Rainy River District Aboriginal Addiction Needs Assesment Survey Report - Couchiching First Nation

Treatment and Support Services Project
Rainy River District Aboriginal Addiction Needs

Assessment Survey Report
Couchiching First Nation
Brenda Newton-Taylor
Research Associate II/Project Manager
Kathleen Larion
Research Assistant
Social, Prevention and Health Policy Research Department

Centre for Addiction and Mental Health
November, 2009
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Couchiching First Nation Addiction Needs Assessment Survey Report
Acknowledgements
Couchiching Treatment & Support Services Project
Ed Yerxa - Project Coordinator

Ida Linklater - Admin Assistant
Catherine R. Bruyere - Needs Assessment Consultant
Darren Harper - Technical Support
Technical Working Group
Albert Calder - Couchiching First Nation

Shanna Weir - Gizhewaadiziwin Health Access Centre
Becky Holden – North Western Health Unit
Hugh Dennis - Rainy River Substance Abuse Prevention Team
Issac Big George - Big Island First Nation
Michelle Ott - Centre for Addiction and Mental Health
Karen Peterson, - Aboriginal Liaison Consultant, North West LHINS
Lynn Baxter - Program Manager, First Nations Inuit Health Branch (FNIHB)
Couchiching Chief and Council
Chief Charles McPherson

Counsellors:
Nick Mainville
Christine Jourdain
William Perrault
Clint Perrault
Richard Bird
Couchiching First Nation Staff
Valerie Norris – Financial Administrator

Aleta Bruyere – Administrative Assistant
Susie Jones – Financial Clerk
Dale Morrisseau – Band Manager
Louis “Smokey” Bruyere – Band Manager
Interviewers
Tara Yerxa Debbie Fairbanks April Bruyere Bonnie Plourde

Danika Tom Matt Calder Issac Big George Terry Sabean
Joanne Cobiness Alex Cochrane Charmaine Langlais
Addictions Foundation of Manitoba
Ron Linklater
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Aboriginal Partners:
United Native Friendship Centre (Fort Frances)

Richard Bruyere, President
Armand Jourdain Sr. Vice President
Richard Bird
Gerri Yerxa
Darwin Woods
Donna Bird
Debbie Fairbanks
Big Grassy First Nation

Chief Carol Copenace
Councillors:
Debra Whetzel
Lynn Indian
Roy Tom
Chris Jack
Gary Tuesday
Big Island First Nation

Chief Wesley Big George
Councillors:
Robert Handorgan
Carl Big George
Atikokan Native Friendship Centre:

Dolores Veran, Executive Director
Sandra Sedor, President
Rick Stanley, Vice President
Debra Bruyere, Treasurer
Fay Clark
Mary Makarenko
Marie Veran
Sunset Country Métis (Fort Frances)

President, Clint Calder
(Stanjikoming) Mitaanjigamiing First Nation

Chief Janice Henderson
Councillors:
Pamela Johnson
Paul Henderson
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Table of Contents
Acknowledgements.......................................................................................................................2
Table of Contents..........................................................................................................................4
Introduction ...................................................................................................................................5
Methodology .................................................................................................................................6
Respondent Sample Selection ..................................................................................................6
Interviewer Training...................................................................................................................7
Addiction Needs Assessment Survey Instrument .....................................................................8
Socio-Demographics .............................................................................................................8
Status, Language and Culture ...............................................................................................9
Alcohol Consumption, Patterns, and Drinking Context........................................................10
Alcohol Problems and Consequences of Use .....................................................................11
Other Substance Use, and Consequences of Use ..............................................................11
Substance Use and Criminal Behaviour ..............................................................................12
Experiences of Alcohol and Other Substance Abuse Treatment.........................................12
Barriers to Substance Abuse Treatment..............................................................................12
Tobacco Use - Smoking ......................................................................................................12
Mental Health/Psychological Distress..................................................................................13
Community Addiction/Mental Health Services.....................................................................13
Physical, Psychological and/or Sexual Assault ...................................................................14
Important Considerations ........................................................................................................15
Conclusions ................................................................................................................................16
References..................................................................................................................................19
Appendix - Tables .......................................................................................................................21
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Introduction
The Rainy River District Treatment and Support Services Project (Project) is a multi-year project
examining the addiction treatment needs of the Aboriginal population of Rainy River. The project
is sponsored by Couchiching First Nation, and funded by Health Canada through the Aboriginal
Health Transition Fund. The Project consists of three phases: project planning and community
assessment, analyzing and evaluating community assessments, and preparation of service
enhancement strategy development.
In December of 2008 the Project Coordinator contacted the Kenora Office of the Centre for
Addiction and Mental Health (CAMH) for assistance with conducting the addiction needs
assessment survey component of the Project. In turn, the CAMH Kenora Office Community
Consultant contacted the principle author, a Research Associate/Project Manager with the
Social, Prevention and Health Policy Research Department of CAMH because of my work in the
area of community based needs assessments and my interest in research among Aboriginal
peoples (Newton-Taylor, in progress, 2007, 2001). Between December 2008 and May 2009
there were extensive discussions and meetings between the Project Coordinator and Staff,
members of the Project Technical Working Group (TWG), and CAMH partners to develop the
groundwork and framework for the addiction needs assessment survey.
It was critically important to each and every one of us to adhere to the values and practices of
the OCAP principles (ownership, control, access, and possession) of research involving
Aboriginal peoples developed by the National Aboriginal Health Organization (NAHO) (First
Nations Centre, 2007; NAHO 2007, 2003; Schnarch, 2004). OCAP principles arose from years
of unregulated research conducted among Canada’s Aboriginal peoples. Such research was
most often inappropriately obtained, and used in a manner that was detrimental to Aboriginal
people. The following quote highlights the background and purpose of the OCAP principles:
“First Nations need to protect all information concerning themselves, their traditional
knowledge and culture, including information resulting from research. The principles of
OCAP enable self-determination over all research concerning First Nations. It offers a
way for First Nations to make decisions regarding what research will be done, for what
purpose information or data will be used, where the information will be physically
stored, and who will have access … Research must respect the privacy, protocols,
dignity and individual and collective rights of First Nations. It must also derive from
First Nations values, culture and traditional knowledge.” (NAHO, 2007, p. 1, 5)
The current addiction needs assessment survey was, from start to finish, designed, developed,
and implemented by Aboriginal members of the Project Team, the Project TWG and invited
community members. CAMH project staff provided the technical expertise necessary to facilitate
the addiction needs assessment survey. Changes in CAMH research policy required a written,
legal research contract between CAMH and Couchiching First Nation as the sponsoring body
for the addiction needs assessment survey. The contract negotiation process was new to both
parties. However, we were able to negotiate a contract with the OCAP principles imbedded in
the document. This document has been circulated (with the partner name excluded for
confidentiality) within CAMH as a template for future research contracts involving Aboriginal
populations.
Throughout the entire process of the project, we developed a dynamic, mutually respectful
partnership resulting in the successful completion of the addiction needs assessment survey
and the current report.
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Methodology
The addiction needs assessment survey conducted in this project was based on the established
and substantiated belief that community members know and understand their communities best.
Community member experiences, opinions, beliefs, and perceptions of their community are
crucial to the evaluation, development, and sustainability of applicable and appropriate
programs and services.
These values and understandings were exemplified through our fundamental belief in the
necessity of incorporating traditional and culturally appropriate methods throughout the process
of conducting the addiction needs assessment survey. We asked people to tell us their most
private and intimate stories, to share their opinions and perceptions, and to talk about areas of
their lives that have been kept in darkness and silence. In doing so, we were always aware of
the importance of giving respect and honour to the people, providing them with comfort and
ease, and safeguarding their rights to privacy and confidentiality.
Respondent Sample Selection

The Treatment and Support Services Project Coordinator negotiated agreements with four First
Nation Band Councils and the Boards of three Aboriginal community services in the Rainy River
District. The First Nation communities participating in the addiction needs assessment survey
were Couchiching, Big Island, Big Grassy, and Mitaanjigamiing. The community service sites
were the Fort Frances United Native Friendship Centre, Atikokan Native Friendship Centre, and
the Fort Frances Sunset Country Métis Association.
The addiction needs assessment survey sampling protocol was based on a household survey
for the four First Nation communities, and a selection of individuals using the three services
during the data collection period. Due to the household size of the First Nation communities, the
target sample size represents a complete census of all households in the communities.
Respondents from the three services were selected using convenience sampling techniques,
whereby interviewers approached individuals using these services during the data collection
period.
The original target sample across all seven locations was 800 completed addiction needs
assessment survey questionnaires. At the end of the data collection period 578 completed,
usable addiction needs assessment survey questionnaires were received by the CAMH office.
Specifics related to each of the locations are highlighted in the following table.
It is important to note that most of the addiction needs assessment survey sites reached their
target goals in terms of completed questionnaires. The exceptions to this were Big Island, Big
Grassy, and Mitaanjigamiing First Nation. The reason for this is these communities are very
small and have less than 50 households each. This means that the target sample size was
unrealistically high for these communities.
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Target and Completed Sample Size
Target Sample Completed

Location Size Questionnaires
Couchiching First Nation 240 200

Big Island First Nation 100 45
Big Grassy First Nation 100 41
Mitaanjigamiing (Stanjikoming) First Nation 100 35
Sunset Country Métis Association – Fort Frances 100 92
Fort Frances United Native Friendship Centre 100 107
Atikokan Native Friendship Centre 60 58
Total 800 578
Interviewers were given a letter of introduction to hand to each person they approached at the
point of initial contact. The letter explained the purpose of the survey, respondent rights of
refusal, confidentiality, and anonymity. The letter included the Project Coordinator’s name and
contact information. Interviewers were given identification badges to prove they were working
with the Project. Respondents were encouraged to contact the Project Coordinator if they had
any questions, comments or concerns about any aspect of the addiction needs assessment
survey.
The Project wanted to include youth ages 15 to 17 in the addiction needs assessment survey. In
order to facilitate this, parental consent forms were developed. Interviewers were instructed to
have at least one parent/legal guardian sign these forms before they could interview youth. The
youth were then approached, given a letter of introduction, and had to give their agreement to
participate in the addiction needs assessment survey.
Interviewer Training
Addiction needs assessment survey interviewers were recruited and hired by the Project
Coordinator. All of the interviewers were members of the seven participating communities.
Interviewers were trained to administer the addiction needs assessment survey instrument and
to follow the sampling and other protocols in a full day meeting with the CAMH Project Manager.
During the training, interviewers were given a comprehensive review of the sampling
methodology and the addiction needs assessment survey instrument. Interviewers were
encouraged to provide input and advice during the training and discussions. Interviewers were
required to sign an oath of confidentiality administered by the Couchiching Band Financial
Administrator, a certified notary public. Assuring respondent confidentiality and anonymity was a
major concern. It was important for respondents to feel safe and comfortable talking with the
interviewers and sharing their private and sensitive thoughts, behaviours, and experiences.
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Addiction Needs Assessment Survey Instrument
The addiction needs assessment survey instrument was developed through collaboration and
partnership between the CAMH Project Manager and the Project TWG over a period of several
months during face-to-face meetings and teleconferences. Representatives from other partners
and interested parties also attended planning meetings and teleconferences. These included
the Couchiching First Nations Band Council and Elders, the North West Local Health Integration
Network (LHIN), and members of the target communities.
The original intent of the addiction needs assessment survey was to focus on addiction
treatment needs in the selected communities. However, during our initial discussions it became
apparent that addiction within Aboriginal communities is a complex and interwoven problem at
both a community and individual level. Addictions treatment cannot be understood or addressed
in isolation of social, historical, cultural, economic, political and interpersonal contexts. Members
of the addiction needs assessment survey planning committee stressed that research among
Aboriginal populations must incorporate cultural and traditional components both in terms of
examining problems and issues, as well as looking for viable, culturally relevant solutions. As a
result of these crucial considerations, the addiction needs assessment survey instrument
developed for this project is a comprehensive document developed specifically for use among
Aboriginal populations.
Administering the addiction needs assessment survey required face-to-face interviews with
trained interviewers. However, given the sensitive nature of some of the questions in the
instrument respondents were given the option of completing it themselves and having the
interviewer return within a day or two to collect the completed instrument.
The instrument is comprised of the following major components: socio-demographics; status,

