Abstract
The number of opioid-related deaths in Ontario is rising, and remote First Nations communities face unique challenges in providing treatment for opioid use disorder. Geographic barriers and resource shortages limit access to opioid agonist therapy, such as buprenorphine or methadone. However, attempts to rapidly expand access have the potential to overlook community consultation. Our experience in Moose Factory, Ontario, offers insight into the ethical questions and challenges that can arise when implementing opioid agonist therapy in Northern Ontario and provides an example of how a community working group can strengthen relationships and create a culturally relevant program. We call on medical regulators and the provincial and federal governments to invest in community-based opioid dependence treatment programs that incorporate cultural and land-based healing strategies and draw on First Nations teachings.
Résumé
Le nombre de décès liés aux opioïdes est en hausse en Ontario, et les communautés éloignées des Premières Nations font face à des difficultés uniques pour traiter les troubles de consommation d’opioïdes. Les obstacles géographiques et la rareté des ressources limitent l’accès au traitement par agonistes opioïdes comme la buprénorphine ou la méthadone. Les tentatives d’élargissement rapide de l’accès risquent toutefois de passer outre aux consultations communautaires. Notre expérience à Moose Factory (Ontario) nous a donné un aperçu des questions éthiques et des difficultés qui peuvent se poser durant la mise en œuvre du traitement par agonistes opioïdes dans le Nord de l’Ontario et nous a montré qu’un groupe de travail communautaire peut renforcer les relations et créer un programme culturellement approprié. Nous invitons les organismes de réglementation de la médecine et les gouvernements fédéral et provinciaux à investir dans les programmes communautaires de traitement de la dépendance aux opioïdes qui intègrent des stratégies de guérison fondées sur la culture et le territoire et qui puisent dans les enseignements des Premières Nations.
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Acknowledgements
We would like to thank members of the Opioid Dependence Treatment Program Working Group for their important contributions to the program.
We would also like to acknowledge and express gratitude for leadership from the Moose Cree First Nation and MoCreebec Eeyoud Council, support from the Weeneebayko Area Health Authority, and guidance from those with personal or family lived experience.
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Dorman, K., Biedermann, B., Linklater, C. et al. Community strengths in addressing opioid use in Northeastern Ontario. Can J Public Health 109, 219–222 (2018). https://doi.org/10.17269/s41997-018-0055-4
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DOI: https://doi.org/10.17269/s41997-018-0055-4