The morning of his sister’s funeral, Jonathan Ewenin walked out of Vancouver General Hospital not knowing why he’d slept there.
Rail-thin, dazed and alone, he worried what his sister, Mary Bee, would have thought of him and of how he’d almost missed the chance to say goodbye.
It was Nov. 4, 2016, Ewenin’s 19th birthday. A fentanyl overdose had nearly killed him the night before, Ewenin later learned. His 26-year-old sister died Oct. 22. Her cause of death remains unknown.
Ewenin rushed to St. James Anglican Church in the Downtown Eastside for the funeral service, which was to be based on the West Coast, Cree and Dakota protocols of his family.
When Ewenin arrived for the service, relatives told him it was time: He had to quit meth, to which he’d become addicted earlier that year. He needed to reconnect with his aboriginal culture — drumming, dancing, smudging — or he too would end up dead, warned his older brother, Ian Bee.
CULTURE AS TREATMENT
As Western medicine struggles to stymie the death toll of B.C.’s overdose crisis, some aboriginal people are turning to culture-centred treatment to help them escape deadly addictions, which are claiming lives among First Nations people to a disproportionately high degree.
Last month, Interior chiefs and elders declared a state of emergency because of overdoses in the region. Interior Health data show that 20 per cent of people who visit its emergency departments after a known or suspected opioid overdose identify as First Nations — yet aboriginal people make up less than eight per cent of the health region’s population.
The B.C. Coroners Service is working with B.C.’s First Nations Client File database to find out how many of the 922 people who died of illicit-drug overdose in 2016 were aboriginal, but the information likely won’t be available for several weeks, a spokeswoman said.
“We know that we’ll probably be overrepresented,” said Dr. Evan Adams, chief medical officer for the First Nations Health Authority.
“We don’t have the same advantages as other ethnic groups in the country,” he said. “We’re the poorest of any ethnicity and we know that our colonial history contributes to poor outcomes.”
The FNHA has been distributing take-home naloxone kits to as many aboriginal health workers and communities as possible. About 100 nursing centres on reserves can respond to an overdose, said Adams.
Adams hears often from drug users who want to supplement Western treatments with traditional practices, such as attending ceremonies and using a sweat lodge. The FNHA is “pulling out all the stops” to save lives, he said.
“For us, it means culturally safe services,” he said. “Services that are built for us, maybe that are near our homes — services that recognize we come from very particular experiences and cultures.”
The spiritual side of healing has been neglected by Western medicine, said Colleen Dell, a sociology professor at the University of Saskatchewan.
“In the Western world, we have a very biomedical model,” said Dell, who has researched cultural interventions and addiction.
“Indigenous understandings of health and wellness are about the animals, humans and the environment — the linkage to Creator that leads to everything,” she said.
A powerful component of cultural treatment is how it can reconnect a person with a supportive community, Dell said.
Vancouver’s Downtown Eastside, where the Ministry of Health says 40 per cent of residents are First Nations people, has been devastated by overdose deaths.
Here, the Aboriginal Front Door Society supports community members as they reel in the aftermath of lives lost to opioids and other drugs.
Nora Hanuse, housing navigator for the society, said families come by looking for missing loved ones or to post funeral invitations.
“We’re dealing with a lot of deep trauma in our community,” said vice-president Debbie Krull. “Right now, we’re in survival mode. We’ve had no time to grieve.”
Krull said they help survivors of residential schools, the foster care system and cultural genocide. Some use drugs to self-medicate because of these traumas. The society steers them toward cultural tools to reconnect with the Creator, themselves and each other.
Hanuse said they use the medicine wheel for guidance. For some people, its four colours – red, black, yellow and white – represent four races and their approaches to healing.
“Once the world learns what that medicine was for and gets back down to the basics of it, then we can start healing,” Hanuse said.
EARLY DRUG USE
After both Ewenin’s parents died when he was a toddler, he wound up in the foster-care system. From ages seven to 12 he lived with a family in Aldergrove who encouraged him to dance and drum.
But while living in a group home at 13, he began to use alcohol and cannabis. After he moved in with a family in Langley, his mom there gave him materials for regalia and encouraged his return to dancing. She’s still always there for Ewenin on his “darkest days,” he said.
When he became addicted to meth in 2016, he attended Alcoholics Anonymous and Narcotics Anonymous meetings and stayed at the Young Bears Lodge, a culturally focused recovery program run by the Urban Native Youth Association.
“I was just having a good time, drumming, dancing, learning how to sing,” Ewenin said.
But meth crept back into his life, even after his sister’s funeral. Following a miserable two-week binge, he’d had enough. He walked into a youth meeting at the Aboriginal Front Door Society, sat down and told the group he’d been clean for eight hours. He was done for good, he said.
With support from his community and family, Ewenin has stuck to that pledge. Now, he faces each day “one second at a time,” he said.