language and culture; alcohol use; other substance use; substance use treatment; mental
health/psychological distress; community addictions/mental health services; and physical,
psychological, and sexual assault. As outlined below, questions pertinent to Aboriginal culture
and traditions are integral components of each section. The following is a brief overview of the
addiction needs assessment survey instrument.
It must be noted there are instances where data is not presented because of the small numbers
of cases, or individual respondents, involved. In order to protect respondent confidentiality and
anonymity, data is not presented in this report where the number of respondents for any
variable is less than five.
Socio-Demographics
The addiction needs assessment survey instrument contains standard socio-demographic

questions such as age, gender, marital status, number of children, household composition,
education, employment status, respondent and spouse/partner income and occupation. Living
arrangement was measured by on/off reserve and urban/rural indicators appropriate for the
population. Residential school attendance was also included in this section. These results are
outlined in Table 1 of the appendix.
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Status, Language and Culture
The addiction needs assessment survey instrument included several questions related to
Aboriginal status, language and culture. Aboriginal status focused specifically on registered
status (i.e. registered, non-status, Métis). Questions relating to language focused on respondent
ancestral or Aboriginal language, and the extent of their knowledge, understanding and use of
these languages. Questions about Aboriginal culture focused on how involved respondents
were in traditional cultural events and ceremonies, and respondent assessments of the
importance of traditional culture and teachings such as learning more about traditional prayer,
medicine and healing, and spirituality. Respondents were asked how frequently, if ever, they
thought about historical events specifically relevant to Aboriginal peoples such as loss of land,
language, culture, spirituality, traditional ways, and self-respect. These results are detailed in
Table 2 of the appendix.
The question regarding Aboriginal cultural background allowed for multiple responses and there
were several cultural backgrounds mentioned such as Anishinaabe, Cree, Chippewa, Sioux, Oji-
cree, Dene, Shawnee, Mi’kmaq, and Mohawk, However, these were most often mentioned in
addition to, or in combination with, Ojibway or Métis.
Respondents were asked to indicate their involvement in traditional cultural events and
ceremonies. These questions allowed for open-ended responses, and respondents mentioned
134 coded responses. These responses were grouped by members of the Treatment and
Support Services Project team into seven categories: traditional arts and crafts, political
meetings and events, seasonal ceremonies and feasts, addiction/mental health cultural
activities, pow wows, cultural ceremonies and rites, and other cultural events and ceremonies.
Traditional arts and crafts included activities such as beading and leather classes, and regalia
making. Political meeting/events included items such as Treaty 3 meetings, treaty gatherings,
swearing in new chief and council, and election of grand chief. Seasonal ceremonies and feasts
included harvesting wild rice, winter/spring/fall ceremonies, drum feast, and Seven Generations
feasts. Addiction and/or mental healthy activities mentioned by respondents included sharing
circles, drug treatment ceremony, and sobriety pow wows. Ceremonies and rites included
healing ceremony, sweat lodge, smudge, shaking tent, and spiritual gatherings Respondents
were also asked if they had a traditional spiritual leader/mentor, and if so, how often they
received spiritual guidance from this person in the 30 days prior to the survey.
Respondents were asked to rate how important traditional Aboriginal culture and teachings were
to them from a predetermined list of 15 items. These items included: learning more about
traditional prayer, learning more about traditional medicine, to have more education about
traditional spiritual beliefs, to learn the meaning of traditional ceremonies and events, knowing
their clan, speaking their traditional language, to have a traditional name and colours,
participating in traditional cultural and ceremonial events, learning more about the Creator,
renewing their traditional spirituality, learning more about traditional medicine and healing, and
receiving medical help from a tribal medicine person.
The questionnaire contained a section asking about how frequently, if ever, respondents
thought about historical events such as: loss of land, language, traditional spiritual ways, and
culture; loss of family ties because of residential schools, loss of families from the reserve or
area because of government relocation, loss of self respect from poor treatment by government
officials, losses from the effect of alcoholism, loss of people though early death, and loss of
respect by children for elders.
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Alcohol Consumption, Patterns, and Drinking Context
Respondents were asked about their drinking history (e.g., ever drank in lifetime, drank in past
12 months, age first drank, age first intoxicated). Most of this section focused on alcohol
consumption in the past 12 months among drinkers only. Alcohol consumption was measured
using a quantity/frequency measure where average weekly consumption was computed from
the frequency they drank in the past month, and the number of drinks usually consumed when
they drank This measure of consumption is widely used in research studies, and has been
validated (Heeb & Gimel, 2005). Other consumption measures included heavy drinking (5 or
more and 8 or more drinks on a single occasion), and highest number of drinks consumed on
one occasion. These results are contained in Table 3 of the appendix.
When reviewing the results for this section contained in Tables 3 and 4 of the appendix, it is
important to keep the following guidelines in mind.
Current Canadian drinking guidelines, developed by the Centre for Addiction and Mental Health
(CAMH), state the following as low-risk drinking guidelines:
• no more than two standard drinks on any one day,

• women - no more than nine standard drinks a week, and
• men - no more than 14 standard drinks a week.
Current internationally accepted guidelines define heavy drinking as:
• women - four or more standard drinks during a single occasion, and

