Addiction and Harm Reduction


People may be drawn to use substances for many reasons. Alcohol and drug use are symptoms of systemic challenges facing First Nations, such as racism, poverty, and lack of health services – issues that often hide in plain sight.

First Nations people have higher rates of substance use, but the fact is, addiction affects anyone. There are some reasons why:

  • Stress
  • Pain or trauma
  • Desire to try new things
  • To try to find a balance in life

Physical Dependence

Addiction can happen fast.

Drugs target the reward/pain areas of the brain, areas that feel numbness, calmness, reduced pain, and relief. Drugs end up changing the brain to crave more of the substance to feel better, physically and emotionally.

“Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviours that become compulsive and often continue despite harmful consequences. Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.”  (American Society of Addictions Medicine)

Many First Nations find resiliency for their wellness, grounded in culture, language, ceremony and Indigenous Knowledge, supported by nurturing relationships with land, family and community.

Harm Reduction

What Is Harm Reduction?

Harm reduction refers to policies, programs and practices that aim to reduce drug-related harm without requiring people to stop using the substance. Harm reduction strategies aim to reduce drug-related harms not just for the user, but also for families, friends and communities.


Harm reduction is understood as helping people move from self-harm to a level of functioning that promotes wholistic wellness, to minimize negative health, social and legal impacts associated with substance use. It may or may not include total abstinence.

It involves people defining their own treatment goals.

It may include moderating, decreasing or abstaining from substances to reduce risks, improve health and connect people with services.  It may also include ensuring a safe supply of pharmaceutical grade drugs to prevent death and overdose from contaminated drugs

Examples of Harm Reduction Approaches

  • Safe needle distribution/recovery programs
  • Opioid replacement therapies i.e. methadone, Suboxone, sublocade, probuphine or cannabis
  • Supervised consumption sites
  • Outreach and education services to encourage safer behaviour
  • Peer support programs, group meetings, e.g., Alcoholics Anonymous is an example of a successful 24/7 peer support model

Indigenous Knowledge and Harm Reduction

Said by one Indigenous Elder, “Indigenous harm reduction is love.” [1]  Our knowledge and kinship systems teach us that we are in relation to each other, and to everything in Creation. Fear and stigma are not natural ways of interacting in our relationships.  When we seek to learn about the experiences of people who use drugs, we can better find ways to connect and build our strengths toward achieving wellness together.

Indigenous people have survived much and, in many cases, are overcoming challenges imposed by colonialism and other circumstances. Our languages, teachings, and connection to land are cultural strengths. They instruct us in how to remain strong—this includes everyone and may especially benefit people who use substances or seek help for all forms of wellness.

[1] Indigenous harm reduction reducing the harms of colonialism


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