Ian Bee said culturally based treatment doesn’t work for everyone, but his brother is proof it can help. Ewenin learned to take what he needed from AA and NA while using cultural practices to stay close to his community and away from the temptation to use, Bee added.
“I’m very proud of him,” he said.
‘SCHOOL THAT’S BURNING DOWN’
At a cafe across from the B.C. Mobile Medical Unit in the Downtown Eastside, parked there to combat a shocking surge in overdoses, Patrick Smith said he attends several memorials each week for locals lost to overdoses.
“Not to sound paternalistic but how I feel, especially on Monday mornings when I come into work, is imagine you’re a principal in a school that’s burning down and you’re counting kids,” said Smith, director of Aboriginal Health Services at PHS Community Services Society.
He wears a T-shirt emblazoned with the slogan that defines his work: “Culture Saves Lives.”
The motto came after he read a report by Mary Ellen Turpel-Lafond, former B.C. representative for children and youth, on Paige, a 19-year-old aboriginal girl living in the Downtown Eastside. Paige died of an overdose in 2013 after years of being shuffled among her addicted mother, family placements and foster homes.
Smith, who also grew up in foster care, was struck by Paige’s story. The only stable time in her life was during a stay at a “culturally active” youth treatment centre, he said.
Smith said he lost his cultural connection decades ago while fighting an opioid addiction but rebuilt it during a stay in 1992 at Armstrong’s Round Lake Treatment Centre, where the philosophy is “Culture Is Treatment.”
He now runs weeknight circles that bring dozens of aboriginal and non-aboriginal people together to share stories of the devastation caused by fentanyl.
Smith takes drug users to sweat lodges, drum-making workshops and “out on the land to connect with who they are,” he said. He believes in the power of songs, dances and traditional food systems kept alive by elders and ceremonial knowledge keepers.
“It’s all medicine that’s been vital in strengthening our spirit to overcome those challenges,” he said.
‘WAKES UP THAT LITTLE BIT OF GOODNESS’
Elder Tom Oleman, who runs the Cwenengitel Aboriginal Society Centre in Surrey, believes healing starts when people “wake up” the cultural medicine of song, dance and ceremony.
On a frosty January morning, he prepared for one of the 48 sweat lodge and pipe ceremonies he’ll run this year, heating up stones and bringing them inside a hut made of willow branches and blankets.
“It allows the person to do physical and spiritual cleansing,” Oleman explained.
Cwenengitel runs a dozen recovery beds and people come from across Canada to use them. About 80 per cent suffer post-traumatic stress disorder, Oleman said.
“We run into a lot of people who have been brought up outside any sense of normalcy, as the larger population sees it. They grew up in a home where people are using and who are desensitized with violence,” he said.
The centre’s spirituality and elder knowledge work in conjunction with treatment programs such as the Creekside Withdrawal Management Centre and Quibble Creek Sobering and Assessment Centre.
“When they ask these so-called higher powers and spiritual entities for clarity, it wakes up that little bit of goodness in every human being,” Oleman said.
But while a mixture of cultural and medical treatment is becoming more available to First Nations communities, chiefs say aboriginal people are still neglected by the heath-care system when it comes to the overdose epidemic.
Grand Chief Stewart Phillip, president of the Union of B.C. Indian Chiefs, said spending on health-care services for aboriginal communities is deficient amid “one of the most deadly crises in the history of all people” in B.C.
“It is a matter of grave concern within our communities,” Phillip said. “I think both levels of government get an ‘F’ in terms of making the type of investments necessary to address this growing crisis.”
Shelda Kastor, secretary of the Western Aboriginal Harm Reduction Society, said fentanyl-overdose deaths have long plagued aboriginal drug users but government didn’t respond to overdose deaths until they became an issue outside the Downtown Eastside.
“It seems that there wasn’t a crisis until the weekend warriors started dying,” Kastor said.
In a statement, the B.C. Ministry of Health said it’s working closely with the First Nations Health Authority on the crisis.
“Aboriginal patients treated within the B.C. health system should expect to be treated in a culturally safe manner,” a ministry spokeswoman said.
“We know that up to 40 per cent of the population of the Downtown Eastside are aboriginal and this is one of the areas, along with other hot spots, that we are targeting with our efforts in dealing with this public health emergency.”
At a recent Tuesday night pow wow in the gymnasium at the Vancouver Aboriginal Friendship Centre, Ian Bee ran through songs with members of his drum group Starchild.
With a naloxone kit hanging from the belt loop of his baggy jeans, Ewenin strolled up to a warm welcome, sat down and began to play.
He sang lyrics written by his brother, a mix of Cree, Dakota and Kwak’wala, his voice cutting through the thundering drumbeat.
Asked afterward how it felt to have survived an overdose, Ewenin couldn’t help but get choked up. A lot of his friends are dead because of fentanyl. That scares him.
“I live for the people that couldn’t make it and are still struggling out there,” Ewenin said.
“It’s scary to think that the life you were given can be taken away so fast.”
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