• men - five or more standard drinks during a single occasion.
Drinking context and consumption were measured through questions related to where (i.e.,
location), and with whom respondents usually drink and examines relationships between alcohol
consumption and drinking context. The focus here is on where and with who people drink, and
how these factors effect or change their level of alcohol consumption. Respondents were asked
two questions related to where they usually drink. Both questions allowed for multiple
responses. The first question presented a pre-determined list of 10 items most appropriate for
the population and geographic location of the community (home, friends, party at someone’s
house, pit party, bush party, restaurant, licensed premises, public place, in/on motorized
vehicle, and while fishing). The second question was open-ended asking for any other locations
where they usually drink. Respondents listed 32 ‘other’ drinking locations, such as while golfing,
at the cottage, while camping, on the lake, while fishing, at concerts or plays, on the riverbank,
and at hockey games. Based on responses to both questions, the following location categories
were computed: at home, at a party at someone’s house, at a friends home, and at licensed
premises. These locations were also selected because they represent distinct conceptual and
physical environments for comparison purposes.
Respondents were asked two questions related to whom they usually drink with. The first
question presented a pre-determined list of seven of the most common drinking partners
(spouse/partner, close friends, acquaintances, parents, brother/sisters, grandparents, other
relatives). The second question was open-ended, asking respondents to write in any ‘other’
person they usually drink with. ‘Other’ persons with whom they usually drink included: co-
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workers, children, or roommates. Less than 2% of respondents indicated ‘other’ persons. Seven
respondents indicated they usually drink alone. From these results, three groups were made,
based on their distinctive relationship with respondents: spouse/partners, close friends and
family. These results are included in Table 3 of the appendix.
Alcohol Problems and Consequences of Use
Hazardous and harmful level of alcohol consumption was measured through the use of the
Alcohol Use Disorders Identification Test (AUDIT). The AUDIT has been extensively used in
alcohol research and has been psychometrically validated for use with various social and
cultural populations (Babor, Higgins-Biddle, Saunders & Monteiro, 2001). AUDIT results are
presented based on average total score, and categorical scores indicating harm drinking
(scores of 7 or less), harmful drinking (scores of 8 to 15), and hazardous/dependent drinking
(scores of 16 or more). Audit scores can range from 0 (the absolute lowest, with no indication of
alcohol use) to 40 (the absolute highest scores, with indications of extremely hazardous alcohol
use). Respondents were also asked about harmful effects of their personal own alcohol use,
and alcohol use by a family member across several domains including: friendship/social life,
physical health, mental health, overall happiness, marriage/home life, work/studies/employment,
and financial position. These questions asked for a yes/no response.
This section of the questionnaire briefly asked about alcohol and violence in terms of whether or
not alcohol had been a factor in any physical altercations and how often this happened in the
past 12 months. The second sub-section examined alcohol use in the home during the
respondents’ childhood. These results are presented in Table 5 of the appendix.
Other Substance Use, and Consequences of Use
In order to make a clear and concise distinction between substance types, substances in this
section are referred to as ‘drugs’. Illicit and licit drug use was included in the questionnaire. Illicit
drugs included marijuana, crack/cocaine, methamphetamines, hallucinogens, solvents, and
MDMA/ecstasy. For the purpose of this report, the types of illicit drugs used were grouped into
the following categories: marijuana, crack/cocaine, and other illicit substances (solvents,
methamphetamines, hallucinogens, MDMA/ecstasy).
Licit drugs included pharmaceuticals obtained both with and without a prescription including
antidepressants/barbiturates (e.g., seconal, amytal, prozac), stimulants (e.g., uppers, diet pills),
tranquillizers (e.g., valium, librium, xanax), and opiates (e.g. T3’s, Percocet, oxycontin,
oxycodone). The types of prescription drugs used were collapsed into two groups: opiates and
other prescription drugs. Opiate use, with and without a prescription, was examined separately.
However, because of the low numbers of respondents using other prescription drugs the
categories were combined into one (i.e. with/without a prescription). Respondents were asked to
indicate how frequently they used these drugs across nine mutually exclusive time periods. For
the purpose of this report frequency of use was collapsed into the following categories: never in
their lifetime, used but not in the past 12 months and used in the past 12 months. These results
are contained in the appendix in Table 6.
Respondents were asked about harmful effects of their own illicit drug use and the illicit drug
use by a family member on the same life areas as previously listed for harmful effects of alcohol
use. These included a yes/no response regarding: friendship/social life, physical health, mental
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health, overall happiness, outlook on life, marriage or home life, work/studies/employment and,
financial position. These results are contained in Table 7 of the appendix.
Substance Use and Criminal Behaviour
This section of the addiction needs assessment survey instrument contained questions related
to alcohol and other substance use and criminal behaviour in more detail. For the purpose of the
analysis alcohol use and the use of illicit substances were combined into a single measure
referred to as ‘substance use’. Respondents were asked whether or not substance use was a
factor in any criminal activity ever in the respondent’s life and in the past 12 months, and if their
substance use was a factor in being subsequently incarcerated or placed on probation/parole.
Respondents who had been incarcerated and/or on probation/parole were asked whether
substance abuse treatment was offered while incarcerated or on probation/parole, if they felt the
treatment was effective, and if the treatment was based on traditional aboriginal values,
practices or healing methods. These results are outlined in Table 8 in the appendix.
Experiences of Alcohol and Other Substance Abuse Treatment
The addiction needs assessment survey instrument contained questions relating to respondent
experiences of alcohol and other substance abuse treatment such as the number of times they
had been in treatment in their lifetime, in the past 12 months, and before the age of 18, and the
type(s) of treatment the had received. Respondents were asked if the substance abuse
treatment they received was based on traditional Aboriginal culture, values or beliefs, and
whether the program provided Aboriginal treatment counsellors. The instrument contained a
section of community-specific factors related to substance use relapse after treatment.
Respondents were asked to indicate how important these factors were to their substance use
relapse. All respondents, regardless of whether they had been in any type of substance abuse
treatment or not, were asked their opinions of how important traditional Aboriginal components
were to treatment, recovery, and aftercare. These results are contained in Table 9 of the
appendix.
Barriers to Substance Abuse Treatment
Respondents were asked to consider a time when they felt they needed treatment for their
substance use, and from a pre-selected list of 20 items respondents were asked to indicate how
important each item was for them as a barrier to substance abuse treatment. The barriers to
treatment in the survey were developed by the Project team, and included items relating to
location of treatment, treatment costs, treatment program factors, personal assessment of need
for treatment, and obstacles raised by family and/or friends. The results are included in Table 10
of the appendix.
Tobacco Use - Smoking
The section in the addiction needs assessment survey instrument related to tobacco use
focused on smoking, and not other forms of use. Respondents were asked if they smoke
tobacco for ceremonial purposes, if they had ever smoked daily, how old they were when they
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started smoking daily, whether they currently smoke and how often, the number of cigarettes
they smoke each day, and if they were not current smokers, how long they had been abstinent.
These results are included in Table 11 of the appendix.
Mental Health/Psychological Distress
Respondent mental health was examined using the General Health Questionnaire (GHQ). The
GHQ is a standardized instrument widely used in survey research (Kalliath, O’Driscoll & Brough,
2004). The GHQ has been psychometrically validated across various cultural groups including
Aboriginal populations (Duran et. al., 2004). The GHQ examines indicators of psychological
distress measured by 12 items over a time frame of the past few weeks. GHQ items include:
being unable to concentrate on tasks, lost sleep over worry, not feeling you play a useful part in
things, feeling incapable of making decisions, feeling constantly under strain, being unable to
enjoy normal day-to-day activities, being unable to face up to problems, feeling unhappy or
depressed, losing self confidence, thinking of self as a worthless person, and generally feeling
unhappy. Positive responses to four or more of these items indicated elevated levels of
psychological distress. These results are contained in Table 12 of the appendix.
Community Addiction/Mental Health Services
Respondents were asked whether they knew of services, groups, agencies, programs, activities
or organizations in their community focusing on alcohol, drug use or mental health (referred to in
the following as ‘services’). If they knew of such services, respondents were then asked to write
in the names, or a brief description of them, and to specify what type of service it was (i.e.
alcohol, drugs, mental health, other). Once respondents had listed the services, they were
asked to specify which one(s) they felt were working well in their community, and which ones
were not working well.
A listing of the 187 respondent identified services was submitted to the Treatment and Support
Services Project Co-ordinator for classification into more manageable categories for statistical
analysis. Existing community services were collapsed into five broad categories: First Nations
specific community based services, First Nations specific tribal programs, urban Aboriginal
services, non-urban Aboriginal services, and ‘other’ services. It is important to note these
classifications may not be mutually exclusive. Major services have broad catchment areas and
serve a wide variety of client populations. These results are outlined in Table 13.
First Nations specific community based services included items such as NNADAP, Treatment
and Support Services Project, Aboriginal Health and Wellness Services, elders, substance
treatment services, healing centers, community counselling services, and traditional healers.
First Nations specific tribal program items included Tribal Health Services, Atikokan Community
Counselling Services, Weechi-it-te-win Child and Family Services, Gizhewaadiziwin Health
Access Centre, Rainy River Health Unit, Warrior Program, cultural awareness, home health
care, family health team, men’s wellness meetings, and child care.
Urban Aboriginal services included: Aboriginal Health Access Centre, United Native Friendship
Centre, Atikokan Native Friendship Centre, Sunset Country Métis, Métis hall/office, talking
circles, alcohol/drug workers, and home care. Non-Urban Aboriginal services included North
Western Health Unit, Riverside Health Care, Riverside Community Counselling, Rainy River
District Social Services, Mothers Against Addiction, addictions/mental health counsellors, family
13
health team, and victim services. The ‘other’ categories included a variety of non-specific items
covering a broad range of services including general mention of addictions and/or mental health
services, violence/assault programs, family groups, groups for mothers and children,
workshops, marriage counselling, hospital services, and support programs.
A second question asked respondents to indicate whether there were alcohol, other drug
services, or mental health groups, agencies, programs, organizations or activities that are not
available in their community, but which they felt should be. Respondents indicating the need for
services were asked to specify either a specific name or to provide a brief description of the type
of service they felt was needed. Once respondents had listed their opinions of needed services,
they were asked to select three which they felt were the most important for their community to
have.
Respondents listed and/or provided descriptions of 227 types of services needed in their
communities. The list of responses was submitted to the Rainy River District Treatment and
Support Services Project Coordinator for classification into more manageable categories for
data analysis. Needed services were grouped into five main categories: addiction services,
mental health services, services for children and youth, culturally appropriate services, and
‘other’ services. These results are outlined in Table 14 in the appendix.
Needed services within the addiction services category included items such as: general mention
of addiction services, detox, methadone treatment, substance counselling, residential treatment
facility, education, prevention, relapse prevention, local treatment, recovery groups, support
services, treatment costs, and in-home treatment/counselling. Services included in the mental
health category included: suicide prevention, anger management courses, the need for local
psychologists and psychiatrists, mental health support services, services for domestic violence,
crisis lines, victim services, mental health groups, services for residential survivors, and dual
diagnosis services. Needed services for children and youth included: teen outreach programs,
youth mentoring, substance use prevention programs, suicide prevention, after school activities,
education programs, inpatient/outpatient youth services, and social skills education. Items
included in the category of culturally appropriate services included: traditional healing
ceremonies, Aboriginal operated treatment, healing lodges, more native awareness in schools,
sobriety pow wows, elder and youth gatherings, language classes, smudging circles, warrior
programs, and age/gender appropriate councils. Items included in the ‘other’ category covered a
broad range of respondent identified services needed in their communities including: safety,
healthy lifestyle, improved policing, family planning, economic development, skills training,
resources for low income families, communication, and accountability.
Physical, Psychological and/or Sexual Assault
The addiction needs assessment survey contained a fairly extensive section related to
respondent experiences of physical, psychological and/or sexual assault both as a victim and as
a perpetrator. The questions asked were based on the Conflict Tactics Scale (CTS) (Strauss,
2007). This scale has been extensively used across various cultures and populations, and has
been psychometrically tested and validated.
The CTS measures of physical assault include being hit slapped, punched, pushed, grabbed
shoved, choked strangled, threatened with a weapon, injured with a weapon, or hit with an
object. Psychological assault measures include being called insulting names, being
embarrassed in public or among family/friends, being constantly criticized, and being isolated
14
from family or friends. Sexual assault measures include being forced to have sex when they did
not want to, being forced to have sex in a way they did not want to, being touched or grabbed in
a sexual way they did not want the person to do, and being sexually assaulted during a violent
incident.
The types of relationships involved with assault experiences included victims of domestic (i.e. by
a spouse/partner, boyfriend or girlfriend), by someone else living in their home (i.e. non-
domestic partner/spouse), and assault by someone outside of their home who is not a
spouse/partner or boyfriend/girlfriend (i.e. acquaintance, stranger). Respondents were also
asked if they had been the perpetrator of domestic and/or acquaintance assault. Assault
questions related to ever in their adult life and in the past 12 months. Respondents were also
asked if, during the latest incident either they or the other person had been drinking alcohol.
Only respondent’s age 18 or older were asked these questions.
It is also worth reiterating that this section of the questionnaire was treated with great care and
confidentiality. Respondents completed these questions themselves and then placed and
sealed the pages into an envelope. The envelopes were coded with an identifying number so
the data could be entered. The envelopes were only opened at the CAMH office by the research
assistant for data entry. The CAMH Project Manager and research assistant did not have
access to names or any information that could identify respondents. These questions were not
included in the questionnaire provided to youth ages 15 to 17. These results are presented in
Table 15 of the appendix.
Respondents were asked whether anyone in their family or anyone other than a family member,
physically, psychologically or sexually assaulted them when they were children under the age of
16. Respondents were also asked to identify their relationship with the perpetrator from a pre-
selected list, or to write in their relationship with the perpetrator if he/she was someone other
than those on the list. These results are contained in Table 16 of the appendix.
Important Considerations
This report presents data based on statistical significance, as is usual for a technical report.
However, it is important to keep in mind there is a difference between statistical significance and
whether a relationship is substantively different. Some of the analyses in this report are affected
because of a small number of applicable respondents. Variable relationships may or may not be
statistically significant simply because of the number of cases represented within cells of the
data analysis.
This is particularly true when looking at variable relationships by age group and age/gender
combinations. It is an established fact that women drink less and use illicit substances less often
than men. Women are more often victims of substance-related behaviours, such as criminal
activity or violence, while men are more often perpetrators. Age often represents what we call
‘risk of exposure’, whereby one’s risk of exposure to a phenomenon may increase or decrease
based on age itself. For example, someone’s risk of exposure to substance-related criminal
behaviour may increase with age. Someone who is 18 years of age has a much shorter lifespan
to accumulate criminal charges, or length of time incarcerated, because of their substance use
compared to someone who is age 50 or more. Alternatively, someone who is older may have
experienced a ‘maturation’ effect with age whereby their substance use and/or criminal
behaviour may decrease as they get older.
15
This report is based on the quantitative data collected from the specific communities included in
the addiction needs assessment survey component of the Treatment and Support Services
Project. The following results are based on a technical analysis of this data, and as such, there
are limitations and constraints on the interpretations and conclusions which can be drawn from
the data. The quantitative data from the addiction needs assessment survey report will be
incorporated into a comprehensive Project report containing qualitative and secondary data
collected by the Project team. The combined data in the final Project report will provide the
detailed information necessary to make substantiated recommendations and conclusions.
Conclusions 1
“If we treat people in their capacity of becoming, we then discover all the potential for
well-being, for healing, for change, for hope, and for community.’ (First Nations of
Quebec/Labrador Health and Social Services Commission, 2003, p. 26)
“Recovery for First Nations people will take many paths. One path alone will not be
enough. Each path will strengthen the other. Each person who moves towards health
and healing helps their families and their community to heal. Think of people who have
become addicted to alcohol and who have attempted to heal at a treatment centre for
addictions, and are still burdened by inner pain. Their path needs to include a focus on
internal wellness and dealing with losses that were never grieved.” (Canadian
Collaborative Mental Health Initiative, 2006, p. 9)
“It is important to understand our history, to acknowledge the oppression we have

