Institute of International Peace Leaders

The harsh reality First Nations reserves are facing while fighting the opioid crisis

Dr. Austin Mardon & Imran Ahmed

The opioid crisis has become an ever growing concern for public health in Ontario, in particular, First Nations communities as well. More than 116 First Nations people lost their lives to opioid overdoses during the first year of the COVID-19 pandemic. This is up approximately 132% from the previous year, according to the news report presented by the chiefs of Ontario, in collaboration with the Ontario Drug Policy Research Network (Manitoulin Expositor). Furthermore, the number of First Nations people that had to utilize hospital care for opioid related poisoning jumped to 816 during the first year of the pandemic, compared to 601 for the year prior (Manitoulin Expositor). According to the same report, while the rates of opioid prescription declined from 2013-2019 for First Nations and non-First Nations people, the rates of opioid use remained higher in First Nations people compared to non-First Nations people (Chiefs of Ontario). The rates of opioid related poisoning has increased amongst First Nations and non-First Nations people in Ontario since 2016, largely due to the growing presence of fentanyl in unregulated drug supply (Chiefs of Ontario). However, the rate of opioid related deaths among First Nations people in 2019 was found to be four times higher than for non-First Nations people (Chiefs of Ontario). The report further sheds light on the fact that it seems that First Nations people aged 44 years or younger are even more impacted by the rising rates of opioids. Thus, reinforcing the notion that additional support and access to services need to be made available to this demographic (Chiefs of Ontario). To further add to the conversation on demographics, opioid use disorder and opioid related harm seem to occur predominantly in men more so in non-First Nations people, compared to First Nations people (Chiefs of Ontario). Thus, both organizations involved in writing this report strongly believe in removing barriers to accessing services focused on supporting First Nations females suffering from opioid use disorder (Chiefs of Ontario).


Both organizations will continue to monitor trends in opioid use in First Nations communities and use them to develop opioid specific programs and services for First Nations people (Chiefs of Ontario). The work planned to implement these changes will include investigating treatment pathways for First Nations individuals that are suffering from opioid use disorder and are beginning Opioid Agonist Therapy, examining the factors and circumstances associated with opioid poisoning deaths, and education on the medical conditions associated with starting an opioid prescription and long-term use of opioids(Chiefs of Ontario).


It is paramount that a community based approach is taken to properly address all that is happening in First Nations communities with respect to the opioid crisis. There needs to be a comprehensive and long-term implementation of programs that are culturally appropriate that incorporates First Nations healing, wellness and aims to place emphasis on the root causes of these substance use disorders (Chiefs of Ontario). Specifically, there is a tremendous need to address the historical trauma experienced by generations of First Nations people. It is the hope that this information will help many readers see how important this issue is for the lives of not just First Nations, but all Ontarians.

About Writers:

Imran Ahmed is a student in the Faculty of Science at McMaster University. Austin Mardon, PhD, CM, FRSC, is an Adjunct Professor in the Faculty of Medicine and Dentistry at the University of Alberta.