Knowledge Synthesis

A realist review synthesis oriented to inform intervention policy and practice, emphasizing need to contextualize knowledge around healing practices to local realities among Indigenous contexts in Alberta.

We Asked:

1. What are best practices for prevention, treatment, and harm reduction related to opioid misuse in Indigenous contexts?

2. What are contextual factors framing opioid misuse and Indigenous community-based responses in Alberta? 

3. What non-pharmacological wrap-around support models indicate promise for initiating and maintain opioid-dependent patients in Indigenous contexts? 

Step One: Knowledge Holders Gathering

Banff Centre, May 2018

28 Elders, primarily First Nations from Treaty 7 and Treaty 8 territories, gathered and spoke about their community experience of opioids and addictions. These discussions guided the focus of the literature review and ultimately directed the review to explore mechanisms and outcomes of healing the whole human being within contexts affected by colonization. 


The Knowledge Holders Gathering resulted in key principles guiding our work, and future research, policy and programs pertinent to opioid misuse in Indigenous contexts. These guiding principles can be found here. 

Step Two: Literature Searches

Peer Reviewed Literature

Searched for opioids (and related terms) in Indigenous contexts International peer reviewed literature Canada/USA/NZ/AUS: 

Results (26 included sources):

  • 11 qualitatitve

  • 6 quantitative

  • 6 mixed methods

  • 3 review

Grey Literature

Searched for opioids (and related terms) in Indigenous contexts within Canada. 

Results: Mainly reports, PPT presentations, resources/toolkits

Step Three: Consensus-Building Meetings

Five full-day meetings gathered more than 80 individuals for greater understanding of Alberta contexts, each meeting focused on healing among different groups:

  • August 23, 2018 - Calgary, AB : Indigenous men

  • August 27, 2018 - Calgary, AB: Systems-involved Indigenous people

  • August 29, 2018 - Calgary, AB: Indigenous women

  • September 5, 2018 - Calgary, AB: Indigenous people in recovery

  • September 24, 2018 - Edmonton, AB: From perspective of FN health providers

Key Findings:


  • Resource disparities and underfunding of transaction within and between systems perpetuate revolving door of existing treatment models


  • Healing the whole human being requires coordinated community and wrap-around supports in addition to appropriate and accessible medical care

  • Healing the whole human being evident in programs focused on keeping individuals connected to family and community, restoring cultural knowledge & healing from trauma


  • Impact of holistic intervention evident in far more than morbidity and morality rate, evidence in policing, schooling, and social services indicators

Please contact us if you would like a brief of this report. We can prepare for organization specific contexts.