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Addiction, Substance Use & Suicide Awareness

Overqualified and Underfunded: The Paradox of Indigenous Addiction Services

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Carol Hopkins-Thunderbird

Carol Hopkins

Chief Executive Officer, Thunderbird Partnership Foundation

In Canada’s Indigenous communities, born out of necessity when other support was unavailable, a powerful framework of evidence-based addiction treatment and culturally relevant intervention has been developed. It’s arguably the best and most successful such system in the country. And yet these efforts remain so chronically underfunded and under supported by the provincial, territorial, and federal governments that their essential mandate becomes nearly impossible to fulfill.

Across Canada, the growing impacts of addiction are being felt in all communities, rural and urban. As the opioid epidemic compounds upon the pre-existing burden of other addictions and mental health conditions, the support infrastructure that keeps Canadians healthy and safe is every day becoming more overwhelmed. In Indigenous communities, particularly, the weight of addiction and mental illness is felt keenly as an additional pressure exacerbating long unresolved issues of colonialism, racism, exclusion, and intergenerational trauma. In this context, properly funded and supported addiction and wellness services in these communities is an absolute necessity.

Addiction, Substance use, and Suicide Awareness - Thunderbird Partnership

First Nations Communities Sidelined in the Midst of Nationwide Addiction Crisis

The Thunderbird Partnership Foundation is a national organization providing support to youth and adult addiction treatment programs in First Nations communities across Canada. With an Indigenous worldview, Thunderbird promotes the use of culture-based practices in concert with the most modern mainstream treatment frameworks to support wellness. In addition to supporting treatment on the ground in these communities, Thunderbird conducts research, engages in knowledge translation, provides training and education, and works with policy-makers to create an environment that encourages real progress. It’s a battle they’ve been waging for a long time, and their victories have come hard fought and well earned.

“The intergenerational trauma in Indigenous communities, from residential schools, from unmarked graves, from a host of other issues, remains unresolved,” says Carol Hopkins, Chief Executive Officer of Thunderbird Partnership Foundation. “For First Nations people in Canada, trauma is not an individual burden, it’s endemic. Loss of land, fragmented connection to culture, and diminishing the connection to our original languages. When people live with this kind of trauma that has not been resolved, when they have not found a way to be able to talk about it or to address it, the data tells us that they are, for example, three times more likely to experience the harms of opioids. Meanwhile, people who need support in our communities are left without equity. The same addiction and mental health services that are available to every other Canadian are not available to a First Nations person.

People who need support in our communities are left without equity. The same addiction and mental health services that are available to every other Canadian are not available to a First Nations person.

The Perennial Blind Spot in Canada’s Progressive Policies

At the United Nations Commission on Narcotic Drugs, Canada is seen as a world leader, but when you look below the surface, that reputation is not being realized in an equitable way. The lack of equity in health services for Indigenous Canadians is tied up in a tangle of funding and jurisdictional division that seems at times almost designed to leave these communities in a dangerous no-man’s-land. Time and again, when trying to find a solution to the health funding gap in Indigenous communities, advocates get directed to the provincial and territorial governments by the federal government, and then back to the federal government by the provinces and territories. Meanwhile, the basic funding formula underlying mental health and addiction programs has not been evaluated or updated in decades, completely failing to keep pace with the changing realities across the country.

“The cost of doing nothing in the face of this will be the continuing rise of overdoses and drug poisoning deaths,” says Hopkins. “It will be the continuation of drug-related gangs coming into our communities from urban areas. It will be our communities seeing more violent deaths, gun-related deaths and stabbings. That is what will happen if we do nothing. Without equitable funding, First Nations do not have capacity to put in place long-term solutions to wellness”


And so, of course, these communities are doing everything. Even as advocates like Thunderbird fight for a reevaluation of outdated funding frameworks that leave First Nations addiction workers earning nearly 45 per cent less than their provincial counterparts, Indigenous communities have been building the infrastructure for world-class treatment programs with the most prestigious accreditation and the most innovative cultural intervention paradigms. This culturally-relevant programming is rooted in the re-establishment of Hope, Belonging, Meaning and Purpose in those who have had these things taken from them. And it works.

Culture as Intervention

“We have developed core competencies for the addictions workforce,” says Hopkins. “We have trained people, we’ve monitored certification, and we’ve updated those core competencies to reflect the current drugs people present with and our understanding around trauma-informed care. The measure of quality and the standards of excellence in our treatment centres exceed what exists in publicly funded addictions treatment programs in mainstream Canada.”

But with salaries in Indigenous communities still so much lower than for similar positions elsewhere in the country, workers are coming to these centres for training and experience, and then being lost to the provincial system. Staff turnover rates at Indigenous treatment centres are as high as 50 per cent, even as the need for these services, and especially stability of services, continues to grow. “How can we keep our skilled workers when they could make the same salary serving hamburgers as what they earn delivering trauma-informed, culturally-based services to First Nations people?” Hopkins asks. It’s their commitment to purposeful and meaningful work, the wellness of First Nations, that keeps the workforce engaged, but they too have families to feed and want to enjoy life with their children.

In this national moment of reconciliation, there is a glimmer of hope that this will be the day when this fight finally begins to get a little bit easier. The Thunderbird Partnership Foundation and its allies have delivered a clear 5-point plan of action to the federal government outlining a path to meaningful change. But even if this country fails these communities once again, the fighters will fight on.

“Even as we continue to live in poverty, we will also continue to survive,” says Hopkins. “First Nations people are the most innovative, resilient, and creative people because they continue to be driven by their passion for the wellness of their people.”

Addiction, Substance use, and Suicide Awareness - Thunderbird Partnership
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