ALCOHOL AND DRUG ABUSE AMONG ABORIGINAL PEOPLES: A COPING MECHANISM By: Mirna Concha January 2006 Traditionally, most Aboriginal peoples have perceived a responsibility to “take care of” or to maintain the land that may have been inhabited for thousands of years by their ancestors. That land, together with the plants and animals have historically been the basis for survival and the geography determined their daily behaviours, making a direct link between customs and cultures. Their Circle of Life and Sacred Hoop (Native World) was impacted by colonization (domination, theft of land, imposition of “unnatural” social order, residential schools, destruction of native family systems, slavery, prejudice, stereotyping, racism, etc.). Aboriginal peoples became trapped between two cultures. This “multi-generational trauma” has caused various illnesses of the soul, leading to depression, hopelessness and destructive behaviours such as alcoholism, drug addictions and sexual promiscuity or violence among the native peoples of the world. Their style of life was crashed. Their communities were dislocated, they lost their pride, self-respect, identity, language, spirituality, culture and ability to parent. The root of this damage and these losses are reflected in the statistics that show high levels of family violence, suicide, alcohol and other substance abuse in Aboriginal communities. Who are the Aboriginals? The Aboriginal peoples in Canada embody approximately 50 culturally diverse groups, the roots of which are found in distinct languages and land bases. The Constitution Act defines “Aboriginal” as an inclusive term, referring to First Nations, Inuit and Metis. Aboriginal people refer to themselves by their specific tribal affiliation. First Nations people may also be referred to as Native or “Indian”, although this last term is considered to be offensive to some of them. The government classifies First Nations people according to whether or not they are registered under the Federal Indian Act. 2 “Status Indian” registered numbered 976,305 in 2001 Census. Nevertheless, this data is likely to underestimate the number: some reserves were incompletely enumerated, other were not included in census counts, Aboriginal peoples tend to move more often and make up a significant proportion of homeless people and some may have chose the category “Canadian” rather than specifying Aboriginal ancestry. The chronic undercounting is even more likely because there are a lot of “Non-Status” Indians and also because until 1985 women who married Non-Status men lost their status and benefits. Thousands of aboriginal men also lost their status as a condition of their military enrollment. Thus, the 2001 Census established that the number that acknowledged to be Aboriginal is 3% of the Canadian population and out of them, 70% live off reserve, 62% identify as Indians, 30% as Metis and 4% as Inuit. Census statistics hold that the Aboriginal population of Canada is much younger than the general Canadian population, with an average of 25.5 compared to 35.4 in the general population. Children under 15 account for 38% of all Aboriginal people, compared with 20% of general population. Half of all Aboriginal peoples in Canada are under the age of 24 years. Out of these, 70.9% live off-reserves and 1 out of 5 live in seven of Canada’s 25 metropolitan census areas (Winnipeg, Edmonton, Vancouver, Saskatoon, Toronto, Calgary and Regina). It has also been established that Aboriginal children under the age of 15 are more likely than non-Aboriginal children to live in single parent families (32% vs 16%). In urban areas, over half of Aboriginal children under 15 live in single parent families. The Metis: their ancestry can be traced to the intermarriage of European (mainly French but also Scottish) men and First Nations women in the western provinces during the 17th century. Their traditional homeland was the western prairie, were most of them still live. Nevertheless, there are significant populations in Ontario, British Columbia and the Northwest Territories. It is known that 65% of Metis live in urban areas. They also have a young population: 37.8% are 14 ages or under. 3 The Inuit: also have a strong connection to the land and to the sea. The majority of them live in and around 55 communities in the Arctic and sub-Arctic regions of Canada, most of which are remote and isolated. “Inuk” is a specific Inuit person and the term “Eskimo” (eaters of raw meat) is also considered offensive to some of them. There are now four Inuit regions in Canada: Nunavut, Inuvialuit (western Arctic), Nunavik (northern Quebec), and Nunatsiavut (northern Labrador). Theirs is also a very young population. The birth rate of Inuit women (3.4) is the highest of all Aboriginal populations. Alcoholism and drug use The Canadian Centre on Substance Abuse states that “there is currently little clear information describing substance use problems among Canadian Aboriginal peoples”. Thus, some research has established that most problems in aboriginal communities result from a drinking spree/binge drinking pattern rather than from the effects of sustained excessive consumption. Statistics from the Government of Northwest Territories show that more Inuit are abstinent and those who drink do so less often than non-Inuit. “It is the quantity