Culturally appropriate addiction treatment for Aboriginals

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She took her first drink at age eight, was living on the streets at 15 and started doing crack by the time she was 17. A turbulent life of abuse, neglect and turmoil stacked the odds against Candace Goss. Today 35, sober and on the road to recovery, she has found happiness through the tools she had all along; her heritage.

Goss tried countless times to get help, but nothing worked. After being released on bail for drug trafficking in September 2008, the court ordered her to undergo drug and alcohol counselling, which led Goss to the Aboriginal Day Withdrawal Program run by Toronto East General Hospital (TEGH).

“This program was a lot different from the others,” says Goss. “It’s Aboriginal and our problems are a lot different because of the hard times we’ve had growing up. I was completely defeated and powerless when I came through these doors and this place gave me a little bit of hope for a better way to live.”

In 2005, withdrawal management programs in Toronto were being restructured, which made Doug Smith, Manager of Withdrawal Management at TEGH, aware of gaps in services available for the Aboriginal community. In partnership with Native Child and Family Services of Toronto, TEGH developed the Aboriginal Day Withdrawal Program, which today stands as the only withdrawal management program specifically for the Aboriginal community in Ontario and is a safe haven for people with addictions to heal and recover.

“We work with some of the most damaged souls,” reveals Smith. “There’s a whole chain of events on why people are brought to substance and behavioural dependence, and if they’re believers in the healing process, they can eliminate it from their blood; their soul.”

“A chief in the north once told me that what happened to Aboriginals was spiritual genocide,” reveals Smith. “When you take away a culture that has been there for thousands of years and implant something else, there is loss and disconnect. How do you regain that? A coping mechanism for many has been drugs and alcohol.” The program, led by Michele Watson, six nations Mohawk, took time to grow and build trust within the Native community. Yet, having the program developed by and for Aboriginals soon helped it expand so large that a second case manager, Richard Fournier, was needed.

Every weekday morning, the day program begins with the trickling in of 23 men and women into the one-room space in downtown Toronto. Acupuncture, administered by Watson and Fournier, is used on every client as a stress reliever to calm and relax them. After 45 minutes of rest, traditional Aboriginal practices, such as smudging and prayer, are followed by the day’s scheduled program, which may include weekly sweat lodges and naming ceremonies; all of which are culturally appropriate.

“So many times, our clients have given up on themselves,” says Watson. “This program helps move clients to where they want to be, not where our system says they need to be. They may want to —drink three days a week rather than seven and who are we to decide if that’s right or wrong.”

The program doesn’t advocate a particular treatment; instead, it opens the client’s knowledge to the options available, allowing them to choose which one will best meet their needs. Following three to five weeks of treatment at the day program, clients move on to limited longer term care. For Candace Goss, this meant the 21 day residential program at the Jean Tweed Centre, a new partner of the Aboriginal day program that works with women who suffer from substance abuse.

Having overcome tremendous hurdles, Goss is still in the healing process and continues to visit the day program regularly. “I owe my recovery and wellness to this place. It gave me the strength to continue my journey and I keep coming back here to continue what I have. I now share my story with the newcomers that are here.”

The team credits TEGH for giving them the freedom to develop the program. “They have encouraged and supported this from the beginning,” states Smith. “It’s huge.” The Ministry of Health and Long-Term Care (MOHLTC) and the Toronto Central Local Health Integration Networks (LHIN) have also offered support and funding to sustain the program.

“TEGH is proud of the many mental health and addictions programs located in the community to better serve the people of East Toronto,” says Marla Fryers, Vice President Programs and Chief Nursing Officer, TEGH. “A unique program is the Aboriginal Day Withdrawal Program. Careful attention is given to providing services in a culturally competent manner. This improves care for those who deliver it as well as those who receive it.”

Now earning a reputation for bringing families back together, the program’s facilitators continue to have a strong desire to help people. “At 36, I was given my spirit name, which provides identity, purpose and direction,” says Watson. “My name is ‘Woman who Walks on Water,’ the messenger, which is how I ended up here; to guide others.”

“It’s amazing what we’ve been doing,” says Fournier. “It just continues; we’re going further and further and it’s like TEGH didn’t give us boundaries. We get calls from other programs and other hospitals; from social workers asking us to come in and we’re encouraged to do just that.”

As for Goss, her future goals are to work in addictions and help people in a positive way.
“I live life happily today and I really never thought that would happen. Now I am going to try to give back as much as possible.”