suffered, and recognize the significance of our emergence as a people known as
Métis. To talk about traditional health knowledge and healing practices, to discuss
spirituality, healing and medicines, we need to acknowledge the foundation we are
working from.” (Métis Centre, 2008, p. 15)
To ensure the conclusions drawn from the addiction needs assessment survey data were based
on an Aboriginal framework and perspective, interpretation of the data was conducted in
collaboration with the Project Coordinator and staff, the Project TWG, and members of the First
Nation and Métis communities. Each section of the report was read and extensively discussed
during a two-day meeting. The role of the report’s primary author was to present the data and to
ensure conclusions for this report did not go beyond the confines or scope of the data and the
addiction needs assessment survey project. Unfortunately, these constraints limit the extent to
which we can make detailed conclusions. However, the final Project report will be able to
expand and elaborate on these conclusions and make recommendations because it contains
both the addiction needs assessment survey quantitative data and the community consultation
qualitative data, whereby each strengthens the other. The following is a brief outline of the major
interpretations and conclusions reached by the Aboriginal partners previously mentioned.
Community member opinions and perceptions shape reality, and that is why it is so important to
give them a voice to be able to express their thoughts, opinions and experiences. The success
1
these conclusions, and the data, are based on total respondents from the main final report
16
of this addiction needs assessment survey lies in the fact that community members were willing
to open their doors to us, and to tell us their stories, even the most intimate, personal, and
painful parts of their lives. They entrusted us with their stories, and our obligation is to protect
that trust, and to ensure their stories are told with respect and honour, in ways that will benefit
the community.
Substance use is a significant problem in these communities. Significant numbers of people

exceed low-risk drinking guidelines on a weekly basis. Almost half of respondents exceed heavy
drinking guidelines. Addiction needs assessment survey respondents were five times more
likely to have AUDIT scores of eight or more (i.e. hazardous/dependent drinking) than the
general Canadian population. These high levels of consumption are regularly practiced by both
men and women, and across all age groups. Women in childbearing years consume hazardous
amounts of alcohol on a weekly basis. Seventy percent (70%) of respondents said as a child
they witnessed someone in their home abusing alcohol. Based on respondent estimates of their
level of consumption and AUDIT scores, 70% of respondents with children are providing their
children with the same experiences and consequences.
Illicit substance use is also a significant problem in the communities included in the addiction
needs assessment survey. Respondents were three times more likely to use marijuana or other
illicit drugs, and nine times more likely to use crack/cocaine in the past 12 months compared to
the general Canadian population. Twenty-percent (20%) of respondents used opiates either with
and/or without a prescription in the past 12 months. Opiate use was prevalent across all of the
age group categories. Thirty-four percent (34%) of respondents stated as a child someone in
their home abused drugs. Just over 50% of respondents with children are exposing their
children to the same experiences and consequences.
It is crucial to acknowledge that substance use among the Aboriginal respondents of this
addiction needs assessment survey is not a ‘primary’ problem. Rather, substance use may be
more of a symptom of fundamental, or core issues such as poverty, social isolation,
marginalization, the absence of cultural and traditional knowledge and practices, widespread
and pervasive abuse as children and as adults, historical events and trauma, the residential
school system, and intergenerational transfer of social, economic, and political issues.
Substance use in these communities is just one facet of deeply imbedded, interwoven, multi-
layered, complex and dysfunctional social, community and family structures. Holistic treatment
modalities are needed to simultaneously address substance use and these complex core
issues. Based on respondent statements, community members are seeking culturally relevant
treatment, reflective of their traditional language, values, and practices. Spirituality, perhaps
more than any other indicator, is a key factor in Aboriginal perceptions and practices of healing,
and of the holistic framework from which people are able to attain and sustain healing and well-
being in these communities.
The rate of tobacco use is exceptionally and hazardously high among respondents. Compared
to the general Canadian population, total respondents were three times more likely to be daily
smokers. In the general Canadian population, there are significant differences in smoking rates
among age groups. This is not the case among addiction needs assessment survey
respondents. Rates of smoking is particularly alarming among respondents ages 15 to 17 who
are 10 times more likely to be daily smokers than similarly aged teens in the general population.
Approximately 60% of those with children in the home reported being daily smokers, and thus
exposing their children to the effects of second-hand smoke.
Mental health issues are prevalent among addiction needs assessment survey respondents.
Almost 30% reported GHQ scores of four or more indicating elevated levels of psychological
17
distress including anxiety/depression, social dysfunction, or loss of confidence. Comparable
research statistics indicate 12% of the general Canadian population have GHQ scores of four or
more.
Both male and female respondents reported exceptionally high rates of victimization. Sixty
percent (60%) reported being victims of domestic violence at some point in their lives. Twenty-
three percent (23%) reported being victims of domestic violence in the past 12 months. Past 12
month rates of domestic violence among respondents is three times higher than rates reported
in the general population, even though the general population data time measure is for five
years. Respondents reported alcohol use, either as victims or perpetrators, was involved in 60%
to 80% of the most recent domestic and non-domestic assault events. Alcohol use was
particularly prominent among both victims and perpetrators of domestic and non-domestic
sexual assault.
Respondent’s self-reported childhood physical, sexual and/or psychological assault was almost
three times the rate reported in the general population. Sixty-six percent (66%) of respondents
reported being childhood victims of five or more types of abuse perpetrated by three or more
types of family and/or non-family perpetrators. As children, these respondents must have lived
in constant terror, with no safe places to go and no safe people to go to. Some research
suggests there is a 30% rate of intergenerational transmission of child abuse, and among
Aboriginal populations this rate may be as high as 60%. This means an alarming number of
children are currently being, or have been, physically, psychologically and/or sexually abused by
persons in their home and by members of their community.
Aboriginal research literature clearly illustrates protective factors between language, culture,
spirituality, and traditions and increased individual and community resilience, health and
healing, and overall well-being (for example see: Fleming & Ledogar, 2008; Hunter, Logan,
Goulet & Barton, 2006; Lalonde, 2006; Twigg & Hengen, 2009; Waldram, 2008). Addiction
needs assessment survey respondents gave mixed reports of their involvement with their
culture. Over 75% said they had attended pow wows in the pervious year, but significantly fewer
attended seasonal ceremonies or feast, or cultural ceremonies and rites. Fewer still reported
having a traditional spiritual leader or mentor. Only 14% reported having a conversational level
of fluency in their ancestral language.
However, respondents very clearly indicated interest in their traditions and culture and placed a
high level of importance on learning more. This was particularly apparent among respondents
between the ages of 25 to 49. Respondents in this age group were more likely to participate in
cultural events/ceremonies, to fluently speak their ancestral language, and to have a spiritual
mentor. They were also more likely to express the desire to learn more about their culture and
teachings. This is a very exciting result, and may be indicating a resurgence of cultural
awareness and identity among those in these ages.
The most effective agents of change are those which come from within. This is true of both
individuals and communities. Members of the First Nations and Métis communities included in
this addiction needs assessment survey were clearly looking toward their cultural and spiritual
traditions for relevant solutions to their personal and community problems.
18
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Initiative.
Duran, B., Sanders, M., Skipper, B., Waitzkin, H., Malcoe, L., Paine, S. & Yager, J. (2004).
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National Aboriginal Health Organization (NAHO) (2007). OCAP principles. Ottawa, ON: National
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and New Zealand: A Review of the Literature. Submitted to the World Health Organization,
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Newton-Taylor, B., Wereley, T. & Jelley, J. (2001). A community based needs assessment for
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20
Appendix - Tables
21
Rainy River District Aboriginal Addiction Needs Assessment Survey Report
Couchiching First Nation
Table 1: Socio-Demographics
Total Couchiching Men Women

Sample First Nation N = 89 N = 110
N = 378 N = 200 % (n) % (n)
% (n) % (n)
Basic Demographics
Gender ns 44.7 (89) 55.3 (110)
% male 41.5 (154) 44.7 (89)
Age ns
mean age - in years 36.3 (368) 35.4 (188) 34.2 (83) 36.3 (105)
15 - 17 9.0 (33) 10.6 (20) 9.6 (8) 11.4 (12)
18 - 24 22.8 (84) 18.6 (35) 21.7 (18) 16.2 (17)
25 - 49 46.7 (172) 47.9 (90) 49.4 (41) 46.7 (49)
50+ 21.5 (79) 22.9 (43) 19.3 (16) 25.7 (27)
Current Marital Status ns
single (never married) 39.3 (147) 47.0 (93) 54.0 (47) 41.8 (46)
married/cohabitating 47.9 (179) 41.4 (82) 39.1 (34) 42.7 (47)
separated/divorced/widowed 12.8 (48) 11.6 (23) 6.9 (6) 15.5 (17)
Number of Children/Children in the Home
Number of Children
mean number – overall ns 2.1 (359) 2.2 (193) 1.7 (85) 2.6 (108)
mean number - of those with children ns 2.9 (256) 3.1 (140) 2.8 (53) 3.2 (87)
0 none 28.7 (103) 27.5 (53) 37.6 (32) 19.4 (21)
1 12.0 (43) 10.4 (20) 10.6 (9) 10.2 (11)
2 23.4 (84) 24.4 (47) 20.0 (17) 27.8 (30)
3 16.2 (58) 16.6 (32) 20.0 (17) 13.9 (15)
4 9.2 (33) 11.9 (23) 7.1 (6) 15.7 (17)
5+ 10.6 (38) 9.3 (18)
Mean Number of Children by Age Group ns
ages 0 to 5 0.6 (250) 0.6 (136) 0.7 (50) 0.6 (86)
ages 6 to 14 0.7 (249) 0.6 (136) 0.6 (50) 0.6 (86)
ages 15 to 17 0.2 (249) 0.2 (136) 0.2 (50) 0.2 (86)
ages 18 to 24 0.5 (247) 0.4 (132) 0.3 (49) 0.5 (83)
ages 25 or more 0.9 (249) 0.9 (132) 0.9 (49) 0.9 (83)
Number of Children in the Home ns
mean number 1.2 (254) 1.4 (137) 1.3 (52) 1.5 (85)
0 none 33.5 (85) 27.7 (38) 36.5 (19) 22.4 (19)
1-2 51.6 (131) 56.9 (78) 51.9 (27) 60.0 (51)
3+ 15.0 (38) 15.3 (21) 11.5 (6) 17.6 (15)
Household Composition
Number of People in the Home ns
mean number 3.4 (378) 3.4 (196) 3.2 (86) 3.6 (109)
1-2 33.9 (128) 27.6 (54) 30.2 (26) 25.7 (28)
3-4 42.9 (162) 52.0 (102) 53.5 (46) 50.5 (55)
5+ 23.3 (88) 20.4 (40) 16.3 (14) 23.9 (26)
Household Members Living in the Home ns
spouse/partner 53.9 (185) 48.9 (89) 47.4 (36) 49.5 (52)
own children 48.4 (166) 53.8 (98) 42.1 (32) 62.9 (66)
parent(s) 28.9 (99) 27.0 (54) 35.5 (27) 25.7 (27)
other family 30.3 (104) 38.5 (70) 40.8 (31) 37.1 (39)
Data Tables Couchiching First Nation 22

