Home » Side Event: Indigenous-led harm reduction interventions

Side Event: Indigenous-led harm reduction interventions

Indigenous-led harm reduction interventions that align with indigenous knowledge and practice.

Sarah Helm: Welcome. We are starting with a traditional He karakia poto, an indigenous non-religious prayer. (Prayer). As an indigenous person, it is an honor being here today representing my country, my foundation and hosting an event on this topic. We are grateful for our supporters – it is a long list: Canada, Australia, Peru, NZ, OHCHR, and many others. It is a shame we are here in this small room at the end of the week, but we are here, Indigenous people, with a common experience regarding drugs, drug harm, and policy. For opening remarks, I hand over to Carlos Antonio Figueroa Henostroza, Executive President of the National Commission for Development and Life without Drugs of Peru.

Mr. Henostrosa, Peru: Good evening, I would like to begin by reiterating the commitment of the Peruvian government against the war on drugs and to the conservation of biodiversity. We are affected by the external pressure of the global demand for cocaine as almost all global cocaine production is from our country. This is a serious threat to the state and people’s enjoyment to fundamental rights, it dangers the environment and vulnerable populations, including indigenous communities. We are among the 10 countries with the (…) biodiversity on the planet. With ancestral knowledge of the regions, biodiversity is a great responsibility for us as it affects sustainable development and opportunities. Peru´s borders, indigenous areas, protected natural areas, buffer zones, and permanent production forests represent 60% of the cultivated areas with a steady upward trend in cultivation. Cocaine cultivation can pose a serious threat to the environment due to the contamination of rivers and soil because of the use of harmful chemicals in production. Trafficking, illegal mining, and illegal lodging are also threatening our flora and fauna. Addressing this is an important element of our national drug strategy for sustainable development. We seek to generate legal income for vulnerable families. The Peru model promotes the presence of the state and a culture of peace, so to strengthen our weak spots that are vulnerable to the drug chain (…) it is vitally important that harm reduction interventions are seen from a cultural perspective, particularly in countries with indigenous communities. Thank you.

Sara Helm: We have been watching the proceedings this week and we thank you for representing the rights of indigenous people as best as you could.

Gilbert Taurua, Te Rau Ora & NZ Drug Foundation: Lovely to see so many like-minded people, though I smile a little as today is the last session. The lack of appreciation of indigenous issues in this significant strategical forum has been shocking. My organization is a Maori-led organization with the majority of employees also coming from Maori communities. We have suffered for too long under social issues, that have led to serious deterioration of Maori health. We did not have drugs and alcohol traditionally. Substances were introduced as a direct result of colonialization. Many of our agreements have been signed while our people have been intoxicated. Of course, there are positive effects of colonization but ultimately we have lost our identity and remain underrepresented. We were colonized by the British and had a number of associated issues then that are alive today as the principles of the treaty remain with us in our societies today. The Drug Laws in New Zealand to align with the International Conventions meant for us another wave of colonization.  Over 60% in jail are indigenous while only 17% of the population comprises us, we are 40% more likely to be convicted, 50% more likely to go to prison, and sadly, 3 times more likely to die.  We are not a big homogenous group; we place a high value on sub-tribes and families. While Harm Reduction as an international movement is not indigenous, Maori approaches to addressing and reducing drug harm overlap with such values and practices: Rahui is a concept to protect nature and is a device for separating people from tapu (taboo) things. Tohunga is an expert person that can guide people and protect them with the use of spiritual forces. Whanau and hapu support are the traditional family structures that were meant to support each individual and the sub-tribe as a whole. Mana is the essential life-force in each person and Manaakitanga is the process of showing respect and care for people and their stories, meeting them where they are ar. We have undergone a significant review of our health system in 2022 because it has not worked for us at all. We have a parallel health authority of NZ and Maori – this is a complete reversal of how things used to run as a result of recognizing how Maori health has been declining. Kaupapa Maori health and addiction services have been evolving in the last two decades and include harm reduction. Some services are advocating for pill testing with the Drug Foundation and are calling for the establishment of an overdose prevention center (consumption room) as well.  We are investing a lot in Maori-to-Maori interventions and work with elders constantly to create new destigmatizing words. We have first nations people looking after their own, for example the Maori Wardens as an intervention date back to the 1860s where local councils implemented this community response to curb the impacts of alcohol on tribesmen. Moreover, trial into the therapeutic benefits of our native psilocybin mushroom, Weraroa, is being driven by Maori to address addiction. The resolve and fortitude of our people are the strength that enables our leaders to stand and pave the pathway forward.

Julia Bareham, University of Saskatchewan: In Canada, we have about 1.8 million indigenous, that is 5% of the population. They share one thing in common – they share ongoing structural violence that is pushing them to the margins of society. It started with the “Indian Act” and the creation of the reservation system that included the deliberate killing of wildlife and sled dogs, forced relocation and the so-called ‘60s scoop. The violation of treaty rights continues today. We have to focus on reducing the harms of colonization, not tethered to the use of substances. Policies and programs that are holistic, decolonizing, innovative, evidence-based, and inclusive are what we need. It has to decolonize, go beyond addressing substance use and associated behaviors; it has to question and analyze the neo-colonial systems as well as structures to center power where it has been systematically removed, in a peer-led, trauma-informed, and reflexive way. We have to recognize that traditional practices have included a lot more diverse population than what we are used to today. These programs therefore need to be indigenized, grounded in local indigenous knowledge, tradition, language, It has to be based in wellness, ie. Salutogenic, and be led by indigenous on all fronts. Programs need to be holistic and wholistic (sic) – create conditions to support mental, physical, emotional and spiritual wellness, provide equitable access to all social determinants of health as per the medicine wheel. Without being explicitly inclusive, innovative and evidence-based, addressing racism, trauma, and all the social determinants of health, we are not being effective. The Indigenous Harm Reduction Principles and Practices are connected to spirituality, holism and the natural environment – for an example, see British Colombia: First Nations Health Authority.

