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Addressing the health needs of individuals in remote and rural Indigenous communities, as well as Indigenous people living in urban areas, requires a shift from Western-centric solutions. To emphasize the diversity of Indigenous Peoples, tailored and culturally-relevant approaches are crucial. This can include mobilizing peer and family support, recognizing the significance of culture, Elders, spirituality, and building community capacity through sustainable funding of Indigenous-led programs.

In this episode, award-winning journalist David P. Ball and family physician Dr. Esther Tailfeathers discuss the realities of substance use care in Kainai Nation, a rural community where Dr. Tailfeathers works. We also hear from Helen Knott, award-winning author and founder of Indigenous wellness program Fierce With Heart, about her own healing journey and relationships to substance use, the land, and health care systems.


Learning Objectives

  1. Identify gaps in the continuum of substance use care within rural and remote Indigenous communities, recognizing that the burden to close these gaps falls disproportionately on Indigenous people.
  2. Discuss the importance of “the language of healing” and using strengths-based narratives to facilitate safe spaces for healing from substance use.
  3. Understand that healing is often not a linear process. Discuss ways to empower your clients in their healing journeys, recognizing any challenges or setbacks they encounter.


In this episode, you’ll hear:

  • 1:48 – Dr. Esther Tailfeathers, Co-host – Family Physician, Kainai Nation Blood Reserve
  • 8:08 – Helen Knott, Guest – Author, Facilitator, and Educator, Fierce With Heart

Clinical Pearls

Here’s what listeners can take away from this episode:

  1. Healing from a substance use disorder requires the courage to be vulnerable. As a clinician, it is important to reflect on the power differentials between yourself and your clients and take time to understand where your client is coming from on their healing journey.
  2. In rural and remote communities, individuals with substance use disorders often have to travel outside of their community to receive specialized care. Even when harm reduction, treatment, and mental health services are accessible to a community or individual, it is important to recognize additional barriers to receiving care, including biases against Indigenous people within those institutions.
  3. Every community has unique strengths and resources that can help people on their substance use healing journey. From support circles, to beading groups, to all the grandmothers and mothers and aunts and uncles and fathers and grandfathers who love their family- and community members, connectedness is an important part of healing. To learn more about what social supports and programs are available near your practice, start by looking up the nearest Friendship Centre or contacting the local First Nation/Community.


Indigenous programs and resources


Indigenous films and podcasts on related topics


Credits: Art and music

Episode cover art by Nevada Lynn entitled “Nch’kay”.

Nevada Lynn is a Red River Métis digital artist studying Visual Art with a focus on printmaking at ECUAD. She lives on the shared, unceded territory of the Skwxwú7mesh Nation and the Lilwat7úl Nation and leverages her creative practice to work in the realms of social justice, climate justice and water protection.

Music by Justin Delorme/Chippewa Travellers (“Determination”), Handsome Tiger/Chippewa Travellers (“Healing” and “SummerBlues”), and Mimi O’Bonsawin (“NewDay”). Available on Nagamo Publishing. Licensed by Nagamo Publishing Inc.