* p < .05; ** p < .01, *** p < .000, ns = not significant
N = 378 N = 200 % (n) % (n)
% (n) % (n)
Education/Occupation/Income
Education Level ns
less than completed secondary school 39.6 (149) 45.0 (90) 53.9 (48) 38.2 (42)
graduated secondary school 16.0 (60) 13.5 (27) 14.6 (13) 11.8 (13)
some post-secondary 24.2 (91) 20.0 (40) 14.6 (13) 24.5 (27)
graduated post-secondary 20.2 (76) 21.5 (43) 16.9 (15) 25.5 (28)
Employment Status ns
employed full/part time 46.8 (176) 49.5 (98) 43.7 (38) 53.6 (59)
student 14.9 (56) 13.1 (26) 11.5 (10) 14.5 (16)
unemployed 29.3 (110) 32.3 (64) 42.5 (37) 24.5 (27)
retired/disabled/other 16.0 (60) 10.1 (20) 8.0 (7) 11.8 (13)
Usual Occupation ns
unskilled 21.0 (48) 27.0 (31) 38.9 (21) 16.4 (10)
semi-skilled 16.2 (37) 13.9 (16) 16.7 (9) 11.5 (7)
skilled 14.0 (32) 6.1 (7)
sales/service/clerical 13.1 (30) 13.9 (16) 13.0 (7) 14.8 (9)
health care/social services/education/managerial 35.8 (82) 39.1 (45) 20.4 (11) 55.7 (34)
Spouse/Partner Employment Status ns
employed full/part time 53.3 (98) 59.4 (57) 56.1 (23) 61.1 (33)
student 4.3 (8) 7.3 (7)
unemployed 23.9 (44) 22.9 (22) 19.5 (8) 25.9 (14)
retired/disabled/other 18.5 (34) 10.4 (10)
Family Income Source
employment ns 61.2 (205) 66.5 (119) 65.4 (51) 67.0 (67)
employment insurance * 14.0 (47) 7.3 (13) 7.7 (6) 7.0 (7)
welfare/family benefits ns 25.4 (85) 23.6 (42) 25.6 (20) 22.2 (22)
other ns 13.2 (44) 11.2 (20) 10.3 (8) 12.0 (12)
Estimate of Total Household Income ns
less than $20,000 per year 34.0 (121) 36.0 (64) 36.6 (30) 35.4 (34)
$20,000 - 39,999 per year 25.3 (90) 28.7 (51) 26.8 (22) 30.2 (29)
$40,000 - 59,999 per year 16.3 (58) 20.2 (36) 18.3 (15) 21.9 (21)
$60,000 or more per year 24.4 (87) 15.2 (27) 18.3 (15) 12.5 (12)
Living Arrangements - Location
Currently Live ***
on-reserve 35.7 (133) 92.5 (184) 93.3 (83) 91.7 (100)
ns
If Living Off-Reserve
live in urban area 60.6 (132) 62.5 (10)
Residential School Attendance
Respondent Residential School Experiences ns
attended residential school 10.6 (35) 7.1 (12)
Family Member Attended Residential School
mother ns 36.8 (98) 33.9 (63) 35.4 (29) 33.0 (34)
father ns 44.4 (118) 42.5 (79) 51.2 (42) 35.9 (37)
brother/ sister ns 54.9 (146) 55.4 (103) 48.8 (40) 60.2 (62)
aunt/uncle * 45.1 (120) 55.9 (104) 48.8 (40) 61.2 (63)
grandparent ** 47.7 (127) 62.9 (117) 63.4 (52) 62.1 (64)
great grandparent ns 22.6 (60) 21.5 (40) 23.2 (19) 20.4 (21)
other family ns 32.3 (86) 25.8 (48) 25.6 (21) 26.2 (27)

Table 2: Status, Language and Culture

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Aboriginal Status and Cultural Background
Aboriginal Status
registered status Indian *** 58.4 (218) 99.5 (199) 98.9 (88) 100.0 (110)
non-status Indian
Métis 33.2 (124) 0.0 (0)
Cultural Background
Ojibway 63.5 (231) 98.4 (189) 97.7 (84) 99.0 (104)
Métis
other First Nation
Ancestral Aboriginal Language and Knowledge/Use of Language
Ancestral Aboriginal Language ns
Ojibway 89.4 (330) 94.0 (187) 94.4 (84) 93.6 (102)
other 10.6 (39) 6.0 (12) 5.6 (5) 6.4 (7)
Fluency in Traditional Language ***
fluently speak/understand language 19.0 (68) 4.8 (9)
understand when spoken to, but cannot speak
30.0 (107) 34.6 (65) 37.2 (32) 32.7 (33)
language
cannot speak or understand language 51.0 (182) 60.6 (114) 58.1 (50) 62.4 (63)
**
Language Used Most Often in Daily Life
English 84.8 (317) 94.5 (188) 95.5 (84) 93.6 (103)
Traditional language 15.2 (57) 5.5 (11)
Language Spoken In Home as a Child **
English 58.1 (219) 70.2 (139) 75.0 (66) 66.1 (72)
Traditional language 41.9 (158) 29.8 (59) 25.0 (22) 33.9 (37)
Participation in Traditional Aboriginal Cultural Events/Ceremonies
Participated in Traditional Aboriginal Cultural Events – Past 12 Months
% yes ns 60.9 (227) 68.5 (135) 66.3 (57) 70.9 (78)
Participated in Traditional Aboriginal Ceremonies – Past 12 Months
% yes *** 45.1 (167) 29.2 (57) 34.5 (29) 25.5 (28)
If Participated in Traditional Cultural Events/Ceremonies – which ones
traditional arts and crafts
political meetings and events
seasonal ceremonies and feasts *** 52.9 (128) 30.0 (42) 35.0 (21) 26.3 (21)
addictions and mental health cultural activities
pow wows * 74.6 (173) 84.7 (116) 86.4 (51) 83.3 (65)
cultural ceremonies and rites ns 38.9 (91) 33.6 (46) 37.3 (22) 30.8 (24)
other cultural events and ceremonies ns 12.1 (28) 6.6 (9)

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Traditional Spiritual Leader/Mentor
Have a Traditional Spiritual Leader/Mentor
% yes ns 28.3 (104) 29.9 (59) 27.3 (24) 32.4 (35)
if yes: number of times received spiritual guidance from this person in past 30 days
mean number of times ns 3.8 (98) 2.7 (54) 3.0 (22) 2.5 (32)
0 20.4 (20) 25.9 (14) 27.3 (6) 25.0 (8)
1 time 21.4 (21) 31.5 (17) 27.3 (6) 34.4 (11)
2 times 24.5 (24) 18.5 (10)
3 or more times 33.7 (33) 24.1 (13)
Importance of Traditional Aboriginal Culture and Teachings
% important/very important ns
learn more about traditional prayer 52.5 (190) 53.3 (106) 47.7 (42) 58.2 (64)
learn more about traditional medication 52.9 (191) 48.5 (96) 44.3 (39) 52.3 (57)
have more education about traditional spiritual beliefs 64.1 (234) 68.5 (137) 58.4 (52) 77.3 (85)
learn the meaning of traditional ceremonies 66.6 (243) 70.0 (140) 61.8 (55) 76.4 (84)
learn the meaning of traditional events 68.9 (250) 72.9 (145) 60.2 (53) 82.7 (91)
know your clan 65.4 (238) 70.1 (138) 66.7 (58) 72.5 (79)
to speak you traditional language 59.7 (216) 66.5 (133) 58.4 (52) 72.7 (80)
have a traditional name 60.2 (219) 63.6 (126) 56.3 (49) 70.0 (77)
have your colours 58.9 (212) 64.6 (128) 57.5 (50) 70.9 (78)
participate in traditional cultural events 66.3 (242) 71.6 (141) 64.8 (57) 76.9 (83)
participate in traditional ceremonial events 60.6 (220) 64.8 (129) 59.1 (52) 70.0 (77)
learn more about the Creator 59.2 (216) 67.2 (133) 58.0 (51) 74.3 (81)
renew your traditional spirituality 59.1 (214) 61.6 (122) 55.7 (49) 67.0 (73)
learn more about traditional medicine and healing 64.7 (238) 67.2 (133) 61.4 (54) 71.6 (78)
receive medical help from a tribal medicine person 52.5 (192) 55.3 (109) 49.4 (43) 60.6 (66)
Thoughts of Historical Events

Ever Think About
the loss of our land ns 75.3 (213) 79.8 (130) 75.0 (54) 83.3 (75)
the loss of our language ns 80.4 (242) 80.6 (133) 71.2 (52) 87.9 (80)
losing our traditional spiritual ways ns 83.0 (253) 80.1 (137) 71.8 (56) 87.0 (80)
the loss of family ties because of residential schools ns 76.2 (218) 70.7 (118) 68.0 (51) 72.8 (67)
the loss of families from the reserve, or area, due to
69.9 (197) 60.1 (92) 59.7 (40) 60.5 (52)
government relocation *
loss of self respect from poor treatment by
80.2 (231) 73.5 (119) 72.0 (54) 74.4 (64)
government officials ns
the loss of trust in whites from broken treaties ns 74.7 (213) 70.2 (118) 69.9 (51) 70.5 (67)
losing our culture ns 85.5 (259) 81.1 (137) 70.3 (52) 89.4 (84)
the losses from the effects of alcohol on our people * 87.1 (264) 79.9 (139) 70.3 (52) 86.9 (86)
loss of respect by our children and grandchildren for
85.9 (262) 84.1 (138) 76.4 (55) 90.1 (82)
elders ns
loss of our people through early death * 87.6 (261) 79.9 (139) 72.7 (56) 85.4 (82)
loss of respect by our children for traditional ways ns 86.5 (257) 80.7 (134) 73.2 (52) 86.3 (82)

