Community-led Recovery from the Opioid Crisis through Culturally-based Programs and Community-based Data Governance

Abstract

The opioid crisis is disproportionately impacting Indigenous communities in Canada. There is a need to evaluate practical approaches to recovery that include community-based opioid agonist treatment (OAT) and integration of cultural treatment models. Naandwe Miikan, translated as The Healing Path, is an OAT program that blends clinical and Indigenous healing concepts and providers in a community-based setting. Aside from OAT pharmaceutical treatment, clients work with Indigenous counsellors that integrate culture with treatment, such as land-based activities, that reconnect the community to Indigenous teachings and harvesting. In this paper, we present a case study showcasing community advocacy in creating innovative funding models and engaging with clinicians to provide a shared care OAT model with traditional Indigenous counselling, cultural programs, and data sovereignty. Policy needs are identified.

The Healing Path: reconciling the attempt to eliminate Indigenous healing in Canada

“… 2 Recently, a policy framework has emerged with the potential to support a more inclusive approach to health care for Indigenous Canadians who value ceremonies, land-based teachings, identity formation and connection to family and community as part of health and healing. 1 – 3 …”

“…9 Wikwemikong leadership tried again, aiming to create a more durable administrative structure that integrated western and traditional treatment options. 3 , 9…”

“…Wikwemikong assumed ownership of the clinic and committed to maintaining the cost of operations, recognizing the fragility of the previous funding model. 3 Furthermore, the community enhanced case management with a more robust holistic model consisting of clients meeting with Elders, traditional healers and natural helpers (those who assist healers) in land-based activities that included identifying traditional medicines, hunting, fishing and land-based teachings. Program counsellors connected clients with community resources such as education, employment and training.…”

“…2 Recently, a policy framework has emerged with the potential to support a more inclusive approach to health care for Indigen ous Canadians who value ceremonies, land-based teachings, identity formation and connection to family and community as part of health and healing. [1][2][3] Canada's Truth and Reconciliation Commission Call to Action 22, states, "We call upon those who can effect change within the Canadian health care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients." 4 This aligns with the United Nations Declaration on the Rights of Indigenous Peoples, Article 24, 1, which states, Indigenous peoples have the right to their traditional medicines and to maintain their health practices, including the conservation of their vital medicinal plants, animals and minerals … 5 On June 21, 2021, the United Nations Declaration on the Rights of Indigenous Peoples Act received royal assent by the Government of Canada with the expressed commitment to implement the declaration to address "lasting reconciliation, healing and cooperative relations."…”

“…9 Wikwemikong leadership tried again, aiming to create a more durable administrative structure that integrated western and traditional treatment options. 3,9 In 2015, in partnership with a physician and a pharmacist, Wikwemikong leadership exerted self-determination in health care by creating the Naandwe Miikan (translated as the healing path) clinic. 3 This name symbolized a new approach and a new phase for addiction healing in Wikwemikong.…”