Theme: Social Science & Policy Research Year: 2019
Background: Substance use is typically seen by Western society through an individualistic
framework, where current health status results from poor decision-making and lifestyle choices.
However, an Indigenous health determinants framework, which emphasizes structural and
sociocultural impacts on health, especially colonization, better explains Indigenous overrepresentation in substance use and related conditions (e.g., hepatitis C, HIV). Indigenous peoples
have historically used land-based retreats for wholistic wellness. More recently, these are being
explored for their effectiveness in restoring connections and promoting healing in the context of
substance use.
Methods: A land- and culture-based retreat which included the Medicine Wheel Spirit Shadow
Dance (MWSSD) – a wholistic, strengths-based approach developed by people living with HIV, many
of whom had a history of substance use, to promote self-exploration and healing based on medicine
wheel teachings – along with post-retreat activities, was designed as a healing intervention with
contextualization by Knowledge Holders for their specific communities. This was piloted in two sites
– a First Nation community in Saskatchewan and an urban Indigenous community in British
Columbia. A Two-eyed Seeing multi-pronged evaluation included qualitative analysis of intra- and
post-retreat sharing circles, self-reflexivity, and an innovative First Nation self-assessment tool.
Results: Findings identified elements of land- and culture-based healing effective at restoring and
promoting wellness for Indigenous people who use drugs. The MWSSD provides a shame-free space
for sharing of and both individual and collective learning from deeply personal narratives.
Conclusion: Culture and ceremony offer a promising path towards wholistic wellness for Indigenous
persons and communities impacted by HCV, HIV and substance use. Yet, despite the demonstrated
need for land-based cultural practices, these programs face many challenges regarding funding and
acceptance by policy-makers. Given the extent of health inequities faced by Indigenous
communities, it is imperative that these gaps in research and services be amended as soon as
possible.
Disclosure of Interest Statement: This project was supported with research grants awarded by the
Canadian Institute of Health Research.