Table 3: Alcohol Use and Consumption Patterns

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Drinking History - Total Respondents
Ever Dank in Lifetime ns
% yes 96.3 (363) 95.0 (190) 95.5 (85) 94.5 (104)
ns
Drank in Past 12 Months
% yes 71.5 (259) 68.4 (130) 69.4 (59) 67.3 (70)
ns
Age Had First Drink - Excluding Sips
mean age 13.5 (355) 14.0 (188) 13.6 (84) 14.4 (103)
age 12 or less 31.3 (111) 24.5 (46) 27.4 (23) 21.4 (22)
13 - 14 30.1 (107) 35.6 (67) 32.1 (27) 38.8 (40)
15 - 16 29.0 (103) 25.0 (47) 28.6 (24) 22.3 (23)
17 or more 9.6 (34) 14.9 (28) 11.9 (10) 17.5 (18)
Age First Time Intoxicated ns
mean age 14.3 (346) 14.5 (184) 14.2 (84) 14.8 (99)
age 12 or less 24.1 (83) 18.6 (34) 22.6 (19) 14.3 (14)
13 - 14 26.7 (92) 36.6 (67) 32.1 (27) 40.8 (40)
15 - 16 32.5 (112) 27.9 (51) 32.1 (27) 24.5 (24)
17 or more 16.8 (58) 16.9 (31) 13.1 (11) 20.4 (20)
Frequency of Drinking
lifetime abstainer 3.7 (14) 5.0 (10)
past year abstainer 27.5 (103) 30.2 (60) 29.5 (26) 30.9 (34)
less than once a month 19.2 (72) 30.7 (61) 26.1 (23) 34.5 (38)
1 - 3 times a month 19.5 (73) 13.6 (27) 15.9 (14) 11.8 (13)
once a week 10.1 (38) 8.5 (17) 10.2 (9) 7.3 (8)
2 - 3 times a week 12.5 (47) 9.5 (19) 9.1 (8) 9.1 (10)
daily/almost daily
Past Year Abstinent: - Total Number of Years Abstinent ns
mean number of years 9.8 (98) 9.3 (57) 9.1 (24) 9.4 (33)
number of years
1 - 5 years 53.1 (52) 57.9 (33) 58.3 (14) 57.6 (19)
6 or more years 46.9 (46) 42.1 (24) 41.7 (10) 42.4 (14)
Alcohol Consumption In Past 12 Months - Drinkers Only
Frequency of Drinking
1 - 3 times a month 28.3 (73) 20.9 (27) 24.1 (14) 18.6 (13)
once a week 14.7 (38) 13.2 (17) 15.5 (9) 11.4 (8)
2 - 3 times a week 18.2 (47) 14.7 (19) 13.8 (8) 14.3 (10)
daily/almost daily
Average Weekly Alcohol Consumption ns
mean number of drinks 13.9 (245) 9.7 (122) 14.3 (54) 5.9 (67)
number of drinks
1 - 7 drinks 58.8 (144) 63.1 (77) 48.1 (26) 76.1 (51)
8 - 14 drinks 16.7 (41) 18.0 (22) 24.1 (13) 13.4 (9)
15 - 28 drinks 11.0 (27) 11.5 (14)
29+ drinks 13.5 (33) 7.4 (9)

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Average Weekly Alcohol Consumption by Age Group - Mean Number of Drinks *
age group
15 - 17 8.0 (19) 2.8 (12)
18 - 24 15.3 (67) 11.5 (25) 14.6 (12) 8.6 (13)
25 - 49 14.2 (112) 8.0 (59) 9.3 (29) 6.8 (30)
50 + 10.0 (42) 5.7 (18)
Highest Number of Drinks on One Occasion ns
mean number of drinks 14.5 (231) 15.6 (111) 21.4 (50) 10.9 (61)
number of drinks
1-5 10.0 (23) 16.2 (18) 12.0 (6) 19.7 (12)
6 - 10 32.6 (75) 27.0 (30) 14.0 (7) 37.7 (23)
11 - 15 20.4 (47) 17.1 (19)
16 - 20 18.7 (43) 14.4 (16)
21+ 18.3 (42) 25.2 (28) 44.0 (22) 9.8 (6)
***
Highest Number of Drinks on One Occasion by Age Group - Mean Number of Drinks
age group
15 - 17 12.0 (20) 7.6 (10)
18 - 24 16.3 (65) 17.0 (24) 20.3 (12) 13.7 (12)
25 - 49 15.2 (106) 17.7 (57) 23. 8 (28) 11.8 (29)
50+ 9.9 (36) 7.6 (14)
Frequency of Drinking 5 to 7 Drinks on One Occasion ns
never 6.7 (17) 8.7 (11)
less than monthly 44.1 (112) 49.6 (63) 41.4 (24) 57.4 (39)
once a month or more 49.2 (125) 41.7 (53) 51.7 (30) 32.4 (22)
Frequency of Drinking 8 or More Drinks on One Occasion ns
never 8.6 (21) 10.2 (13)
less than monthly 54.7 (133) 54.3 (69) 50.9 (29) 58.0 (40)
once a month or more 36.6 (89) 35.4 (45) 42.1 (24) 29.0 (20)

Table 4: Alcohol Consumption and Drinking Context

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Locations Where Usually Drink
at home - % yes * 69.7 (175) 57.0 (73) 59.6 (34) 54.3 (38)
average weekly alcohol consumption
mean number of drinks ** 16.8 (169) 12.3 (66) 19.3 (30) 6.0 (35)
mean number of drinks by age group **
15 - 17
18 - 24 17.6 (48) 10.8 (14) 14.1 (7) 7.4 (7)
25 - 49 16.9 (81) 8.9 (35) 11.1 (18) 6.6 (17)
50+ 10.7 (29) 7.4 (11)
at friends - % yes ns 70.9 (178) 70.3 (90) 73.7 (42) 67.1 (47)
mean number of drinks * 16.3 (169) 11.1 (83) 16.3 (38) 6.4 (44)
15 - 17 10.0 (13) 3.4 (8)
18 - 24 17.5 (56) 9.6 (19) 13.2 (8) 7.0 (11)
25 - 49 15.9 (71) 8.7 (41) 9.3 (21) 7.9 (20)
50+ 12.2 (26) 8.5 (9)
at a party at someone’s house - % yes ns 58.5 (148) 60.2 (77) 66.7 (38) 55.7 (39)
mean number of drinks ns 15.4 (139) 9.8 (71) 12.7 (35) 6.9 (36)
15 - 17 10.2 (14) 3.1 (11)
18 - 24 15.3 (50) 12.6 (21) 15.3 (11) 9.8 (10)
25 - 49 16.0 (56) 10.1 (32) 11.8 (17) 8.1 (15)
50+
at a licensed premises - % yes * 53.3 (136) 64.3 (83) 60.3 (35) 67.1 (47)
mean number of drinks ns 15.5 (129) 10.9 (81) 17.1 (34) 6.0 (46)
mean number of drinks by age group *
15 - 17 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0)
18 - 24 18.3 (41) 10.7 (14)
25 - 49 14.1 (72) 7.8 (50) 8.9 (23) 7.0 (27)
50+ 15.6 (15) 5.8 (13)
Number of Locations Where Usually Drink
mean number of locations (range = 1 - 4) ns 2.5 (254) 2.5 (129) 2.6 (58) 2.4 (70)
mean number of drinks by number of locations **
1 - 2 locations 10.5 (122) 5.9 (67) 7.4 (25) 5.1 (42)
3 - 4 locations 17.8 (119) 14.6 (54) 20.9 (28) 7.2 (25)

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Person(s) Usually Drink With
spouse/partner - % yes ns 27.1 (58) 18.4 (19) 13.0 (6) 21.4 (12)
mean number of drinks 11.2 (55) 7.3 (17)
mean number of drinks by age group
15 - 17 (not applicable)
18 - 24
25 - 49 10.7 (34) 6.7 (10)
50+
close friends - % yes ** 58.8 (140) 74.6 (88) 76.9 (40) 73.8 (48)
mean number of drinks ns 11.3 (132) 11.5 (83)
mean number of drinks by age group ns
15 - 17 10.9 (13) 2.8 (12)
18 - 24 12.7 (42) 11.3 (21) 13.7 (11) 8.8 (10)
25 - 49 10.8 (54) 9.0 (38) 11.7 (16) 7.0 (22)
50+ 9.9 (21) 11.8 (7)
family members - % yes ns 15.4 (33) 10.5 (11)
mean number of drinks * 24.9 (31) 7.4 (10)
mean number of drinks by age group *
15 - 17 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0)
18 - 24
25 - 49
50+

Table 5: Alcohol Problems and Consequences of Use

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Past 12 Months
Hazardous/Harmful Levels of Drinking (AUDIT) ns
mean AUDIT score 12.5 (205) 11.7 (105) 12.9 (47) 10.7 (58)
drinking risk
7 or less % low risk 29.3 (60) 28.6 (30) 19.1 (9) 36.2 (21)
8 -15 % harmful drinking 42.4 (87) 52.4 (55) 57.4 (27) 48.3 (28)
16+ % hazardous/dependent drinking 28.3 (58) 19.0 (20) 23.4 (11) 15.5 (9)
Harmful Effects of Own Alcohol Use On - % yes ns
friendship/social life 28.5 (71) 30.7 (39) 33.3 (19) 29.0 (20)
physical health 31.5 (78) 34.1 (44) 39.0 (23) 30.4 (21)
mental health 27.4 (68) 22.8 (29) 22.8 (13) 23.2 (16)
overall happiness 32.4 (81) 27.8 (35) 28.6 (16) 27.5 (19)
outlook on life 30.0 (75) 28.9 (37) 31.0 (18) 27.5 (19)
marriage or home life 32.5 (81) 30.7 (39) 29.8 (17) 31.9 (22)
work, studies or employment opportunities 28.3 (69) 26.0 (33) 22.8 (13) 29.0 (20)
financial position 32.3 (80) 32.3 (41) 40.4 (23) 24.6 (17)
Harmful Effects of Family Members Alcohol Use On - % yes ns
physical health 48.6 (152) 46.3 (81) 39.7 (29) 51.5 (52)
mental health 47.5 (151) 41.0 (71) 40.3 (29) 42.0 (42)
outlook on life 45.3 (144) 43.1 (75) 37.5 (27) 47.5 (48)
Alcohol and Violence
involved with a physical fight while drinking ns 18.2 (47) 21.5 (28) 28.8 (17) 15.7 (11)
frequency in the past 12 months
at least once a month
Alcohol Use In The Home During Childhood
As a Child: Someone In Home Abuse Alcohol
% yes 70.2 (212) 72.2 (117) 63.2 (43) 79.6 (74)
relationship - % yes
mother 48.1 (126) 53.3 (72) 47.2 (25) 57.3 (47)
father 60.7 (159) 68.1 (92) 66.0 (35) 69.5 (57)
step parent 20.2 (53) 14.8 (20) 15.1 (8) 14.6 (12)
other family member 41.2 (108) 33.3 (45) 35.8 (19) 31.7 (26)

