First Nations 'triaging grief' as opioids claim lives at more than 8 times the rate of the rest of Alberta

First Nations people in Alberta have been dying from opioids at more than eight times the rate of the rest of the population, according to newly published data that puts harder numbers on a grim reality Indigenous leaders have been sounding the alarm over for years.

Jody Plaineagle says it's hard to put into words the cascading effects the opioid crisis has had on people in communities like hers.

"You lose someone and you're trying to grieve and then somebody else dies," she said.

"You're triaging your grief and loss."

Plaineagle is a member of the Piikani Nation in southern Alberta — a region that has been hit especially hard by the opioid crisis, according to a recently published report with long-awaited data focused on the province's First Nations.

The report shows a surge in deaths among First Nations people, with 373 unintentional opioid poisonings in 2021 and 344 in 2022.

That works out to more than 200 deaths per 100,000 people each year, which is more than eight times the rate among the rest of the Alberta population.

The numbers provide two more full years of data than was previously available but still present a picture nearly two years out of date.

As the crisis has continued to play out in recent months, Indigenous communities have signalled the scale of the challenges they're facing.

In April 2023, the Blood Tribe in southern Alberta declared a state of emergency due to opioids, in part targeting drug traffickers. The Confederacy of Treaty 6 First Nations declared an emergency a few months later.

In January of this year, the Piikani Nation also declared a state of emergency. In a letter to Piikani citizens, the nation's chief and council wrote that though the situation facing the community wasn't unique to Piikani, the impact has been tragic.

"We all the know the deaths caused and the lives destroyed by these drugs and the criminals who peddle them. Each life lost breaks our collective hearts. This cannot be allowed to continue," the letter reads.

'Attending funerals is exhausting'

Plaineagle says many people in her community barely have time to process one death before another occurs.

She says there are sometimes "chain reaction" deaths within families, when one person dies of an overdose and, in their grief, other family members die of opioids or other causes related to mental health.

"Because of the multiple deaths, attending funerals is exhausting," she said. "Or sometimes you just don't want to go. You're trying to but you can't move on, because how can you move on if you haven't even begun the healing journey? I guess you could say you're trying to just keep your head above water."

Sometimes people feel shame, she said, when they compare their own loss to families who have suffered even more.

"All of sudden it's like, OK, well, maybe my situation isn't as bad as theirs," she said. "It's almost like survivor's guilt."

She says community members try to be there for one another — especially for families who have lost multiple people in a short span of time — but the scale of it all can be overwhelming.

"You have to kind of pick and choose who you're going to go support and be there for," she said, "because if you were to attend all the funerals and everything, that's all you would be doing."

Families with 'hardly anybody left'

Death rates have been especially high in Lethbridge and Alberta Health Service's South Zone.

That's where Amber Jensen lives.

"I'm seeing families where there's hardly anybody left," she said.

She's the Lethbridge representative for the advocacy group Moms Stop The Harm and has taken in a number of at-risk Indigenous youth as foster children. Two were later lost to fentanyl poisoning.

"People are grieving the loss of family members and their friends … it's exponentially harder to try and make positive changes when you're grieving," she said.

That grief, paired with trauma that runs through generations, is why some say Indigenous communities across Canada face challenges unlike those seen elsewhere.

"Poverty and trauma are the two biggest factors … in our minds, in our Indigenous minds, we need to save our mothers and fathers, our sisters and brothers," Dr. Esther Tailfeathers, a family physician with the Blood Tribe, told CBC News in February, prior to the latest data being released.

Children left behind

While the majority of people dying from opioids in Alberta are men, the latest report notes "the proportion of deaths among females was higher among First Nations peoples."

Women made up 41 per cent of First Nations deaths in 2022, compared to 23 per cent among the rest of the population.

Young First Nations women have been dying at an especially high rate, especially those under 25. In that age range, women made up the majority of First Nations deaths in 2022.

Among both men and women, people under the age of 40 make up a higher proportion of the First Nations deaths than they do among the rest of the province.

Plaineagle says many young children are being left behind as their parents either struggle with addiction or die of overdoses. Where possible, grandparents or other extended family members are taking care of these kids, but that's not always an option and many end up placed in the care of non-Indigenous families.

"That takes them away from their roots," she said.

"Now they're at the risk of losing their identity, their sense of belonging, their language, their culture. All of that."

The 2023 calendar year was the deadliest year on record for opioids in Alberta, with at least 1,867 deaths recorded across the province. That's more than five deaths per day. No breakdown is yet available when it comes to how many of those deaths were among First Nations people.

Plaineagle believes the long-term effects of the current crisis will be felt for generations. 

"This opioid epidemic has caused a lot of other things than just fatal overdose," she said.

"There's going to be a lot more impacts to come."