Asked Questions

The opioid and methamphetamine crisis in Canada is described as the worst public health crisis in modern history.

In First Nation communities, the weight of addiction and mental illness is overwhelming.

Without adequate resources to support the mental wellness of First Nations people, they may look for ways to cope through the use of substances that can provide a false sense of relief from the pain of intergenerational trauma (for example, residential schools, disconnection from land, family, and culture through child welfare) and personal traumatic experiences in their life (for example, family violence, sexual abuse, neglect, racism) (FNMWC, 2015 [1]).

People who use drugs are people – people who have the right to health and social supports. Reducing the risk of harms for people who use drugs also reduces the risk of harms to family and community. Here are some frequently asked questions about harm reduction.

Harm reduction strategies save lives. Full stop. By using evidence-based practices to focus on preventing harm, rather than on preventing substance use itself, and a non-judgmental approach to meet people where they are at in their life, without imposing expectations or conditions on them, harm reduction aims to keep people alive.

Indigenous values and ways of knowing and doing guide us to care for each other with kindness, compassion, and acceptance to ensure protection of the sacred breath of life, and to ensure that people who use substances, and their loved ones, can continue to live.

Many First Nations people find resiliency for their wellness grounded in culture, language, ceremony, and Indigenous Knowledge, supported by nurturing relationships with land, family, Elders, Knowledge Keepers and community [2]. The First Nations Mental Wellness Continuum recommends support through a range of client-centred, culturally competent approaches offered in a range of settings such as First Nations communities, treatment centres, and on the land.

Substance use and addiction is a way of coping with life; it is a health issue that must be approached with non-judgmental wellness support. We know that overall well-being comes from a balance of spiritual, emotional, mental and physical wellness. This balance is enriched as we find:

Hope: Belief in the teachings of our ancestors, the Creator gifted us with kindness and compassion, and our unique identity. There is no drug that can erase or take away First Nations identity, the gift of kindness or the value of people. Acceptance opens the possibilities for us to take care of each other and to promote life and wellness.

Belonging: Meet people where they are and offer support, without judgment or stigma, to keep individuals, families, and communities safe. A connection to land ensures a connection to life.

Meaning: Understand that addiction is a chronic disease. Provide access to culture, support for a safe place to rest, eat and to take care of themselves physically. Offer harm reduction programs and services without judgement or stigma to support life.

Purpose: Like other chronic diseases, addiction needs medicine. Drug replacement therapy, or a safe supply of substances, can be used as medication for people to manage their disease to reduce severe withdrawal symptoms and stay alive and find purpose in their lives. [3]

Naloxone/Narcan – to help temporarily reverse the effects of opioid overdose

Condoms – to protect against sexually transmitted infections

Needle exchange services and sterile drug use kits – to reduce the spread of blood borne infections and diseases that can occur when people share needles and other drug gear

Withdrawal management – to promote the quality of life for people who use drugs

Rapid access to addictions medicine (e.g., buprenorphine-naloxone) – to improve access to support for substance withdrawal and wellness

Links to essential resources (e.g., safety, shelter, food, clothing, health care, counselling, etc.) – to support wellness

Outreach activities – to improve connection and support for people who use substances and encourage a sense of belonging

Emergency shelters – to support warmth and a safe place to sleep

Decriminalization of personal possession of drugs – to stop the criminalization and over incarceration of First Nations people and support their right to health and social services

Naloxone (pronounced na-LOX-own) is a fast-acting drug used to temporarily reverse the effects of an opioid overdose. Naloxone can restore breathing within 2 to 5 minutes.

Opioids are a family of drugs that are usually prescribed to relieve pain. Examples include codeine (in Tylenol No. 2, No. 3 and No. 4), oxycodone, morphine, hydromorphone (Dilaudid) and fentanyl. Other medical uses include controlling coughs and diarrhea, and treating addiction to other opioids. [4]

Safe injection sites, also called drug consumption rooms or supervised injection facilities, are safe spaces for people to use illegal drugs under medical supervision. The purpose is to reduce the number of overdose deaths by providing medical supervision, and reduce harms, such as infectious diseases or other medical concerns, to people who use substances by providing a safe place and sterile equipment. The sites also provide referrals to medical programs, treatment programs and essential services.

Crisis support (phone numbers and online resources) are available through a number of programs.

Treatment centres across Canada also provide support and treatment.

The first step is to talk to someone, whether that’s an Elder in your community, a community outreach worker, health care provider or mental wellness worker. They can help you support you, and can help you access different supports and treatment options.

You may wish to ask about different addiction treatment options, including harm reduction, detoxification, counselling, medication, treatment centre programs, and long-term follow-up.

Individuals who remain well-connected to their community through community harm reduction and other supports such as group events (such as gatherings, feasts, Indigenous ceremonies), and through connections to family and the land may be less likely to engage in risky substance use, and therefore face fewer secondary risks.

— Thunderbird Partnership Foundation [5]

Individuals with addiction and/or mental health challenges may need support to best understand how to get access to the support they need. Those who access care options also benefit from strong connections to support networks such as family and community.

 — Thunderbird Partnership Foundation [6]

[1] Thunderbird Partnership Foundation. (2015). First Nations mental wellness continuum. National Native Addictions Partnership Foundation Inc. (

[2] Ibid.

[3] Ibid.

[4] CAMH. (2023). Prescription Opioids. CAMH. (

[5] Thunderbird Partnership Foundation. (2011). Honouring our strengths: A renewed framework to address substance use issues among First Nations Peoples in Canada. National Native Addictions Partnership Foundation Inc. (

[6] Thunderbird Partnership Foundation. (2015). First Nations mental wellness continuum. National Native Addictions Partnership Foundation Inc. (

Together we can work to protect the sacred breath of life and create safer communities, for all.

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