Table 6: Other Substance Use

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Illicit Substances
Marijuana: ns
used in past 12 months 49.3 (170) 46.4 (90) 52.4 (44) 41.3 (45)
used but not in past 12 months 24.6 (85) 28.9 (56) 33.3 (28) 25.7 (28)
never used in lifetime 26.1 (90) 24.7 (48) 14.3 (12) 33.0 (36)
Marijuana Use by Age Group - Used in Past 12 Months ns
15 - 17 53.1 (17) 60.0 (12)
18 - 24 63.4 (52) 67.6 (23) 64.7 (11) 70.6 (12)
25 - 49 54.3 (88) 49.4 (43) 55.3 (21) 44.9 (22)
50+ 18.0 (11) 22.0 (9)
Crack/Cocaine: ns
Crack/Cocaine Use by Age Group - Used in Past 12 Months ns
15 - 17
18 - 24 27.8 (22) 27.3 (9)
25 - 49 18.6 (30) 20.9 (18) 24.3 (9) 18.4 (9)
50+
Other Illicit Substance Use 2 ns
Other Illicit Substance Use by Age Group - Used in Past 12 Months ns
15 - 17
18 - 24
25 - 49 16.5 (26) 8.2 (7)
50+
Injection Drug Use ns
ever in lifetime - % yes 9.5 (27) 12.5 (18) 12.5 (9) 12.7 (9)
in past 12 months - % yes
Age First Used Illicit Drugs ns
mean age 16.8 (101) 17.4 (49) 16.0 (27) 19.3 (21)
ages 14 or less 33.7 (34) 40.8 (20) 48.1 (13) 28.6 (6)
15 - 19 47.5 (48) 38.8 (19) 37.0 (10) 42.9 (9)
20 or more 18.8 (19) 20.4 (10)
Past Year Abstinence: Number of Years Abstinent ns
2
other illicit substances include: solvents, methamphetamines, hallucinogens, and MDMA/ecstasy
N = 378 N = 200 % (n) % (n)
% (n) % (n)
Prescription Drugs
Opiate Use With Prescription ns
Opiate Use With Prescription by Age Group - Used in Past 12 Months
15 - 17
18 - 24 ns 26.6 (21) 18.8 (6)
25 - 49 * 31.1 (50) 17.6 (15) 22.2 (8) 14.3 (7)
50+ ns 21.3 (13) 21.1 (8)
Opiate Use Without Prescription ns
Opiate Use Without Prescription by Age Group - Used in Past 12 Months ns
15 - 17 25.0 (8) 30.0 (6)
18 - 24 33.8 (27) 32.3 (10)
25 - 49 19.1 (31) 26.7 (23) 34.2 (13) 20.8 (10)
50+
Other Prescription Drug Use With/Without Prescription ns
Other Prescription Drug Use With/Without Prescription by Age Group - Used in Past 12 Months ns
15 - 17
18 - 24 25.3 (20) 24.2 (8)
25 - 49 26.3 (42) 18.6 (16) 18.9 (7) 18.4 (9)
50+ 18.0 (11) 17.9 (7)

Table 7: Harmful Effects of Drug Use

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Past 12 Months
Harmful Effects of Own Drug Use On - % yes ns
physical health 37.8 (65) 30.7 (27) 34.0 (16) 25.0 (10)
mental health 31.2 (54) 27.3 (24) 27.7 (13) 25.0 (10)
outlook on life 31.4 (54) 31.8 (28) 34.0 (16) 27.5 (11)
Harmful Effects of Family Members Drug Use On - % yes
friendship/social life * 39.7 (104) 50.7 (72) 39.0 (23) 58.5 (48)
physical health ** 40.9 (105) 55.6 (79) 42.4 (25) 64.6 (53)
mental health ns 42.7 (111) 52.1 (74) 36.2 (21) 62.7 (52)
overall happiness ns 45.6 (119) 53.1 (76) 41.7 (25) 61.0 (50)
outlook on life ns 42.9 (112) 53.5 (76) 44.1 (26) 59.8 (49)
marriage or home life * 42.5 (111) 54.6 (77) 43.3 (26) 62.5 (50)
work, studies or employment opportunities * 40.7 (105) 52.8 (75) 37.3 (22) 63.4 (52)
financial position ** 43.3 (113) 56.9 (82) 44.3 (27) 65.9 (54)
Drug Use In The Home During Childhood

As a Child Someone In Home Abuse Drugs ns
% yes 33.7 (101) 34.0 (55) 35.3 (24) 33.3 (31)
relationship - % yes
mother 45.3 (43) 35.2 (19) 33.3 (8) 36.7 (11)
father 38.9 (37) 38.9 (21) 41.7 (10) 36.7 (11)
step parent 25.3 (24) 16.7 (9)
other family members 38.9 (37) 50.0 (27) 41.7 (10) 56.7 (17)

Table 8: Alcohol and Other Substance Use and Criminal Behaviour

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Substance Use and Criminal Behaviour
Substance Use as a Factor In Any Criminal Activity - % yes ns
ever in life 41.4 (149) 47.3 (86) 55.3 (47) 39.6 (38)
in past 12 months 10.5 (33) 8.0 (13)
Ever Been Incarcerated ns
% yes 36.1 (127) 32.6 (61) 50.0 (43) 17.0 (17)
if yes
was substance abuse a factor - % yes 81.0 (102) 83.3 (50) 82.9 (34) 83.3 (15)
total length of time in jail/prison
less than 1 year 68.6 (72) 75.5 (37) 68.8 (22) 87.5 (14)
1 year or more 31.4 (33) 24.5 (12)
Ever Been on Probation or Parole ns
% yes 40.8 (147) 39.6 (74) 53.5 (46) 28.0 (28)
if yes
was substance abuse a factor - % yes 72.7 (96) 66.7 (48) 65.2 (30) 69.2 (18)
total length of time on probation/parole
less than 1 year 17.6 (21) 19.2 (10)
1 year or more 82.4 (98) 80.8 (42) 87.5 (28) 70.0 (14)
Currently on Probation or Parole
% yes ns 5.6 (20) 9.0 (17) 12.6 (11) 6.0 (6)
if yes
was substance use a factor - % yes ** 75.0 (15) 31.6 (6)
Addictions Treatment While Incarcerated and/or on Probation
Offered Treatment While in Jail or on Probation For: ns
alcohol and/or drug problems - % yes 31.0 (52) 32.1 (27) 35.8 (19) 25.8 (8)
if yes
was the treatment effective - % yes 39.0 (23) 34.5 (10)
mental health - % yes 10.5 (14) 11.8 (8)
if yes
was the treatment effective - % yes
Was Treatment Based on Traditional Aboriginal Values, Practices, or Healing Methods ns
% yes 11.9 (20) 18.6 (16)

Table 9: Experiences of Alcohol and Other Substance Abuse Treatment

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Ever Been in Treatment For Substance Abuse
% yes ns 34.2 (122) 39.2 (73) 42.7 (35) 36.9 (38)
total number of times in lifetime - mean 2.9 (112) 2.8 (64) 2.9 (32) 2.7 (32)
total number of times in past 12 months - mean 0.8 (78) 0.5 (50) 0.4 (27) 0.5 (23)
total number of times before the age of 18 - mean 0.8 (108) 1.0 (62) 1.1 (31) 0.9 (31)
Alcohol Treatment
Number of Times In Lifetime ns
mean 2.8 (107) 2.7 (60) 2.9 (29) 2.4 (31)
1 time 39.3 (42) 45.0 (27) 34.5 (10) 54.8 (17)
2 times 21.5 (23) 28.3 (17)
3 or more times 39.3 (42) 26.7 (16) 24.1 (7) 29.0 (9)
Number of Times In Past 12 Months
mean ** 0.7 (74) 0.1 (45) 0.1 (23) 0.1 (22)
none ns 74.3 (55) 88.9 (40) 87.0 (20) 90.9 (20)
1 or more times
Number of Times Before the Age of 18 ns
mean 0.6 (104) 0.7 (58) 1.0 (28) 0.5 (30)
none 61.5 (64) 58.6 (34) 57.1 (16) 60.0 (18)
1 or more times 38.5 (40) 41.4 (24) 42.9 (12) 40.0 (12)
Type of Alcohol Program
residential ns 32.8 (40) 35.6 (26) 34.3 (12) 36.8 (14)
in patient ns 56.9 (70) 50.7 (37) 45.7 (16) 55.3 (21)
out patient * 18.0 (22) 32.9 (24) 34.3 (12) 31.6 (12)
detox ns 18.9 (23) 28.8 (21) 22.9 (8) 34.2 (13)
AA/self help ns 25.4 (31) 32.9 (24) 31.4 (11) 34.2 (13)
Alcohol Treatment Programs Based on Traditional Aboriginal Culture, Values Beliefs ns
% yes 49.5 (55) 36.1 (22) 30.0 (9) 41.9 (13)
Alcohol Treatment Programs Provide Aboriginal Treatment Counsellors ns
% yes 57.5 (65) 57.1 (36) 58.1 (18) 56.3 (18)
Other Substance Use Treatment
Number of Times In Lifetime ns
mean 1.9 (40) 2.6 (27) 3.7 (14) 1.5 (13)
1 time 60.0 (24) 48.1 (13)
2 times 22.5 (9) 22.2 (6)
3 or more times 17.5 (7) 29.6 (8)
Number of Times In Past 12 Months
mean ** 0.3 (24) 1.1 (16) 0.9 (10) 1.5 (6)
none ns 70.8 (17) 62.5 (10)
1 or more times ns 29.2 (7) 37.5 (6)

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Number of Times Before the Age of 18 ns
mean 0.7 (27) 1.1 (17) 0.7 (10) 1.7 (7)
none 44.4 (12) 35.3 (6)
1 or more times 55.6 (15) 64.7 (11)
Type of Substance Use Program ns
residential 45.2 (19) 37.0 (10)
inpatient 45.2 (19) 44.4 (12)
outpatient
detox 27.5 (11) 48.3 (14)
NA/self help
Drug Treatment Programs Based on Traditional Aboriginal Culture, Values, Beliefs ns
% yes 51.1 (23) 39.3 (11)
ns
Drug Treatment Programs Provide Aboriginal Treatment Counsellors
% yes 61.4 (27) 48.3 (14) 57.1 (8) 40.0 (6)
Importance of Traditional Aboriginal Cultural Components

% important/very important ns
to enhance treatment 72.6 (252) 65.6 (122) 60.2 (50) 70.6 (72)
to facilitate recovery 73.9 (257) 67.9 (127) 60.7 (51) 74.5 (76)
as an incentive to seek treatment 70.6 (245) 65.1 (121) 60.7 (51) 69.3 (70)
as a part of aftercare programs 76.1 (265) 70.3 (130) 67.5 (56) 73.3 (74)
Reasons for Substance Use Relapse After Treatment

% important/very important
lack of support by family ns 49.4 (40) 46.7 (21) 30.4 (7) 63.6 (14)
lack of support by friends ns 54.3 (44) 46.7 (21) 26.1 (6) 68.2 (15)
community issues/problems ns 50.0 (41) 44.4 (20) 34.8 (8) 54.5 (12)
availability of alcohol and other drugs ** 59.8 (49) 53.3 (24) 47.8 (11) 59.1 (13)
personal issues (e.g., financial, family) ns 64.6 (53) 62.2 (28) 52.2 (12) 72.7 (16)
mental health issues ns 65.1 (54) 48.9 (22) 26.1 (6) 72.7 (16)
lack of aftercare services available ns 67.1 (55) 53.3 (24) 47.8 (11) 59.1 (13)
employment related issues ns 62.2 (51) 45.5 (20) 34.8 (8) 57.1 (12)
diagnosed with illness/disorder ns 32.5 (25) 25.6 (11)
Addictions or Mental Health Priorities Related to Services or Programs
% yes
alcohol use ns 68.6 (175) 73.9 (88) 76.1 (35) 72.6 (53)
illicit drug use ns 67.8 (173) 63.9 (76) 67.4 (31) 61.6 (45)
prescription drug use ** 36.6 (93) 55.5 (66) 58.7 (27) 53.4 (39)
mental health ns 32.5 (83) 30.3 (36) 28.3 (13) 31.5 (23)