in binge drinking that results in problems. It is both a learned pattern and a negative coping tool. Most alcohol related personal, social and family problems are the result of this periodic heavy consumption rather than addiction/dependence”, report states. Substance abuse. In 2003, the Canadian Women’s Health Network was alarmed by the increased statistics over the past two decades. Tests report 50% HIV positive compared with only 16% of non-aboriginal women. Within the community, women represent nearly 25% of reported AIDS, while nonaboriginal women account for only 8.2%. The report also shows a large and increasing HIV infections in young aboriginal women between 15 and 29 years of age. Between 1985 and 1995 it was roughly 13%. Statistics show that it increased approximately 37% in 1998 and 45% in 2001. 4 Injection drug use (IDU) is the main mode of HIV transmission, followed by heterosexual contact, sometimes with partner that use injection drugs. In 2002, 64.9% of reported AIDS cases among aboriginal women stated their exposure category as injection drug use, and 30.9% as heterosexual contact. Solvent use: a serious concern The use of solvents for intoxication among children in some communities is a serious concern. In some remote aboriginal communities, gasoline, sniffing, primarily by young people, is said to have contributed to a systematic breakdown of community and family relationships. The 1993 First Nations and Inuit Community Youth Solvent Abuse Survey indicated that users were most often males between 12 and 19 years of age. There are indications that tobacco abuse and injecting drug use are also particular concerns among aboriginal populations, with 1 in 5 aboriginal street youth in seven major Canadian cities reporting they had injected drugs. Suicide, a problem among the youth According to the 1995 Royal Commission on Aboriginal Peoples’ report, the suicide rate is 3 times that of the general Canadian population. After 172 days of public hearing in 92 communities across Canada, commissioners heard that it was one of the most urgent problems. It is estimated that up to 25% of accidental deaths among aboriginal peoples are really unreported suicides. Nevertheless, it is also known that not all communities are affected by suicide. There can be marked differences between provinces, regions and even between communities in the same geographical region. A 1998 study among Status Aboriginals shows that some communities had suicide rates 800 times greater than the national average and that in some others, suicide was virtually unknown. 5 In 1998 Health Canada, First Nations Inuit Health Branch, said that suicide and selfinjury were the leading causes of death for youth and adults up to age 44. In that year, suicide and self-injury accounted for 38% of deaths among youth and 23% of deaths in young adults. Adolescent and young adults were the highest risk. Among aboriginal youth aged 10 to 19 years, the suicide rate was 5 or 6 times higher than among their non-Aboriginal peers. It is in the years between 20 and 29 that both Aboriginal and non-Aboriginal people showed the highest rate of suicide. In Canada’s newest territory, Nunavut, the suicide rate for the years 1993-1997 was 88 per 100,000 compared to 15 for the western arctic and 13 for Canada. The Suicide Prevention Efforts in Aboriginal communities research believes that there are some factors that may explain difference in suicide rate between communities, and states that communities having 3 of the following factors present, experience substantially fewer suicides. 1.- Land Claims (second on line) 2.- Self government (show lowest rate of youth suicide) 3.- Education services (third in predicting low suicide rate) 4.- Police and fire services 5.- Health services 6.- Cultural facilities The Royal Commission also identified as major risk factors: psychobiological (unresolved grief), situational, socio-economic, or culture stress (loss of confidence in the ways of understanding life), increased used of alcohol and drugs to relieve unhappiness. Studies show that in as many as 90% of suicides, victims had alcohol in their blood. Brain damage or paranoid psychosis as a result of the chronic use of solvents is reported as a major factor in suicides by youth. 6 Wellness from within the community Government Health Programs are provided to “status Aboriginals” and “registered” Indians through three governmental structures: the provincial government, the former Medical Service Branch of Health Canada and by the Department of Indian and Northern Affairs. Benefits include pharmaceuticals, medical supplies and equipment dental service, vision care, medical transportation and individual mental health counselling. Nevertheless, First Nation and Inuit Health statistics state that approximately 20% of First Nations communities currently don’t have year round access to health services. It is estimated that nationally 30 to 50% of Aboriginal communities could be described as remote. In most of them there is only a nursing station, physicians and other specialist fly into the community periodically and many services, including rehabilitation, are not commonly available. Communities feel their leaders are more interested in economical development and self government than social problems; events related to suicide create shame and secrecy. Thus, it is well known that best treatments can come from within the communities considering cultural and spiritual revitalization, community bonds, holism, community involvement, control and partnership. The Royal Commission recommended a Canada wide three part response to suicide that is community based. It considers that establishment of direct suicide crisis services, the provision of resources for broad preventive action through the community development and the building of support for self-determination, self-sufficiency, healing and reconciliation. 