Indigenous perspectives on decriminalization of substances - talking circles in KFL&A region

Title: “Understanding Indigenous perspectives and priorities in the development of a model of decriminalization of substance use: a case study of the Kingston, Frontenac, Lennox & Addington region”

Team: Dr. Amrita Roy (Principal Investigator), Dr. Kathy Pouteau, Dr. Nico Selibio, Susan Stewart, Mireille LaPointe, Fran Chaisson, Lorrie Larock, Curtis Maracle, Constance Carriere-Prill, Penny-Dawn Kernon, Dr. Sophy Chan-Nguyen (Research Associate)

Partner organizations: KFL&A Public Health; Indigenous Health and Wellness Council (formerly Indigenous Health Council); One Roof; Elizabeth Fry Society; Indigenous Interprofessional Primary Care Team; Kingston Native Centre and Language Nest; Queen’s University

Funder: Clinical Teachers’ Association of Queen’s University (Endowed Research Grant, awarded 2024)

Description:

The opioid crisis is a worsening public health issue in Canada, including in the Kingston, Frontenac, Lennox and Addington (KFL&A) region. As part of a comprehensive and evidence-based approach to substance use, there is robust evidence favouring decriminalization of small amounts of substances for personal use. Contrary to misconceptions, decriminalization does not increase substance use; rather, it helps mitigate barriers to seeking life-saving care faced by users of substances, such as stigma and fear of criminal persecution. Coupled with social and health service systems that are responsive to the care needs of users of substances, and public policy that addresses the broader drivers of addictions (including trauma, mental health, and the social determinants of health), decriminalization is an important component of an evidence-based public health approach to substance use.

Due to intergenerational trauma and other ongoing impacts of colonialism, Indigenous peoples in Canada face higher rates of substance use and overdose. Indigenous peoples also face higher rates of correlates of addictions such as mental health concerns and disparities along the social determinants of health. Due to ongoing systemic racism, Indigenous peoples in Canada face higher rates of criminal justice involvement and incarceration, and well-documented barriers to accessing health and social services. A trauma-informed, culturally safe, evidence-based, and comprehensive drug strategy that includes decriminalization is thus especially important for Indigenous peoples, who are arguably disproportionately harmed by a criminalized approach to substance use.

KFL&A Public Health and the Community Drug Strategy Advisory Committee conducted a community consultation in 2023 to synthesize and assess community perspectives on decriminalization, including perceptions on community readiness, perceived benefits and harms, and considerations in decriminalization model development in the region. Given the disproportionate impact on Indigenous peoples of current drug policies, an Indigenous-specific consultation is also warranted to facilitate development of a decriminalization model (and, indeed, a multi-faceted community drug strategy) that is responsive to Indigenous perspectives and priorities. Per the principles of Ownership, Control, Access, and Possession (OCAP) in ethical research with Indigenous communities, such a consultation needs to be Indigenous-led using a participatory, culturally appropriate, and community-engaged approach.

Using a Two-Eyed Seeing research approach that integrates Indigenous talking circles with Western qualitative research methods, this study has the following objectives:

1) To understand the experiences of Indigenous individuals and communities with current drug policies, and associated perspectives on possible impacts (including perceived benefits and perceived harms) of decriminalization. 

[PRODUCT: A framework on Indigenous perspectives on decriminalization.]

2) To understand Indigenous perspectives on social and health service needs in the region to appropriately address substance use among Indigenous individuals and communities. 

[PRODUCT: A framework mapping social and health services and community supports required in the short-term and in the longer term to holistically address substance use in Indigenous peoples.]

We are currently looking for participants! Please see the recruitment poster below: