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Elle-Máijá Tailfeathers's career is a heady mix of acting, writing and directing.Sweetmoon Photography/NFB

Seven years ago, Esther Tailfeathers, a doctor who lives on the Kainai First Nation in Alberta, witnessed an overdose in a Walmart parking lot that was like none she’d seen before. With a heroin or oxycodone overdose, one or two injections of the medication naloxone usually will revive a patient. But this time, EMTs were administering dose after dose – four, five, six injections – and the patient wasn’t responding. Because this overdose was fentanyl, a drug 50 to 100 times more powerful than morphine.

Almost overnight, fentanyl use mushroomed into a crisis that traditional 12-step programs based on abstinence could not combat. So Esther Tailfeathers and others on the front lines in the Kainai First Nation – the largest reserve in Canada – embarked on an innovative program of harm reduction, which includes supervised doses of the opiate replacement Suboxone. Five years ago, Esther’s daughter, the actor and award-winning filmmaker Elle-Máijá Tailfeathers (The Body Remembers When the World Broke Open), began to record the results on camera.

“I was witnessing this urgent, mass community mobilization, so many people volunteering countless hours to find solutions and save lives,” the younger Tailfeathers said in a recent phone interview. “But I wasn’t seeing this work reflected in the news coverage of my community.”

The resulting documentary, Kímmapiiyipitssini: The Meaning of Empathy, kicks off Toronto’s Rendezvous with Madness Festival on Thursday, and then opens in select cities throughout November, distributed by the National Film Board of Canada.

Kímmapiiyipitssini (GEE-maa-bee-bit-sin) is a Blackfoot word meaning “giving kindness to each other” – an apt metaphor for harm reduction, which aims to treat without judgment people living with addiction or substance-abuse disorders. But how do you make a truthful, raw documentary about harm reduction that doesn’t further harm its vulnerable subjects?

“That was a huge responsibility that I was consistently aware of,” Tailfeathers replies, her voice both calm and musical. “Especially with our teenage participants. I wanted to record marginalized voices who are often left out of the conversation. But I also knew this film will last forever. How will it impact them 10 years down the road? I had to implement the idea of harm reduction into the filmmaking process itself.”

She spent years with her subjects, forging relationships, building trust. She toured harm-reduction programs on Vancouver’s Downtown Eastside, and put herself on camera to keep herself honest. “My subjects held the power,” Tailfeathers says. “If they wanted to end interviews at any time they could. Everyone saw the film before it was finished. It reflects the way I’ve been raised within my community, the deep listening, the respectful engagement and storytelling.” And she includes a personal pain: A year into shooting, she lost a cousin to an overdose.

At a key moment in the documentary, a participant hints to Tailfeathers (the filmmaker) that he might go on Suboxone – if only he could see a doctor. Tailfeathers (the person) doesn’t hesitate: She sends him straight to her mother.

“My values don’t always align with that of conventional documentary filmmaking, having to remain objective behind the camera,” Tailfeathers says. “This is community-based filmmaking. Morally and ethically, the responsibilities of being a community member are more important. Documentary filmmakers from outside our community have the privilege of walking away, and they have blind spots in their understanding of our experience. We navigate things differently.”

That includes choosing not to show overdoses on camera. “Every single member of my community has lost a loved one to overdose,” Tailfeathers says. “I didn’t want to put people through the unnecessary pain of having to witness it.”

She’s much more interested in “trauma-informed storytelling, a movement that’s happening within the Indigenous filmmaking community,” she continues. “Thinking about how we can take care of our audience, who have experienced so many forms of trauma.”

Tailfeathers is currently on screen in a fiction film, too – Danis Goulet’s Night Raiders, which sets the horrors of residential schools in a dystopian future. Working with Goulet, who is a “friend and mentor,” was a joy, Tailfeathers says: “She’s spent years as an activist, challenging Canadian funding institutions to give Indigenous filmmakers rightful access to resources to tell our stories in the right way.” The set was full of laughter, with children always welcome. “It was a consistent reminder that we were telling a story about Indigenous children, who matter so deeply in our community, and our future.”

Members of the Kainai Nation getting naloxone training. Tailfeathers's new documentary Kimmapiiyipitssini: The Meaning of Empathy chronicles the frontlines of harm reduction.NFB

Growing up in Arctic Norway, where her father is from, Tailfeathers and her younger brother wrote and performed skits “to get through the dark winter months,” and spent countless hours in cinemas. At age 19, she enrolled in the Vancouver Film School as an acting student, the only way she imagined she could work in film. “But because I don’t look like a stereotypical Indigenous person, I couldn’t book Indigenous roles,” she says. “Most of which I didn’t even want, because they replicated harmful stereotypes.”

She returned to university to do women, gender and Indigenous studies. For one class, she made a documentary about the representation of Indigenous women in film. “It was terrible,” Tailfeathers says, laughing, “but the process was transformative for me. I suddenly had agency and power, and was able to tell a story that I really cared about.”

Now her career is a heady mix of acting, writing and directing: She co-starred in Jeff Barnaby’s zombie thriller Blood Quantum; in Darlene Naponse’s upcoming film Stellar; and in the upcoming Amazon series Three Pines, based on Louise Penny’s Gamache mysteries. She’s writing her next directorial effort, “a queer love story/environmental thriller” based on a short story, Water, by the Australian Indigenous author Ellen van Neerven.

And she’s working on a podcast, her first, that delves into a family mystery. “I want to keep telling stories that I needed when I was younger,” Tailfeathers says. “Stories that are useful for my community, that excite me and that matter.” She plans to move back to Kainai and help set up a studio there.

Some of the most harrowing scenes in Kímmapiiyipitssini have nothing to do with addiction – they depict the racism that is an everyday fact of life in Kainai. Was Tailfeathers able to feel empathy even for her haters?

“Open hostility toward Indigenous people exists in many places in Canada, but the Prairies has its own distinct brand of racism,” she replied. “It was challenging to contain the anger I feel about the way my people are treated, without having that skew my ability to tell this story.

“It was a challenge,” she repeats. “But I tried to reflect the humility, dignity and respect I see in my community and its leaders. I tried to channel them.”

Kímmapiiyipitssini: The Meaning of Empathy plays at the Rendezvous with Madness Festival in Toronto, both in-person and virtually, starting Friday (workmanarts.com); it opens in select Canadian theatres starting Nov. 5

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