Honouring the legacy, creating new pathways: advancing Indigenous harm reduction through a culturally safe program
Date
2025
Authors
Cleaver, Keshia
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Abstract
Since 2016, British Columbia’s toxic drug public health emergency has claimed more than 16,000 lives, hitting First Nations communities hardest: mortality rates are up to seven times higher than among other residents. These deaths stem from colonial harms - Indian Residential Schools, the Sixties Scoop, punitive drug laws - that fractured families, suppressed culture, and reshaped the social determinants of Indigenous peoples' health. To address this crisis, the First Nations Health Authority (FNHA) launched Not Just Naloxone (NJN) in 2017, a three-day, in-person train-the-trainer workshop delivering Indigenous-led harm-reduction education. Demand soon outpaced capacity, and the length and emotional weight of the sessions led to delivery challenges, limiting both capacity and reach. This project converted NJN into a self-paced online course rooted in Indigenous ways of learning yet accessible to remote and time-pressed learners. Course development drew on an integrative literature review, monthly meetings with youth and adult peers, Elder guidance, and modular design that blends digital storytelling with flexible activities. Regional consultations and an in-person peer review further refined content. The completed course offers eight interactive modules grounded in culture-based knowing, trauma-informed practice, and BC First Nations narratives. Elders’ prayers open and close the learning journey, and digital stories highlight Indigenous harm reduction and decolonized substance-use care. Early feedback shows the platform supports relational, story-based learning when directed by knowledge keepers and lived experience. Ongoing success will require regular updates, fair compensation for peers, and strategies to dismantle stigma and anti-Indigenous racism.
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Keywords
Indigenous, First Nations, harm reduction, toxic drug public health emergency, British Columbia, Not Just Naloxone, substance use, cultural safety, decolonize, racism, prohibition