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opioid crisis

First Nations people in British Columbia are five times more likely to experience a drug overdose – and three times more likely to die from one – than non-First Nations people, according to a new report providing the first empirical look at how the overdose crisis is affecting Indigenous communities.

First Nations people, who make up 3.4 per cent of B.C.'s population, account for 14 per cent of all overdoses and 10 per cent of overdose deaths, the report found. First Nations women are particularly hard hit, experiencing eight times more overdoses – and five times more fatal overdoses – than non-First Nations women.

The report, released by B.C.'s First Nations Health Authority (FNHA), provides another window into how the opioid crisis is unfolding across Canada and exactly who is being affected as provincial governments and local health authorities, sometimes operating with limited data, struggle to contain it.

The FNHA identified 1,903 overdoses – fatal and non-fatal – involving First Nations people from Jan. 1, 2015, to Nov. 30, 2016; and 60 fatal overdoses from Jan. 1, 2015, to July 31, 2016. It released its findings on Thursday, after some First Nations leaders raised concerns that they have no data on how the overdose crisis is affecting their communities.

"We recognize the root cause of where we are today," FNHA deputy chief medical health officer Shannon McDonald said, "and that root cause rests in colonization, displacement, connection that has been broken."

The report also cites intergenerational trauma and systemic and institutional racism toward First Nations people as possible reasons for substance use.

First Nations Health Council chair Grand Chief Doug Kelly noted the overdose crisis is not the first to devastate Indigenous communities, citing alcoholism and suicides as other examples.

"All of those issues have similar causes: It's unresolved trauma, unresolved grief," he said. "My respected elders have taught me that sometimes physical pain is actually a spiritual pain. Sometimes, a physical pain has a mental cause or an emotional cause. So when we begin to confront those challenges, we need to make sure that we're responding with the appropriate care."

According to the report, women make up 48 per cent of those who experienced an overdose among the First Nations population, compared with 29 per cent of non-First Nations people.

Dr. McDonald said while there isn't one reason First Nations women are so disproportionately affected, "we know that many of our women have been traumatized.

"We know that there are unspeakable experiences that young girls and women are having, that – in poverty, and with trauma – people may end up in lifestyles that put them at significant risk."

The report noted that First Nations people are more likely to access care when it is "appropriate to their wellness beliefs, goals and needs," and noted the need for culturally appropriate health and social services. Traditional healing practices, such as the use of traditional medicines, "are an important part of First Nations health but not currently well integrated within the broader health system," the report said.

The data come from the B.C. Coroners Service, Drug and Poison Information Centre, BC Emergency Health Services/Ambulance Service and emergency-department visits, and are linked to B.C.'s First Nations Client File. This means the figures include only those who are registered with Indian status – and not all First Nations people – in B.C.

Lisa Lapointe, B.C.'s chief coroner, said the province began collecting this data in June, 2016, after a few years of discussions with the FNHA.

"Prior to that, there were some sensitivities: Do you ask people their ethnicity when you're responding to a call, and will that offend people?" Ms. Lapointe said. "But in co-operation with the FNHA, of course, they were asking us to collect that data."

With every reported death, the coroner now must ask whether the person identified as Indigenous, and if so, whether they identify as First Nations, Inuit or Métis, Ms. Lapointe said.

The provincial government declared a public-health emergency last year, when 967 people died of illicit-drug overdoses. Statistics from the B.C. Coroners Service suggest the death toll could surpass 1,500 this year.

Updated statistics on general overdose rates in B.C. are expected to be released on Friday.