S1 Ep6: Indigenous perspectives on health and wellness, substance use, and harm reduction

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Summary

Nearly five British Columbians are dying every day of an overdose, but Indigneous peoples in our region face disproportionate harms: If you’re Indigenous, you are four times more likely to die of an overdose than the rest of the population

In this episode, family physician and addiction medicine specialist Dr. Robert Fox and journalist David Ball discuss why clinicians should be mindful of the disproportionate impact of overdose crisis on Indigenous peoples, and best practices to address the disparity.
 

Lineup

In this episode, you’ll hear:

• 3:19 – Oh Po Kwa Nee, also known as Claudette Cardinal – Community investigator with Canadian Observational Cohort Collaboration (CANOC)
• 11:36 – Dr. Terri Aldred – Primary care physician, Carrier Sekani Family Services

 
Pearls

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

1. It is important to practice cultural safety. Cultural safety is an approach to health care delivery that emphasizes awareness and introspection on the part of the clinician.
2. It is important to realize that Indigenous peoples continue to have considerably less access to determinants of good health because Canada was purposefully structured this way. The cultural safety approach requires a clinician to be aware of this inequality and how power differences led to it, and how power differences perpetuate it.
3. Culturally competent care results in a better experience for both patient, providers, and organizations. Cultural competency does not refer to learning details about cultures other than our own, it refers to everything that is needed for health care to be effectively delivered in cross cultural situations.

 
Resources

Organizations

• CANOC
• First Nations Health Authority (FNHA)

Online learning

• BC ECHO on Substance Use (Online, interactive sessions delivered via Zoom with didactic and case-based portions; currently offering an Opioid Use Disorder series and Alcohol Use Disorder series)
• BCCSU’s Provincial Opioid Addiction Treatment Support Program (Online, self-paced, free)
• BCCSU’s Addiction Care and Treatment Online Certificate (Online, self-paced, free)

Guidance

• BC Centre on Substance Use. A Guideline for the Clinical Management of Opioid Use Disorder [Internet]. 2017.
• BC Centre on Substance Use. A Guideline for the Clinical Management of Opioid Use Disorder — Youth Supplement [Internet]. 2018.
• BC Centre on Substance Use. A Guideline for the Clinical Management of Opioid Use Disorder—Pregnancy Supplement [Internet]. 2018.

Additional resources

• “They treated me like crap and I know it was because I was Native”: The healthcare experiences of Aboriginal peoples living in Vancouver’s inner city. [Internet]. Social Science & Medicine [2017].
• “First Nations in BC and the Overdose Crisis.” [Internet] First Nations Health Authority (FNHA) [2020]
• BC Centre on Substance Use. Opioids: A survivor’s guide [Internet]. Vancouver (BC): BCCSU [2019].
• 24/7 Addiction Medicine Clinician Support Line provides telephone consultation around the clock to health personnel who are involved in addiction and substance use care and treatment in BC
• The Rapid Access to Consultative Expertise (RACE) line is available to provide specialist clinical advice Monday to Friday between 8am and 5pm Pacific time

 

Banner photo by Jason Hargrove from Flickr