Article Commentary: Researching Prescription Drug Misuse among First Nations in Canada: Starting from a Health Promotion Framework

Abstract

The intentional misuse of psychotropic drugs is recognized as a significant public health concern in Canada, although there is a lack of empirical research detailing this. Even less research has been documented on the misuse of prescription drugs among First Nations in Canada. In the past, Western biomedical and individual-based approaches to researching Indigenous health have been applied, whereas First Nations' understandings of health are founded on a holistic view of wellbeing. Recognition of this disjuncture, alongside the protective influence of First Nations traditional culture, is foundational to establishing an empirical understanding of and comprehensive response to prescription drug misuse. We propose health promotion as a framework from which to begin to explore this. Our work with a health promotion framework has conveyed its potential to support the consideration of Western and Indigenous worldviews together in an 'ethical space', with illustrations provided. Health promotion also allots for the consideration of Canada's colonial history of knowledge production in public health and supports First Nations' self-determination. Based on this, we recommend three immediate ways in which a health promotion framework can advance research on prescription drug misuse among First Nations in Canada.

Prevalence and correlates of nonmedical prescription opioid use among a cohort of sex workers in Vancouver, Canada

“…A growing body of literature documents trends in increasingly problematic PO use and street-level availability in Canada: data indicate that rates of NPOU are rising in general adult and student populations (Boak, Hamilton, Adlaf, & Mann, 2013; Health Canada, 2013) and NPOU is emergent among key marginalized populations, including street-drug users (Popova, Patra, Mohapatra, Fischer, & Rehm, 2009), First Nations/Aboriginal people (Dell et al, 2012; Katt et al, 2012), and correctional populations (Johnson, MacDonald, Cheverie, Myrick, & Fischer, 2012). Local Vancouver studies of youth and adults who use drugs have seen a marked rise in the availability of POs, particularly oxycodone and hydrocodone, in street-level drug markets between 2006 and 2010, despite the high and stable availability of other illicit drugs (Nosyk et al, 2012), and injection and non-injection PO use has surpassed heroin use among some drug-using populations in Canada (Fischer et al, 2006; Leclerc, Morissette, & Roy, 2010).…”

Adaptation culturelle d’un programme de prévention universel des dépendances pour les enfants autochtones innus

“…C'est pourquoi d'autres auteurs militent plutôt en faveur de l'adaptation des programmes universels prometteurs ou probants, en impliquant des acteurs-clés en provenance des milieux autochtones (Holleran Steiker et al, 2008 ;Okamoto, Helm, McClain et Dinson, 2012). Cette dernière approche, lorsque bien orchestrée, permet d'adapter les programmes d'une façon rigoureuse (Chino et DeBruyn, 2006 ;Dell et al, 2012 ;Grover, 2010 ;McKennitt, 2007 ;Raghupathy et Forth, 2012 ;Whitbeck, Walls et Welch, 2012 ;Moodie, 2010 ;Kumpfer, Pinyuchon, de Melo et Henry, 2008).…”

“…Une autre limite concerne le fait qu'une seule école autochtone ait participé à l'ensemble du processus d'adaptation. Or, la grande hétérogénéité culturelle parmi les Nations (Dell et al, 2012) ainsi que la disparité géographique entre les communautés autochtones (Whitbeck, Walls et Welch, 2012), incitent à procéder à plus petite échelle pour adapter les activités préventives (Moran et Reaman, 2002). Une fois l'adaptation de Système d complétée, il serait toutefois intéressant de valider la pertinence culturelle de ce programme au sein d'autres écoles autochtones, mais aussi d'en étudier les effets, tel que suggéré à la neuvième étape du modèle de Kumpfer et de ses collègues (2008).…”

Representations of Indigenous Peoples and Use of Pain Medication in Canadian News Media

“…According to the literature, there is a severe lack of empirical research on the prevalence of prescription drug use in First Nations communities in Canada (Dell et al, 2012). Studies that do exist show little difference between rates of substance use in First Nations and non-First Nations populations ( Anderson & McEwan, 2000;MacMillan et al, 2008;Wardman & Khan, 2004).…”