7 In urban areas most programmes are delivered by different agencies. They include the National Native Alcohol and Drug Abuse Programme (NNADAP), the Brighter Futures programme, solvent abuse programmes and the First Nations Health Information System, the HIV/AIDS programme. In Alberta, for example, the Aboriginal Youth Network is working through Effective Principles to Prevent Substances Abuse Among Youth and suggests: 1.- Build a strong framework (address protective factors, risk factors stand resiliency, seek comprehensiveness, ensure sufficient program duration and intensity). 2.- Strive for accountability (base program on accurate information, set clear an realistic goals, monitor and evaluate the program, address program sustainability). 3.- Understand and involve young people (account for the implications of adolescent, psychosocial development, recognize youth perceptions of substance use, involve youth in program design and implementation). 4.- Create an Effective Process (develop credible messages, combine knowledge and skill development, use interactive group process). Also, the National Native Youth Solvent Addiction Program (NNYSA) Resiliency and Holistic Inhalant Abuse Treatment is working since March 2005 in partnership with the First Nations people and Health Canada. It is a solvent addiction residential treatment program with sites across the country. It emphasizes the inner spirit through traditional Native teachings and holistic healing. Other Health Organizations Health Promotion and Prevention – Information Centre on Aboriginal Health (ICAH) - A Tribe Called Quit: An Online Tobacco Healing Circle - Aboriginal Alcohol and Drug Program (Hamilton, ON) - Aboriginal Alcohol and Drug Workers Program - Aboriginal Drug and Alcohol Program (Fort Francis, ON) - Addictions Counseling Programme (Toronto, ON) - Addictions Treatment Program (Ottawa, ON) - Alcohol and Drug Program (London, ON) - Anishnawbe Health Toronto - Baezhig Wawun Youth Centre (ON) - CAMH Aboriginal Services (ON - Dilico Adult Drug 7 Alcohol Treatment Centre (Thunder Bay, ON) - Drug Addictions & Substance Abuse Awareness Workshop (Toronto, ON) 8 - For Erie Native Friendship Centre (ON) Georgian Bay Native Friendship Centre (Midland, ON) Indian Friendship Centre (Sault Ste. Marie, ON) Mooka am (New Dawn) (Toronto, ON) Ne’Chee Friendship Centre (Kenora, ON) North Bay Indian Friendship Centre (ON) N’Swakamok Friendship Centre (Sudbury, ON) Pinganodin Lodge (ON) Thunder bay Friendship Centre (ON) Timmins Native Friendship Centre (ON) Wabano Counselling Centre (Ottawa, ON) Youth Outreach and Support Youth Program (Toronto, ON) 9 Bibliography Smylie, Janet. “The Sociocultural Context of Aboriginal Peoples in Canada”. A Guide for Health Professionals Working with Aboriginal. SOGC Policy Statement, No. 100, December 2000. Aboriginal Peoples Overview. Canadian Centre on Substance Abuse, updated periodically, available at www.ccsa.ca Accessed on January 18, 2006. Site Hosted by Canadian Centre on Substance Abuse (CCSA). The Relationship in Historical Perspective. Indian and Northern Affairs Canada, Looking Forward Looking Back, available at www.ainc-inac.gc.ca Accessed on January 18, 2006. Site Hosted by Indian and Northern Affairs Canada. In depth: Aboriginal Canadians. CBC News Online, November 26, 2005, available at www.cbc.ca Accessed on January 18, 2006. Suicide Among Canada’s Aboriginal Peoples. Centre for Suicide Prevention, September 2003, available at www.suicideinfo.ca Accessed on January 18, 2006. Site Hosted by Canadian Mental Health Association. Miller Chenir, Nancy. Suicide Among Aboriginal People: Royal Commission Report, February 1995, available at www.parl.gc.ca Accessed on January 18, 2006. Site Hosted by Library of Parliament, Parliamentary Information and Research Service. Tracey Prentice. Alarming rates of HIV/AIDS for Canada’s Aboriginal women. National response long overdue. The Canadian Women’s Health Network, Volume 8, Fall 2005, available at www.cwhn.ca Accessed on January 18, 2006. Site Hosted by Network Magazine. Aboriginal Health Issues, Recommended for Grade 11, available at www.schoolnet.ca Accessed on January 18, 2006. Effective Principles to Prevent Substance Abuse Among Youth, available at www.ayn.ca Accessed on January 18, 2006. Site Hosted by Aboriginal Youth Network (AYN). Addiction and substance abuse, available at www.icah.ca Accessed on January 18, 2006. Site Hosted by Information Centre on Aboriginal Health (ICAH). Dell Colleen Anne. “Resiliency and Holistic Inhalant Abuse Treatment”. Journal of Aboriginal Health, March 2005. Korhonen, Marja. “Alcohol Problems and Approaches: Theories, Evidence and Northern Practice”. National Aboriginal Health Organization, Ottawa, June 2004. 10