How did you get involved in harm reduction?
I first got involved in harm reduction when I was living on a reserve on Manitoulin Island and working at a youth centre there doing a lot of health promotion type work. I remember discussing HIV, hepatitis C and safer substance use with the youth – letting them know about not sharing straws to snort and things like that. But my experience in Toronto working with Oahas was what most informed my current work.
My mentor in harm reduction work was LaVerne Monette, who was a Two-Spirit leader and activist who worked at 2-Spirited People of the 1st Nations in their early years and co-founded Oahas. I remember her showing me the Western “Four Pillars” model of harm reduction and telling me that this was not the framework we were going to be working from. She told me that we would be taking a much more holistic approach and really aiming to meet the needs of our community.
What does Indigenous harm reduction mean to you?
There are lots of different perspectives on what Indigenous harm reduction means. To me, Indigenous harm reduction is about reducing the harms of colonialism. It takes a holistic approach, recognizing the importance of our mind, body and spirit, while attending to all the needs of our community and trying to lift our community up. It encompasses Medicine Wheel teachings, our Grandparent teachings and Indigenous teachings of non-interference. It also recognizes that there are many different reasons why people use drugs, and that trauma caused by colonialism can be one of them.
What does Indigenous harm reduction look like in practice to you?
It can involve dismantling systems that cause harm. It can involve providing spaces for safer substance use and distributing harm reduction supplies. It can involve creating safer spaces for us to gather and be connected around our cultural practices. It can also involve providing access to ceremony and to medicines.
The Indigenous Harm Reduction Network started in 2019 when my colleague Les Harper and I applied for a grant to help Indigenous harm reduction service providers and Indigenous people who use drugs in Toronto to gather, be in community and find ways to support each other. But then COVID-19 hit, and I was getting calls from community members in Barrie to say they were responding to multiple overdoses at once in front of their house. Back then they couldn’t get more than one naloxone kit at a time, so I brought naloxone kits from Toronto up to Barrie and started doing outreach there.
We created Indigenous harm reduction kits, which included supplies for safer use as well as cedar tea, which is really important to us as Anishinaabe people. My friend and I gathered cedar by the Nottawasaga River, make cedar tea, and transport it to Toronto so that Les and his team could distribute it to our community members in the city.
We would go on outreach and try to connect with Indigenous community members who use drugs here in Barrie. This was a challenge because Barrie doesn’t have a supervised consumption site and a lot of use happens inside people’s homes. So, we were visiting apartment buildings and people’s houses, as well as doing outreach to encampments. I’d give out cigarettes, cedar tea, harm reduction supplies, sharps bins, food, sleeping bags, coats, mitts – anything and everything that people might need. I would also always have medicines with me in case people wanted to smudge. Eventually people were placing orders with us for what they needed. Indigenous harm reduction isn’t just reserved for Indigenous people. It’s for everyone, so we never denied anyone access to anything because they weren’t Indigenous.
What are some of the challenges you encountered in this work?
I’ve found that stigma around substance use can be a big challenge to bringing harm reduction into smaller communities or onto reserves. There can be a lot of pushback and resistance from residents to implementing harm reduction policies and practices. This makes it challenging for people in some rural or smaller communities to have basic access to harm reduction supplies. Stigma can also lead to isolation for people who use drugs and for people doing harm reduction work. It makes it very hard to be open about drug use, especially for Indigenous women and for Black women. People can be dismissive of our perspectives on harm reduction because they see it as “enabling” drug use, rather than actually saving lives in our community.
Ongoing grief and loss are also major challenges. Our communities are experiencing a tremendous amount of grief and loss, not only from overdose and drug toxicity, but also the grief of our family members dying by suicide, and dealing with food insecurity and a number of other harms. This makes it even harder to rally community support around things like harm reduction, safer supply, decriminalization, supervised consumption sites or support for youth who use drugs.
Another challenge I’ve encountered has to do with service provision between family members. For example, in smaller communities or on reserve, people might not want to access services from people they know well, or from family members who they fear might gossip about them. As a service provider, I’ve run into family members on outreach, which can be a challenge because it’s emotional and you need to be able to process it. But it can also be liberating in a way because you can show your family members how much you really do care about their health and well-being and meeting them where they’re at. Ensuring that there’s always confidentiality is really important for keeping people’s trust.
One thing that has helped to address stigma in the community is creating spaces for discussions and education, where people can learn from each other about what is going on and what is needed. As an example, the Canadian Drug Policy Coalition facilitated their Getting to Tomorrow community public health dialogue in Barrie recently, and I was really happy to see that. It helped to advance the conversation here and made the experiences and needs of people who use drugs more visible. People do use drugs here and we need to make sure supports and services are in place to help them stay safe and alive.
Denise Baldwin is the community engagement and education coordinator, Indigenous focus, for the Canadian Drug Policy Coalition. Denise is a Black-Anishinaabe citizen of the Chippewas of Nawash Unceded First Nation located within Ontario. Denise is from the Turtle Clan. She has over 20 years of experience working on the front lines in prevention, supervision, mentorship, and community service for vulnerable populations, specifically Indigenous people affected by the war on drugs. Denise is dedicated to community building and providing services to diverse communities, both socioeconomically and culturally. Denise is the co-founder and lead administrator of the Indigenous Harm Reduction Network.