Opioid Crisis: How two land-based programs are helping people heal

Diane Wesley knows what it’s like to reach out for help and not be able to connect with a treatment worker.

As the opioid crisis escalates in Ontario, land-based programs in northeastern Ontario are helping people heal.

In Constance Lake, a seven-day community initiative ran from 2015 to early 2020. Wesley, an Eagle's Earth Treatment Centre administrator in Constance Lake, is now hoping to launch an expanded 28-day treatment program.

On Manitoulin Island, there's a residential land-based treatment program for people aged 19 to 30.

Wesley, a former National Native Alcohol and Drug Abuse Program (NNDAP) worker, took her personal experience going through recovery into consideration when developing the initiative in Constance Lake.

Established in 2015, it was a land-based withdrawal management detox program addressing prescription drug abuse. The initiative, which ran periodically about five times a year, received funding from Health Canada. 

"In the past, I'd walk into an office and a lot of times, I couldn't connect to the worker because they've never been through any trauma in their life or maybe they're fresh out of college with no experience," Wesley said. "So it's hard for some people to connect that way."

Rates of opioid-related deaths, hospitalizations and emergency department visits tend to be higher among First Nations people, according to a report prepared by the Institute for Clinical Evaluative Sciences for Chiefs of Ontario and the Chiefs in Assembly.

The impacts of residential schools, child welfare policies, loss of traditional lands, colonialism and assimilation policies are contributing factors in Indigenous peoples' substance use.

When developing the Constance Lake program, Wesley wanted to ensure clients knew they were not alone and that the team had the understanding, empathy and commitment to help.

“I knew that the root cause to a lot of people’s addictions was the unresolved trauma,” Wesley said, who faced her own trauma in her recovery journey.

“The key to any successful program is providing that trauma-focused care and insight and having that opportunity to start dealing with some of those past traumas moving forward.”

From 2015 to early 2020, more than 300 people aged 14 and older completed the program.

It was a week “crammed” with a lot of healing and programming. The clients would start the day with a sunrise ceremony. They learned about the historical impact on Indigenous peoples and listened to residential school survivors share their testimonies.

There was six staff, including traditional helpers, medicine people and Wesley herself, who worked at the program at the time. “The Famous Six” as Wesley referred to them.

In developing the program, she asked her clients about their experience going through other treatment programs. With time, the program also shifted to meet the needs for chemical dependency.

“I knew that suboxone or methadone does not help with crystal meth, methamphetamine,” Wesley said. “But I think what made our program such a success in this short time is that we were able to use our traditional medicines to ease the withdrawal symptoms of our clients.”

The lack of funding at the beginning to provide extended care has been challenging because the team knew that a week is not enough for most people. The pandemic brought challenges as well.

“When you’re trying to develop grassroots initiative, people are not answering their phones. It’s hard to get the information, you need to pull everything together. Because everybody’s working from home, you may not have the contacts that you would normally have pre-pandemic,” she said.

Another big challenge was the construction phase.

“Things you take for granted, they weren’t coming in or you couldn’t find them at the local hardware store. Contractors were having challenges receiving supplies,” Wesley said.

When communities or individuals put together initiatives, there needs to be more support because one person cannot do such initiatives without a team effort, Wesley said.

“If there’s not that support to back up, that vision coming from a grassroots level, I can see why a lot of those initiatives stop sometimes,” Wesley said.

Looking back, Wesley said the program’s goal was to help strengthen people’s identity because most of them didn’t realize they were suffering from a residential school era or intergenerational trauma.

"I want to be kind of the voice to say it's OK. It's OK to talk about it. It's OK to heal. It's OK to share because that's how we heal," Wesley said. "I did all this for the love of my people ... Love is the most important. That four-letter word is so powerful."

In 2018, the program organizers submitted a funding proposal to add additional treatment, relapse prevention and aftercare services to their withdrawal management program.

It will be a 28-day program offered out of the former Eagle’s Earth conference centre. Wesley said there’s a licensing agreement with Whitepath Consulting to deliver the Red Path program.

With the annual $1.5 million funding from the Ministry of Children, Community and Social Services, the program will be available to clients aged 18 and over.

The centre will run programs six times a year, aiming to provide aftercare and relapse prevention in between the programs. Wesley also hopes to train frontline workers to run aftercare programs in their communities.

