before and after attending.
“People who aren’t even in treatment are going to sweat to try to help whatever it is inside of them,” said Kyle Young Pine (Agapi) of the Kainai First Nations Blood Tribe, who formerly struggled with addiction.
Sweat lodges can be combined with other practices to promote drug abstinence, Young Pine says. In his own life, sundancing — a type of Indigenous ceremonial performance — has been particularly useful for building his “recovery capital,” the internal and external resources that can be drawn upon to initiate and sustain recovery.
He described sundancing as a year-round sober lifestyle. He recalled how a friend told him that there was a good spirit resting within the sundance outfit, and that when drugs or alcohol are present, that good spirit could leave.
Healing homes
Kainai is the sole Indigenous treatment centre in southern Alberta. It is funded by the provincial and federal governments, but more support is needed to address growing demand, according to staff at the centre.
The success of centres like Kainai have helped usher in new lodges in Ontario, such as the Sagashtawao Healing Lodge and Waashkootsi Nanaandawe’iyewigamig Healing Lodge, which similarly incorporate cultural healing methods.
In addition to treatment centres, some Indigenous communities are expanding access to pre-treatment housing, sometimes termed “healing homes.”
These homes bridge the gap between detox and treatment, says Earl Thiessen, executive director of Oxford House, a foundation that spearheads the healing homes initiative in Alberta.
These homes are licensed and funded by the provincial government, so their services are provided at no cost to clients. Services include sweat lodge ceremonies, sharing circles, healing circles, elder visits and smudging.
“We have smudging tables right in the home,” Thiessen explained. “We couldn’t have that before because the smell bothered other people so it was very important to have a specific home for cultural practices.”
Success in Indigenous addiction recovery models often stems from lived experience, with many program leaders in Alberta being "wounded healers" who have overcome addiction themselves.
Thiessen, like Wells, has had his own struggles with addiction, catalyzed by intergenerational trauma and sexual abuse in his teens.
“I didn’t know how to emotionally respond to my trauma,” said Thiessen. “So I did drugs and I drank and other deviant behaviours to mask that emotional pain.”
“Half of our staff are success stories,” he said. “When you have a person that has that lived experience and they go back and get their education, that’s a very strong advocate for helping people.”
Unlike detox centres, which can sometimes discharge patients after just 10 days, Oxford House sets no time limit on recovery. While Thiessen recommends a minimum stay of six months, optimal outcomes may require stays of up to two years.
“You’re taking decades of built-up trauma,” said Thiessen. “It’s going to take more than a few months to heal. You have to rewire your brain.”
When Thiessen asks his residents what keeps them at Oxford House for so long, “they all give the same answer, [that] it's the peer support.”
Both Kainai and Oxford House ensure other centres are a part of patients’ plans before they leave.
“We’re making sure that we’re giving a warm hand-off,” Wells says.
‘Built-up trauma’
Indigenous leaders who provide recovery services often stress the importance of understanding intergenerational trauma.
“If you were beaten in residential school for discipline, you were taught that to discipline, you beat,” said Thiessen. “That carries on and and on and on. I’m breaking that cycle with my kids.”
Wells said that she sometimes sees community members “walking around with no identity.” Reconnecting to one’s roots can be integral to healing, she says.
"They gain an understanding of why their parents are the way they are," she explained. "They say, ‘Oh, so that’s why my mom doesn’t know how to say ‘I love you.’ Because they were stripped away from their parents or grandparents and taught to be this very cold person.”
Young Pine similarly highlighted the transformative power of embracing one’s culture. “I grew up being ashamed to be Indigenous,” said Young Pine. “But I reclaimed my identity as an Indigenous person. I love that piece of me now.”
For many Indigenous leaders, it is self-evident that addiction treatment modalities that ignore history, cultural genocide, trauma and racism will never get at the heart of the underlying causes for substance abuse within Indigenous communities. Their views are backed by studies that highlight the positive effects of culture-based interventions in addiction treatment for Indigenous populations.
Thiessen stressed the importance of other provinces following Alberta's lead. The Truth and Reconciliation Commission specifically recommended sustainable funding for Aboriginal healing centres, he notes.
"When the province has people in recovery making decisions, it will just be a wave across the country," he said.
Despite having limited space and federal funding, both Thiessen and Wells keep their doors open to all individuals, Indigenous and non-Indigenous.
“If you have something good and it’s working, don't keep it for yourself, share it,” said Wells. “The colour of your skin doesn’t matter to me if you’re just wanting to heal.”