Sara Helm: I am sure many people are recognizing the thread here that colonization is heavily affecting the daily lives of indigenous peoples everywhere. Now I am handing over to Scott Wilson.

Scott Wilson, Aboriginal Drug and Alcohol Council, South Africa: Althoght we are out of sight and out of mind, being shut away in these small rooms, I acknowledge the traditional owners and custodians of the land on which we meet today. I pay my respects to Elders both past, present and emerging …

(video about the Coalition of Peaks)

So, clearly, we are trying to actually embed indigenous people in Australian life. It is quite a large country so some of our priority reforms are formal partnerships and shared decision-making, building the community-controlled sector, transforming government organizations and sharing access to information. I have been working in this field for decades and have to say I am finally starting to see changes. We have national policy partnerships on housing, justice, and many other key issues – we have 17 socio-economic targets and outcomes. All these can be achieved by tomorrow if the government wanted to. For example, Target 10 aims to reduce the rate of Aboriginal and Torres Strait Islander adults held in incarceration by at least 15% by 2031; Target 11 wants to reduce the 10-17 year old population of Aboriginal and Torres Strait Islanders in detention by 30%. In Australia, same as NZ, aboriginal people are 3 times more likely to die from unintentional substance overdose. Under the Close the Gap initiative, 66 million has been committed to AOD services by the commonwealth government. We have similar issues whether we are indigenous Canadians or Australians, as we make up approx. 500 million people which is actually a lot of folk. Policies affect us quite a lot though… disproportionally a lot. I came here in 2008 and 15 years later back again… what changed? I am not the only aboriginal person here, we are three, including one young person. So, thank you International Indigenous Drug Policy Network for your work to include us in the discourse.

Sara Helm: I can sense the emotions of the room listening to these astounding statistics… we are hearing a very clear need for indigenous leadership and indigenous led service provision.

OHCHR: (video presentation in Spanish)

Sarah Helm: So we have heard some of the issues around indigenous use, rights for participation and I would like to be aware of time but I wonder if there are any questions?

NDARC: (…)

Scott: From our perspective, if there is a room, we do keep people with us for a week. Then we still provide them with takeaway foods. If they come back, we try to get them to accept the services… maybe that is something you can look into as well.

Julia: The training of staff on trauma-informed caring is key. A less stimulating, separate space is also an easy response.

Canada: Ask people “what is not working for you” so understanding standard ways of doing things doesn’t work for everyone.

Sarah: I wonder if anyone has any comments about the resolution (L3) ?

Scott: I find it offensive.

Julia: I don’t have anything nice to say. I understand the challenges of some MS who don’t recognize their indigenous, but coming from our countries, it is very frustrating. I am hopeful about progress though.

Gilbert: I hear what you are saying Scott about the progress of the last 15 years… Friday afternoon after a week of CND, sitting here is odd.

Sarah: I was asked by a non-indigenous colleague if harm reduction is a non-indigenous concept, how do we work with people that don’t seem to agree with us in the community?

Gilbert: I would imagine many see the harms of drugs and struggle to have a mature conversation. It is difficult sometimes to toe these lines.

Scott: When I first started, we were a sobriety group but we changed it to harm minimization. It takes time I think. Some indigenous thought when methadone clinics came in that we are just helping them stay on drugs, but you just need to have conversations, really.

Julia: if it is not working for indigenous people, it is not properly designed for them. We are supposed to meet people where they are at. Our western ideas about use don’t work for many communities.

Sarah: Nonindigenous definition of hare reduction is similar to the western idea… often their ideas are quite in line with ours but it is not coming from a top-down way of doing things.

Audience: as someone part of these negotiations, I would like to point out that for Canada it was very useful to have Julia sitting next to me. We didn’t get the resolution we hoped to get but it was helpful in nation-to-nation communications too.

Audience: I suggest to have something like this next year at the high level meeting.

Audience: I second that!

SSDP: Recognition and stock taking is needed, especially of the intergeneration trauma. In times like these, there is a post-colonial hangover. How can we as youth recover indigenous wisdom and integrate into the western standards?

Julia: Take your energy and innovative ideas to push us forward. Find a mentor, engage.

Gilbert: These philosophies of “nothing about us without us” needs to be observed in regards to the whole population. We are aware that young people are very underrepresented. You are a standout, I hope we can welcome you in Australia one day.

Sarah: SSDP’s last session incorporated two indigenous young speakers and we are very happy about that. This is one of the ways. As a closing thought, a short karakia:

Ki runga
Ki raro
Ki roto
Ki waho
Pai Marirw!
No reira, kia ora tatou katoa.

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