A billboard reads "Naloxone Saves Lives." Image: "Kímmapiiyipitssini: The Meaning of Empathy"/National Film Board.
Credit: "Kímmapiiyipitssini: The Meaning of Empathy" / National Film Board

The Kainai community in Southern Alberta is home to the Blackfoot Confederacy. Located on Treaty 7 land, the largest reserve in Canada has three main communities: Standoff, Levern and Moses Lake. Seven years ago, Kainai found itself facing a fentanyl crisis of epic proportions.  

Initially, community leaders and addiction specialists relied on abstinence-based treatment models. These widely accepted colonial treatment models not only failed, but revealed the inhumane and unrealistic aspects of these programs. In an attempt to prevent more drug poisoning deaths, the community initiated a variety of radically different harm reduction practices.

Filmmaker Elle-Máijá Tailfeathers documents an intimate portrait of her community in her film Kímmapiiyitssini: The Meaning of Empathy. Tailfeathers invites viewers to witness the inspiring changes brought about through the combined efforts of community members with substance-use disorder, first responders and medical professionals as they implement life-changing harm reduction practices.

Kímmapiiyitssini [GEE-maa-bee-bit-sin], the Blackfoot word for, “Giving kindness to each other,” is key in reducing deaths from drug poisoning in Kainai and perhaps right across Turtle Island.

The main drugs of choice are alcohol or alcohol substitutes like mouth wash, rubbing alcohol or cough syrup and the synthetic opioids fentanyl and carfentanyl. Fentanyl is fifty to one hundred times more potent than morphine while carfentanyl is one hundred times more potent than fentanyl and ten thousand times more potent than morphine.

Dr. Esther Tailfeathers, Tailfeathers’s mother, is a frontline witness to the crisis and one of four physicians working at the Kainai Wellness Centre in Standoff. A second smaller health clinic is located in Levern.

In order to improve outcomes for those addicted to alcohol and synthetic opioids, a group of health-care workers, including Dr. Tailfeathers, traveled to Vancouver’s downtown Eastside. Once there, they learned about addiction and effective harm reduction methods from knowledgeable advocates. At Insite, the world’s first government-sanctioned supervised injection site, they learned about the policies, strategies and procedures that reduce the harmful effects of substance use.

The Insite team has saved many lives by supplying clean needles, naloxone and medically regulated supplies of drugs and alcohol. Insite also makes available supervised consumption services and medically assisted recovery. The missing piece to this incredibly successful program? Supportive housing to ensure recovery will be ongoing.

Back in Kainai, a dry community, Tailfeathers takes viewers to the National Native Alcoholic and Drug Abuse Program (NNADAP) residential treatment centre which has incorporated cultural pieces like a healing lodge, smudging and sharing circles into the once-colonial abstinence program built around Alcoholics Anonymous with its twelve-step program.   

The NNADAP in Kainai is one of five in Alberta and one of over 50 across Canada that is funded by Health Canada. However, First Nations treatment centres receive less funding than other publicly funded residential treatment centres.

Residents stay about six weeks with the goal of getting them placed into a detox program. But due to a lack of Federal funding, the wait lists for detox care are long. Without safe, secure, supportive shelter it’s almost impossible to stay clean – a requirement for accessing detox centres.

Bringing the Spirit Home Detox Centre opened in Standoff in February 2019. The centre has four rooms where residents receive 30 days of stabilized care and treatment. Again, a missing piece to ensuring ongoing sobriety is the lack of supportive housing after treatment.

As part of the multi-pronged solution, shelters like the one in Moses Lake provide naloxone training for residents. But these days it is taking between three to eight doses of naloxone to counteract drug poisonings.

Replacement therapy has also led to recoveries. Suboxone, an opioid used to treat opioid addiction, is dispensed daily by local pharmacists or from the mobile medical unit that supplies those who can’t get to a pharmacy. Suboxone grounds those addicted to opioids without interfering with daily life.

As with so many government-funded health-care programs, better services are available off reserve in Lethbridge. The non-profit AIDS Outreach Community Harm Reduction Education Support Society (ARCHES) began as a harm reduction site for HIV/AIDS that expanded its reach and now serves a wider community. But for Indigenous people, access to those services comes with a price.

Racism, hate crimes, and hate homicides are the standard push back from Lethbridge’s white community. Inspired by Winnipeg’s Bear Clan Patrol, Mark Brave Rock started the Sage Clan Patrol to help keep Indigenous people in Lethbridge safe. Three times a week, volunteers patrol and give support to the vulnerable. They also clean up drug paraphernalia on their walkabouts.

In February 2018 ARCHES opened a Supervised Consumption Site (SCS) with wrap-around one-on-one help and cultural supports for Indigenous clients. This was the most-visited drug consumption site in North America. Then, on August 31, 2020, Jason Kenny’s Conservative government withdrew its funding, forcing the permanent closure of the site. Lethbridge now has the highest rate of drug poisoning victims in Canada.

Despite setbacks caused by both the federal and provincial governments, Kainai residents remain hopeful for their future. As one resident of the treatment centre said, “All it takes is one person to care.”

Kímmapiiyitssini: The Meaning of Empathy opens Nov. 5 in Vancouver with screening scheduled across the country throughout November.