Indigenous young people in British Columbia who use drugs are 13 times more likely to die than other young people of the same age, and young women and people who use drugs are even more likely to die, according to research published in CMAJ (Canadian Medical Association Journal)
"This study shows that young Indigenous people in BC who use drugs are dying at an alarmingly high rate, especially young women, who die almost twice as often as young men," says Mary Teegee, Executive Director of Child & Family Services at Carrier Sekani Family Services and Chair of The Cedar Project Partnership. "These deaths are catastrophic for our families and for our communities."
A team of researchers, including Indigenous leaders and Elders who are part of The Cedar Project Partnership, looked at data on 610 young Indigenous people aged 14-30 years who used drugs in Vancouver and Prince George, BC, on Coast Salish and Lheidli T'enneh territories, respectively. Forty young people died between 2003 and 2014, and deaths of young women were almost double that of men.
The leading causes of death were overdose (38%), illness (28%) and suicide (12%). Among young people who died from suicide, 80% were young women, who made up almost three-quarters of deaths from overdose and illness. Infection with hepatitis C at the start of the study was the strongest predictor of death, despite the young age of the population and Canada's universal health care system.
Since this analysis was completed, 16 additional young women and girls and 10 men in The Cedar Project cohort have died.
"Substance use may be a way to cope with trauma; however, it contributes to risk of overdose death," writes Dr. Martin Schechter, Professor, University of British Columbia and co-principal investigator of the Cedar Project, with coauthors. "Furthermore, recent experience of a nonfatal overdose was associated with a 3-fold increase in the risk of death, which suggests that the period immediately after a nonfatal overdose may be a critical time for intervention."
"The death rates among young Indigenous people who use drugs reported in this study are appalling and must be viewed as a public health and human rights issue," write the authors. "This study underscores that young Indigenous people who use drugs continue to be affected by historical and present-day injustices, substance use and barriers to care."
Culturally appropriate programs that build on young people's strengths, with particular engagement of young women, are essential for stemming the flow of these tragic and unnecessary deaths.
In a related commentary, Karen Urbanoski, Centre for Addictions Research of British Columbia and University of Victoria, Victoria, BC, writes, "these findings serve as a stark reminder of the need for tailored services and policies that are better able to meet the needs of Indigenous people in Canada."
She also urges that broader change is needed to address socioeconomic inequities, and social and political barriers that continue to affect the health of Indigenous people in Canada.
The research study was conducted by researchers from University of British Columbia; Canadian HIV Trials Network; Canadian Aboriginal AIDS Network; the Cedar Project, BC Children's Hospital Research Institute; Vancouver Native Health Society; Vancouver General Hospital, Vancouver, BC; and the University of Northern British Columbia, Prince George, BC.