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“Indigenous harm reduction means reducing the harms of colonialism.”- Rawiri Evans, Maori Educator

Mainstream harm reduction practices such as needle exchange programs, naloxone distribution and opioid substitution therapies have been established as a main approach in the prevention of HIV, hepatitis C, and overdoses. While these approaches are lifesaving, they are not enough to make a meaningful difference within Indigenous communities. Mainstream harm reduction models focus too narrowly on substance using behaviours, neglecting the broader social and system-wide issues that contribute to and intersect with substance use for Indigenous peoples in the first place. For Indigenous communities, harm reduction = reducing the harms of colonization. It is inclusive of, but much broader than, a focus on using substances or safer sex. Indigenous harm reduction is a way of life, rooted in Indigenous Knowledges and worldviews, combined with the best of what the Western world can offer, and focused on mitigating the living legacy of colonization. Among Indigenous communities however, harm reduction can be contentious and contested. If Indigenous approaches to harm reduction are to be successful, communities and community leaders must find ways to engage in conversations informed by evidence and understanding to facilitate inclusion of all Indigenous people in ceremony, programs and community life.

With funding from the Public Health Agency of Canada (PHAC) and guided by a national Advisory Committee the Canadian Aboriginal AIDS Network (CAAN), in partnership with ICAD, developed a series of resources outlining Indigenous approaches to harm reduction.

Policy Brief and Promising Practices in Indigenous Harm Reduction

Indigenous Harm Reduction = Reducing the Harms of Colonialism: A policy brief

This policy brief outlines Indigenous approaches to harm reduction with recommendations for governments and organizations to use to incorporate Indigenous approaches to harm reduction in their on-going and future efforts to support the self-defined, self-determined, and distinctions-based health and wellness of First Nations, Inuit and Métis.


Promising Practices:

13 Moons Harm Reduction

13 Moons was informed by the Native Youth Sexual Health Network’s Four Fire Model of Harm Reduction. They include cultural safety, reclamation, self-determination and sovereignty. The program is operationalized under the leadership of Indigenous youth, service providers and organizational leaders through six related program
activities across various organizations, community groups, and helpers or volunteers.


Culture Saves Lives

Culture Saves Lives provides opportunity and space for community members, especially First Nations people who have been oppressed by colonization, such as survivors of residential schools or the foster care system, to rediscover and celebrate their roots. It also provides awareness and education to mainstream service providers of the power, beauty, and enduring strength of First Nations traditions and ceremonies.


Mamisarvik Healing Centre

The residential treatment program began in 2003, with a 12-bed treatment centre and as a 10-bed transition house to meet the overwhelming need of Inuit in crisis. Since then, over 500 people have participated in the residential treatment program and accessed a wide range of Tungasuvvingat Inuit’s comprehensive wrap around services. The program is offered in both English and Inuktitut for women and men aged 18 years and older. It was recognized throughout the country as an early leader in the movement toward trauma-informed recovery through cultural healing and wellness.


Sturgeon Lake Traditional Health Program

In 1995, the Sturgeon Lake First Nation took control of its community health services. The Health Transfer Agreement provided a pathway for Sturgeon Lake to develop its own community health model that would integrate Western health services with traditional Nehiyawak (Cree) whole-of-person health and wellness practices. The Elders recognized, however, that revitalizing traditional Nehiyawak teachings, philosophy and healing practices, was a process that would unfold over time and in many phases and stages.