“I found the aftercare is the most important and I know many communities don’t have aftercare programs,” Wesley said.

'There's light in their eyes again'

On Manitoulin Island, the success of the Gwekwaadziwin Miikan Youth Mental Health and Addictions Program (Gwek) has led to the creation of a pilot project for adults over 30 years old.

The Gwek program currently has one stream: The Seven Grandfathers, for people aged 19 to 30. Program runners are also advocating for funding for their second, Four Directions, stream for youth aged 13 to 19.

In addition to 10 spaces for those aged 19 to 30 within the treatment, five people over the age of 30 have joined the program for a total of 15 participants.

The pilot project, which will run until spring 2022, was created as there was a need for a program for those aged 30 and over, said executive director Sam Gilchrist. Three additional staff were also hired on a rotational basis.

The Seven Grandfathers program consists of a three-month land-based treatment, live-in aftercare (six months to a year) and community aftercare (six months). 

“We don’t just do things because that’s the way they’ve sort of always been done with mental health and addictions. We really try to have an understanding of what works and what doesn’t,” Gilchrist said.

From his experience, the land-based methods work as land is an “amazing healing tool.” 

“You see folks come into the program and they’re lost, there’s a fog in their eyes. Whereas when you see them three months later, on graduation day, there’s light in their eyes again and they’re ready to move forward,” Gilchrist said.

The program runners are doing their own internal outcome measurement by interviewing participants before admission, during their time in the program and after.

During the first phase of the Seven Grandfathers, participants stay on the land for three months doing individual and group counselling and seasonal outdoor activities. In spring and summer, it includes canoeing, fishing, medicine-picking, or making maple syrup. In fall and winter, it involves setting up traps, snowshoeing, storytelling, crafting and skating.

The second phase provides a supported environment and an opportunity for participants to go out in the community and put into practice some of the things they’ve learned in treatment. It’s not a fit for everyone, but for many people, extra supportive work and aftercare are important and helpful, Gilchrist said.

The third phase helps reintegrate participants into their community. They are offered referrals to community services. During the pandemic, the program organizers also started having alumni Zoom meetings for participants to connect.

Before the pandemic, the program had continuous intake every week as long as there was space for new participants. The completion rate was about 67 per cent.

That rate has increased to 80 per cent since the program moved into cohorts. The change meant people were accepted to the three-month treatment program all at once. They had to be tested for COVID-19, quarantined until the test results were in, stay in the program together and graduate on the same day. 

Since the COVID-19 shutdown was lifted, there’s been a 100 per cent success rate with the live-in aftercare with people finding vocational and educational opportunities, Gilchrist said.

“We really try to look at alternate metrics of success. Some folks that haven’t been sober for more than a day and a few years, if they last a week with us, that’s still some level of success,” he said. “Or they complete two months of the program but they have to go home to deal with some legal issues or someone passed away, then there’s still a level of success from that.”

There was a lot of learning from mistakes and trying to stay flexible and adapt the program as it went along, Gilchrist said adding he doesn’t want to romanticize outdoor programming.

He said that there are many learning obstacles, logistics, equipment gear, and manpower involved to make the program happen.

The program receives combined $2 million annual funding from the Ministry of Health and Long-Term Care and the Ministry of Children, Community and Social Services.

The Gwek program, established in 2018, was created to respond to the epidemic of addictions and mental health issues and fill gaps in mental health services. When Gilchrist was hired in June 2015, he began working with the founder of the Pine River Institute who helped in the program’s early development.

“When you’re out on the land, you don’t have technology with you. You’re removed from those people places and things and triggers. You’re really able to focus on yourself, your identity, who you are and where you’re going,” he said.

To connect with resources, ConnexOntario provides free, confidential and personalized responses 24/7 to people regarding mental health, addiction and problem gambling services in the province. It can be reached at 1-866-531-2600. Good2Talk offers confidential support for post-secondary students in Ontario and Nova Scotia. It can be reached by calling-1-866-925-5454 or text GOOD2TALKON (686868). Kids Help Phone is available 24/7 at 1-800-668-6868.

- This story was supported by a reporting bursary from Journalists for Human Rights and the Solutions Journalism Network and made possible by funding from the McConnell Foundation.