Question Period Note: Mental health and substance use

Our Government recognizes that substance use can have devastating effects on individuals, families and communities and their general health and well-being.
We are currently investing $425 million annually for community-based services to address the mental wellness needs of First Nations and Inuit.
This includes a recent investment of $200 million over five years to support substance use and prevention and treatment services for First Nations and Inuit.
We remain focused on supporting long-term investments that improve the health and well-being of Indigenous peoples.

Indigenous communities across Canada are disproportionately impacted by the opioid public health crisis and in particular, First Nations in British Columbia, Alberta and Ontario. The Assembly of First Nations has reported that some First Nations communities are experiencing an epidemic, with as many as 43% to 85% of the communities’ population addicted to opiates (Assembly of First Nations Resolution no. 82/2016 and no. 68/2017). In spring 2017, the Department of Indigenous Services Canada started to track suspected opioid overdoses in 153 participating First Nations communities. The Department continues to work with partners from across the country to improve data collection and reporting, and to better understand how this crisis is affecting different populations

The Government of Canada has announced significant financial investments to help address the crisis. Budget 2018 is providing $200 million over five years (2018/19 to 2022-23) and $40 million per year ongoing to support new investments in substance use prevention and treatment services for First Nations and Inuit including funding to address the ongoing opioid crisis. The investment will support up to: an additional 25 opioid agonist therapy sites offering wraparound services; an additional 75 on the land activities; enhanced services across a network of 45 federally funded treatment centres; and, major renovations at over 20 of these centres. Indigenous Services Canada allocated this fiscal year over $425 million towards culturally relevant and community-based mental wellness supports for First Nations and Inuit that aim to: provide treatment, reduce risk factors, promote protective factors and improve health outcomes associated with mental wellness.

Indigenous Services Canada’s Non-Insured Health Benefits Program for registered First Nations and recognized Inuit provides several services along the drug misuse continuum. Services include:
• Coverage for both methadone and buprenorphine/naloxone (i.e. Suboxone and generics) for the treatment of opioid use disorder;
• Injection based and nasal spray naloxone to prevent overdoses. In facilities where ISC provides primary care services in First Nations communities, naloxone hydrochloride injection is available for administration by health care professionals to reverse the effects of the overdose. There is also a limited supply of Narcan nasal spray in Nursing Stations that is available to community members at no charge. Naloxone is listed in the Branch’s Nursing Station Formulary as a “must stock” medication. To promote client safety, clients receiving these treatments are enrolled in the Client Safety Program, formerly known as the Prescription Monitoring Program. Prior to reimbursing for buprenorphine/naloxone, the Non-Insured Health Benefits Program confirms that the community has infrastructure for the safe storage and handling of the medication;
• Transportation for clients to access supervised treatments may be provided for up to six months in order to allow stabilization for carries (i.e., where the patient takes doses home) or alternate arrangements to be made. Extensions with justification may be considered; and
• Coverage for mental health counseling for up to 22 hours of counseling on a fee-for-service basis.

Tracking of Opioid Use

Our Government recognizes that the opioid crisis continues to have devastating impacts on Indigenous communities nationally, and that quality data is an important part of a comprehensive approach to drug control.
I know that there are significant data limitations on how First Nations and Inuit are affected by this crisis and we are working with partners to overcome these limitations.
We will continue to work with First Nations and Inuit, provincial and territorial partners to explore ways to collectively address opioid-related issues.

Blood Tribe

Our Government remains concerned by the opioid overdoses in Blood Tribe.
In Blood Tribe, our Government has provided funding for the provision of naloxone and mental health supports, contributed to the on-reserve Overdose Prevention Site, and provided funding for additional youth beds in the Safe Withdrawal Management Site.
We will continue to monitor the impact of the opioid crisis, and support community driven approaches such as on-reserve harm reduction efforts while working closely with the Nation and partners.

If pressed on Blood Tribe

Our Government is deeply concerned by the news about ongoing opioid overdoses in Blood Tribe.
We are continuing to support Blood Tribe in their approach to address this crisis. Naloxone kits are available and we are working across Governments to minimize the impact.
Six mental wellness teams operating in communities in Alberta are available to respond to crises as they emerge.
We will continue to stay in touch with the community to ensure necessary supports are in place.

Montreal Lake Cree

We remain concerned by reports of substance misuse reported by the Montreal Lake Cree Nation.
The community is leading a comprehensive, culturally grounded approach to address the harms of crystal meth that includes prevention and awareness, suicide assessments, 24/7 Crisis Response Teams, and land-based Treatment programs.
The Little Red Healing Lodge was also recently opened in the community and a five-year Strategy was developed.
We continue to support the community’s efforts for long-term solutions for the health and healing of community members.

If pressed on North Spirit Lake

Our Government remains concerned by instances of substance misuse reported by North Spirit Lake and recognizes the devastating impacts this can have on community members.
An opioid addiction program which includes aftercare, counseling and education was launched in the community in November this year (2019). We are also working alongside partners to ensure access to other substance misuse programs and mental health counselors.
An additional nurse was sent to the community to provide support to the addictions program, primary health care nursing services, and emergency and urgent care.