Indigenous advocates call for more culturally informed addictions treatment in B.C.

As of last week Avis O'Brien (N'alaga) marked 16 years in recovery from addiction. 

"I was on the Downtown Eastside [of Vancouver] as an Indigenous youth," said O'Brien, who is Haida and Kwakwaka'wakw.

"I was homeless; I was surviving my heroin addiction through sex trade work." 

What she credits for saving her life is reconnecting with her culture. 

"I didn't know physiologically or somatically what was happening when I was engaging in those practices but they felt really good and it was providing me with the kind of relief that I needed to stay on my path," she said. 

Her business, N'alaga Consulting in Courtenay, B.C. on Vancouver Island, creates addictions programming for treatment centres rooted in Indigenous knowledge and healing.

Her programs fill a gap she felt was missing when she was starting recovery. 

"There was no access to elders, there was no cultural teachings, no land-based healing. It just did not exist," O'Brien said.

Statistics from the B.C. Coroners Service released on Jan. 31 show confirmed or suspected illicit drug toxicity claimed the lives of at least 2,272 people in the province last year. 

The report said in November and December about 6.4 people a day died from illicit drug toxicity. 

B.C.'s First Nations Health Authority reports First Nations people were dying from illicit drug toxicity at five times the rate of B.C.'s general population. For First Nations women specifically, compared with non-Indigenous women in the province in the first half of 2022, the rate was 8.8 times higher.

O'Brien's programs are based on the work of people like Michael Yellow Bird and Riel Dupuis-Rossi, who studied the science behind the impacts of colonization on Indigenous people and how cultural connection can heal.

O'Brien's dream for Canada? As many addiction treatment centres as there are churches. 

"We need land-based, culturally rooted, trauma-informed from Indigenous social justice lens treatment centres," she said.

Dream of a new treatment centre 

Cory Cliffe, from the Wei Wai Kum First Nation in Campbell River, B.C., has a vision to create an addictions treatment centre serving 20 to 40 people offering culturally influenced care, something that played a big part of his journey recovering from addiction. 

"Culture is medicine," said Cliffe.

"I can't stress that enough." 

Two years ago he co-founded 7 Generations Stewards Society, a First Nations non-profit offering services including cultural workshops, employment and skills training, mental health and wellness and addictions programming.

Cliffe said a treatment centre serving North Vancouver Island would help centralize services 7 Generations offers.

"The idea is to create something where everybody feels at home and like their culture has had an influence on it," said Cliffe. 

The First Nations Health Authority website lists 10 treatment centres in B.C. for those seeking addiction services. 

Tsow-Tun Le Lum Society in Snaw-Naw-As First Nation on Vancouver Island offers substance misuse and trauma programming.  

"It's always been hugely important that the foundation of what we do is based in culture," said Nola Jeffrey, executive director of Tsow-Tun Le Lum, who is Tsimshian and Coast Salish from Lax Kw'alaams. 

Jeffrey said their wait list varies between three and six months for one of the 20 beds available — even after creating a second substance misuse program eight years ago, when wait times stretched over one year. 

A new centre is being built further south in Duncan, B.C., with space for 32 people and includes more space for residents in the dining room, an area for group work, an exercise and yoga studio and arts and crafts rooms.

The build, though, was impacted by inflation; what was a $12.5 million project before COVID-19 now costs $19 million. Tsow-Tun Le Lum has $16.5 million for the project and Jeffrey said the remainder will come through grants and donations.

The centre is funded by the First Nations Health Authority, Correctional Services Canada — which pays for clients from federal institutions — and grants from banks and private donations. 

Jeffrey said the centre is funded to serve 32 people, even though the demand is much higher. But keeping the centre small is important, he said, for Tsow-Tun Le Lum to feel welcoming and not like an institution.  

"People really can't do their healing work unless they feel safe," Jeffrey said. 

"What we do is we bring them in and we surround them with that safety and that love."

Long waits pose challenges 

Dr. Nel Wieman is the acting chief medical officer at the First Nations Health Authority and is Anishinaabe from Little Grand Rapids First Nation in Manitoba. Wieman said a major gap in these programs is capacity.

People are sometimes told to wait weeks or months when seeking treatment — too long, Wieman said, — and due to a toxic drug supply, many die waiting for help. 

"In some ways that's on us as a society, right?" Wieman said.

"We haven't made that space for people to seek and access service when they need it and when they want it." 

But, Wieman said, there is no one solution for every community's needs.

More treatment beds, outpatient treatment and a more widely available safe supply programs are things Wieman points to, but for certain, Wieman said, culturally informed care is wanted. 

"We hear all the time from B.C. First Nations people and communities, that they very much want to see culture and traditional healing as part of the services that are provided to them," said Wieman.