'It's going to take the community': Yukon faces Canada's worst toxic drug death rate

When the doors close at night at the administration office atYukon's Carcross/Tagish First Nation, a van hits the road and drivesthrough the communities to offer naloxone to reverse overdoses, drugtesting kits, food and even a friendly face to help those strugglingbecause of the opioid crisis.

The First Nation's director of health and wellness, StaceyRobinson-Brown, said the new outreach van a common tool in largerCanadian urban centres is run three days a week to get more"boots on the ground" after-hours and connect with people whomight need support in the communities with a population of just over700 people.

"Not all crises happen before 5 p.m.," she said.

Robinson-Brown said they want to meet people where they are andperhaps help pull them back from deep waters to start a healthierlife.

"Even if we could change the lives of some people in terms ofmaybe some of their use, I think that would make a world ofdifference."

While Yukon faces Canada's highest per capita death rate fromillicit drugs, First Nations in the territory say toxic drugs aredisproportionately affecting their people. Two First Nations have declaredstates of emergency as their members overdose and die.

Carcross/Tagish First Nation declared a state of emergency overthe opioid crisis in January 2022, when three citizens died ofoverdoses in the span of six days, Robinson-Brown said. At the sametime, there were a lot of non-fatal overdoses that just "never makethe news."

The Yukon government declared a "substance use healthemergency" not long after, and earlier this year the First Nation of Na-Cho Nyk Dun in Mayo declared its own opioid emergency over asituation that was "terrorizing" citizens and families withviolence, crime, overdoses and death.

Yukon chief coroner Heather Jones reported 25 deaths last yearattributed to toxic substances, 20 of which involved opioids in theterritory of about 43,000 people. On a per capita basis, that rateis worse than in B.C., which had the country's highest death tolllast year with 2,272 suspected illicit drug toxicity deaths.

Of the 20 opioid-related deaths, Jones said 17 happened inWhitehorse, but Robinson-Brown believes that since the coroner onlyrecords where a person is when they die not where they lived those numbers under-represent the amount of people in communitiesoutside Whitehorse who are struggling.

"I'm speculating at this point, but the majority of people whoare struggling with or going through an overdose make their way,either by ambulance, or someone else brings them, to Whitehorsebecause it's the only general hospital close enough," she said.

It's a crisis that can look different in smaller communitiescompared with urban centres, Robinson-Brown said.

Her department of about 25 people offers everything from socialassistance to outreach, justice and other programs to the FirstNation's citizens, a third of whom live on traditional territory.

That means staff often have multiple "different hats" whensomeone asks for help, she said.

On top of that, many families in the small communities areconnected and have known each other their entire lives.

"We've hired several staff who have made comments like, 'Wow, Inever knew these people in this way,' And it's difficult to see thembecause they recall them as being, you know, happy, carefreeyouth," she said.

"So, I think it's really eye-opening when you consider all ofthe family ties and as well as just being in the community and knowing them in a different capacity."

For some, being able to seek help from someone they know makesthe process easier, Robinson-Brown said, while others might bereluctant to share their struggles with someone they have a historywith.

Across the territory, First Nations are overrepresented in theopioid crisis. Of the 25 deaths from toxic drugs reported last year,17or about two-thirds identified as First Nations, Jones said.

The Yukon Bureau of Statistics pegs the territory's overallpopulation as 22.3 per cent Indigenous.

Last week, First Nations from around the territory held marchesand lit sacred fires following the First Nation of Nacho Nyak Dun'semergency declaration and two murders in the community.

Shadelle Chambers, executive director of the Council of YukonFirst Nations, said such vigils are meant to keep the crisis in thepublic eye, show solidarity and allow people to process their griefover everything that has been lost.

She said the territorial emergency declaration which thecouncil pushed for preceded changes including the expansion of andresearch into harm reduction options, the expansion of Whitehorse'ssafe consumption site to include an area for inhaled substances andresearch being done on safe supply.

"This is a very complex issue and so we can't expect onegovernment to be able to do this. It's going to take the community,it's going to take Yukon First Nations, it's going to take alllevels of government to really look at how we can help address thiscrisis and work toward solutions," she said.

The council is near completion of a business case for a proposedYukon First Nations healing centre, she said. It has also sentalmost 300 people to private treatment outside Yukon and is workingwith hundreds of families in programs specifically designed to keeptheir children out of the foster system.

Chambers said a strategy is needed to work with youth andfamilies to prevent trauma and look at issues including problemsaround housing and the cost of living.

"You can't address the opioid crisis without looking at all ofthe other socioeconomic factors."

She said the territory is dealing with some similar opioid use issues as Vancouver's Downtown Eastside, including crime, gangactivity and the victimization of First Nations women, but on asmaller scale.

"We would hope that because it is a smaller jurisdiction, that we would be able to be more nimble and quick to respond to things but this is a complicated issue. I don't believe that there's one quick solution," she said.

Chambers said there needs to be more financial and human resourcesupports both in Whitehorse and communities outside of the capital.

While Whitehorse residents have access to a program offering amedically prescribed safe supply of opioids, they need to beadministered by a pharmacist, which is not an option in ruralcommunities.

"So, how do we look at virtual options? Expansion of thesethings? How do we ensure that there's safe drug testing kits available in each community, not just from 9 to 5? We need tosupport organizations to do more work in the communities," shesaid.

Tracy-Anne McPhee, Yukon's minister of health and socialservices, said the territory's promised substance use health emergency strategy is in its final stages of development and will bereleased "as soon as possible" along with recommendations.

"This substance use health emergency is not going to go awayany time soon. It's certainly not going to go away during mylifetime in this chair," she said.

McPhee said the government is collaborating with each community toidentify their specific needs and tailor its approach accordingly.

The First Nation of Na-Cho Nyk Dun met with government officialsand the RCMP following its emergency declaration.

Since then, Premier Ranj Pillai has written to Na-Cho Nyk Dun Chief Simon Mervynto offer a series of potential supports including making morecouncillors available and development of community-led restorativejustice initiatives.

McPhee said the territory has been working with all communitiesto expand drug testing capabilities including through local healthcentres.

"We've been working tirelessly with Yukon First Nations, withour community partners and other governments to co-ordinate aresponse, to implement the harm reduction strategiesto expandaccess to treatment and recovery services and to increase the publiceducation and awareness about the dangers of substance use," shesaid.

Chambers said she believes the situation will improve, while shealso recognizes that there are systemic issues that First Nationshave faced for generations.

"The solutions might take decades and generations as well, butit's really important that we see these small wins every day andthat keeps us going."