Sixteen years ago, Lori Flinders decided to make a change. Then dependent on alcohol, she devoted herself to recovery — much of which, she says, involved connecting with her identity as an Anishinaabe woman. “I know who I am today. I’m not walking around with a label of alcoholic or drug addict or even recovery person,” Flinders says. “It’s about finding and connecting to my authentic self.”

A member of Couchiching First Nation, Flinders now works for the Fort Frances Tribal Area Health Services as the director of behavioural health services. Her team is rooted in Anishinaabe culture and geared toward helping people “re-member” who they are and “re-write” their stories.

“We’ve done the colonial way since colonization — not because we wanted to, but because we were forced to,” Flinders says. “We’re bringing back to normal what we always had, what we always were.”

In 2013/14, 23 per cent of the population in the Northwestern Health Unit’s area, which covers the Kenora and Rainy River districts, reported heavy drinking, compared to 18 per cent of the provincial population.

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In 2013, the Fort Frances health service was operating a small outpatient treatment program, Flinders says, but it quickly discovered that that wasn’t enough — people needed a residential option to help them through recovery.

“We knew it had to be something different,” Flinders adds. “We needed something uniquely our own that really empowered our traditional methodologies of healing.”

After three years and six proposal rewrites, the health service finally received funding for the Mino Ayaa Ta Win Healing Centre, which opened in December 2017. The centre, a withdrawal-management and residential treatment facility, offers 28-day, co-ed inpatient care primarily for people from 10 southern Treaty 3 First Nations, in addition to Fort Frances and other neighbouring communities. It also provides a variety of services: medically supervised detox, group counselling, Elder support, and land-based programming, such as fishing, snowshoeing, medicine-picking, and hiking.

Flinders says that after clients leave the program, they are able to bring the teachings home with them. “They might not be able to go and sit and do cathartic rage-reduction therapy when they’re out, but they can go out and trap because they learned how to,” she says. “And then carry on our culture and our tradition in a healthy way.”

According to ConnexOntario, which maintains a database of publicly funded addiction, mental-health, and problem-gambling services in the province, Ontario is home to 16 residential addiction-treatment programs geared specifically to Indigenous people. (Sixty-five per cent of the funding for residential services for Indigenous people comes from the federal government, while 26 per cent comes from the Ministry of Health and Long-Term Care; 9 per cent comes from other sources.)

Treatment for Indigenous populations “needs to be in the hands of the communities,” says Colleen Dell, the research chair in one health and wellness at the University of Saskatchewan. “They’re going to approach with treatment that makes sense specific to their communities.”

The Thunderbird Partnership Foundation’s Opioid Information Package, released in 2016, indicates that some First Nations communities in northwestern Ontario have reported a prevalence of prescription-opioid abuse of between 35 and 50 per cent. A significant portion of the population of some First Nations, says Brian Rush, a scientist emeritus at the Centre for Addiction and Mental Health and a professor in the departments of psychiatry and public health sciences at the University of Toronto, is addicted to opioids but has no access to opioid-replacement medications — including methadone — which have been shown to assist in recovery.

Mae Katt, a nurse practitioner in Thunder Bay, has been helping to bring Suboxone, an opioid-replacement medication, and culture- and land-based programming to remote First Nations in northwestern Ontario since September 2011.

In one community, Katt says, people on the Suboxone program went on a canoe trip. “When they came back, you could see this spirit that came alive — how excited they were, how they could change and talk about a common experience,” she says.

In 2013, one year after North Caribou Lake First Nation developed a treatment model involving substitution therapy and culturally appropriate care, police criminal charges fell 61.1 per cent and child-protection cases 58 per cent, while school attendance increased 33 per cent.

Chris Pike, the chayuuweytim (team lead) and a concurrent-disorders counsellor at Anishnawbe Health Toronto, noticed a similarly positive result in one of his clients who was addicted to crack and crystal meth. She started attending a sweat lodge and eventually began volunteering at one.

“She says getting back to her traditions and community got her well,” Pike says. “Yeah, she saw a counsellor like me; yeah, she saw a psychiatrist — one of my colleagues — but she doesn’t credit us with getting her well. What she credits are the ceremonies and communities.”

New experiences can change trauma by pushing the bad memories away, Katt says. “If you look at community members and experience, they’re able to establish a new bond that’s not related to drugs or even community living. It’s more culture, spirit, laughter — that’s a lot of our healing.”