Table 10: Barriers to Substance Abuse Treatment

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Barriers to Substance Abuse Treatment - % very important/important
was a charge for treatment, could not afford it ** 22.9 (35) 16.5 (15)
**
did not have transportation to get to program 37.2 (64) 26.0 (25) 15.7 (8) 37.8 (17)
**
program was too far away 42.7 (73) 34.0 (33) 25.9 (14) 44.2 (19)
*
hours program operated were not convenient 35.3 (60) 21.5 (20) 13.7 (7) 31.0 (13)
**
could not find program offering type of treatment wanted 42.0 (73) 21.1 (20) 17.3 (9) 25.6 (11)
were not ready to stop using alcohol ns 41.9 (72) 41.4 (41) 32.7 (18) 52.3 (23)
were not ready to stop using other drugs * 41.9 (70) 37.1 (33) 34.0 (18) 41.7 (15)
ns
did not know where to get treatment 41.7 (70) 30.5 (29) 29.1 (16) 32.5 (13)
ns
did not think you needed treatment at the time 41.9 (72) 44.9 (44) 43.6 (24) 46.5 (20)
ns
thought you could handle the problem without treatment 53.2 (92) 44.9 (44) 38.2 (21) 53.5 (23)
ns
did not think the treatment would help 39.7 (69) 41.1 (39) 37.5 (21) 46.2 (18)
ns
getting treatment having a negative effect on job 31.7 (53) 27.2 (25) 26.9 (14) 27.5 (11)
ns
didn’t want others to find out you needed treatment 39.5 (66) 33.3 (32) 27.8 (15) 40.5 (17)
3 *
did not have child care 38.6 (59) 25.8 (23) 21.6 (11) 31.6 (12)
4 ns
spouse/partner would not allow you to go for treatment 22.0 (33) 19.5 (17) 17.0 (9) 23.5 (8)
*
your parents would not allow you to go for treatment 20.3 (31) 16.9 (15) 17.3 (9) 16.2 (6)
ns
the programs were not gender specific 24.8 (39) 18.2 (16) 19.6 (10) 16.2 (6)
ns
programs offered mixed gender treatment only 28.7 (48) 18.3 (17) 18.5 (10) 17.9 (7)
ns
friends discouraged you from getting treatment 27.1 (45) 20.2 (19)
ns
program not based on traditional values and beliefs 37.3 (60) 26.4 (24) 23.1 (12) 30.8 (12)
3
respondents with children only
4
married/cohabitating respondents only
Table 11: Tobacco Use - Smoking

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Ceremonial Tobacco Use
Smoke Tobacco for Traditional Ceremonial Purposes ns
% yes 29.7 (108) 25.5 (49) 35.7 (30) 17.8 (19)
Daily Tobacco Use
Ever Smoked Tobacco Daily ns
% yes 78.8 (287) 84.2 (165) 83.7 (72) 84.4 (92)
Age First Started Smoking Daily ns
mean 14.4 (284) 14.0 (162) 13.6 (71) 14.4 (90)
14 or less 56.0 (159) 65.4 (106) 74.6 (53) 57.8 (52)
15+ 44.0 (125) 34.6 (56) 25.4 (18) 42.2 (38)
Currently Smoke ns
daily 67.5 (193) 71.7 (119) 75.3 (55) 68.5 (63)
occasionally 11.2 (32) 11.4 (19) 12.3 (9) 10.9 (10)
not at all 21.3 (61) 16.9 (28) 12.3 (9) 20.7 (19)
Daily Smoking by Age Group
15 - 17 * 61.5 (8) 93.8 (15)
18 - 24 ns 85.2 (23) 76.8 (43) 83.3 (10) 86.7 (13)
25 - 49 ns 70.9 (56) 64.8 (94) 71.4 (25) 70.5 (31)
50+ ns 68.4 (26) 56.7 (34) 71.4 (10) 66.7 (16)
Number of Cigarettes Smoke Each Day
mean ns 11.6 (222) 12.9 (133) 14.5 (63) 11.5 (69)
1 - 10 * 58.1 (129) 47.4 (63) 36.5 (23) 58.0 (40)
11+ * 41.9 (93) 52.6 (70) 63.5 (40) 42.0 (29)
Previous Tobacco Use

Previously Smoked - Number of Years Abstinent ns
mean 11.5 (57) 12.3 (28) 6.3 (9) 15.2 (19)
1-5 38.6 (22) 39.3 (11)
6 - 10
11+ 38.6 (22) 42.9 (12)

Table 12: Mental Health/Psychological Distress (GHQ)
Total Sample Couchiching Men Women

N = 378 First Nation N = 89 N = 110
% (n) N = 200 % (n) % (n)
% (n)
Percentage Reporting Symptoms of Psychological Distress - Past Few Weeks ns
unable to concentrate on tasks 13.7 (50) 14.9 (29) 15.1 (13) 15.0 (16)
lost sleep over worry 28.1 (103) 28.8 (55) 20.0 (17) 36.2 (38)
did not feel you are playing a useful part in things 17.4 (63) 14.6 (28) 15.1 (13) 14.3 (15)
did not feel capable of making decisions 12.6 (46) 12.4 (24) 14.1 (12) 11.2 (12)
felt constantly under strain 27.3 (99) 26.9 (52) 18.6 (16) 34.0 (36)
felt could not get over difficulties 24.5 (89) 27.5 (53) 22.1 (19) 32.1 (34)
been unable to enjoy normal day-to-day activities 20.4 (74) 14.9 (29) 15.1 (13) 15.0 (16)
been unable to face up to problems 17.9 (65) 15.5 (30) 12.8 (11) 17.8 (19)
feeling unhappy or depressed 30.3 (110) 29.4 (57) 22.1 (19) 35.5 (38)
losing confidence in self 24.2 (88) 24.4 (47) 28.2 (24) 21.5 (23)
thinking of self as a worthless person 15.2 (55) 16.1 (31) 17.4 (15) 15.1 (16)
been feeling unhappy 16.4 (59) 12.4 (24) 12.8 (11) 12.1 (13)
Total Psychological Distress Scores (range 0 - 13) ns
mean 2.6 (366) 2.5 (194) 2.3 (86) 2.7 (107)
elevated psychological distress (GHQ 4+) - % yes 28.4 (104) 29.9 (58) 27.9 (24) 31.8 (34)
mean by age group
15 - 17 2.6 (32) 2.5 (20) 1.3 (8) 3.3 (12)
18 - 24 2.5 (84) 2.2 (34) 2.0 (17) 2.5 (17)
25 - 49 2.9 (168) 2.6 (89) 2.3 (40) 2.8 (49)
50+ 2.5 (73) 2.7 (40) 3.5 (16) 2.1 (24)

Table 13: Respondent Identified Existing Community Addictions/Mental Health Services,
Groups, Programs, Agencies, Organizations

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Currently Available
Any Mentioned – % yes 55.9 (200) 53.8 (98) 39.5 (32) 65.3 (66)
Response Classification
First Nation specific community based services 25.0 (50) 62.2 (61) 62.5 (20) 62.1 (41)
First Nation specific tribal services 18.0 (36) 37.8 (37) 21.8 (7) 45.5 (30)
urban Aboriginal services 31.0 (62) 8.2 (8) 3.1 (1) 10.6 (7)
non-urban Aboriginal services 27.5 (55) 15.3 (15) 6.3 (2) 19.7 (13)
other services 50.0 (100) 37.8 (37) 28.1 (9) 42.4 (28)
Services Working Well in the Community

other services 27.5 (55) 18.4 (18) 15.6 (5) 19.7 (13)
Services Not Working Well in the Community

other services 11.5 (23) 9.2 (9) 12.5 (4) 7.6 (5)

Table 14: Respondent Identified Needed Community Addictions/Mental Health Services, Groups,
Programs, Agencies, Organizations

N = 378 N = 200 % (n) % (n)
% (n) % (n)
Not Currently Available But Needed
Any Mentioned – % yes 55.3 (173) 52.7 (87) 41.9 (31) 61.5 (56)
Response Classification
addiction services 78.6 (136) 78.2 (68) 35.3 (24) 64.7 (44)
mental health services 40.5 (70) 24.1 (21) 28.6 (6) 71.4 (15)
services for children and youth 20.2 (35) 18.4 (16)
culturally appropriate services 14.5 (25) 17.2 (15)
other services 20.8 (36) 18.4 (16) 37.5 (6) 62.5 (10)
Service Needs Rated as Most Important

addiction services 64.2 (111) 69.0 (60) 38.3 (23) 61.7 (37)
mental health services 28.9 (50) 21.8 (19)
services for children and youth 14.5 (25) 16.1 (14)
culturally appropriate services 11.6 (20) 14.9 (13)
other services 13.3 (23) 10.3 (9)

5
Table 15: Respondent Experiences of Physical, Psychological and/or Sexual Assault

% (n) N = 200 % (n) % (n)
% (n)
Assault by Spouse/Partner/Boyfriend/Girlfriend
physical assault ns
ever in adult life 58.7 (178) 60.8 (101) 57.7 (41) 62.8 (59)
in past 12 months 23.5 (70) 21.6 (35) 28.6 (20) 16.5 (15)
drinking during most recent incident - % yes
self 59.5 (91) 54.0 (47) 59.0 (23) 48.9 (23)
other person 72.9 (113) 67.0 (61) 66.7 (26) 66.7 (34)
psychological assault ns
in past 12 months 36.5 (104) 30.4 (48) 34.8 (24) 26.1 (23)
self 46.1 (71) 35.9 (33) 44.7 (17) 28.3 (15)
other person 59.0 (92) 57.0 (53) 57.9 (22) 55.6 (30)
sexual assault ns
in past 12 months 8.2 (24) 5.5 (9)
self 41.3 (26) 30.3 (10)
other person 63.6 (42) 62.9 (22)
Assault by Other Person(s) Living in the Home
physical assault
ever in adult life ns 23.1 (67) 25.5 (41) 29.9 (20) 21.5 (20)
in past 12 months ns 9.0 (26) 8.1 (13) 10.3 (7) 6.5 (6)
self * 50.9 (28) 29.4 (10)
other person ns 67.3 (37) 69.7 (23) 73.3 (11) 64.7 (11)
in past 12 months 16.2 (46) 13.0 (21) 14.7 (10) 12.0 (11)
self 42.4 (25) 29.5 (13)
other person 56.7 (34) 69.8 (30) 73.7 (14) 65.2 (15)
sexual assault ns
in past 12 months
self
other person 86.7 (13) 72.7 (8)
Assault by Non-Family Person(s) Outside Of Home
physical assault ns
in past 12 months 11.8 (34) 16.8 (26) 24.2 (16) 11.4 (10)
self 70.0 (70) 72.1 (49) 85.7 (30) 56.3 (18)
other person 81.4 (83) 87.1 (61) 91.9 (34) 81.3 (26)
5
all respondents were ages 18 or older
% (n) N = 200 % (n) % (n)
% (n)
in past 12 months 16.4 (46) 21.7 (33) 24.6 (16) 19.8 (17)
self 51.5 (51) 59.4 (38) 67.7 (21) 50.0 (16)
other person 63.4 (64) 73.8 (48) 71.0 (22) 75.8 (25)
sexual assault ns
ever in adult life 16.0 (46) 9.7 (15)
in past 12 months
self 76.5 (26) 64.3 (9)
other person 77.8 (28) 75.0 (9)
As Perpetrator of Assault on Spouse/Partner/Boyfriend/Girlfriend
physical assault ns
in past 12 months 14.0 (41) 11.0 (17) 10.8 (7) 11.2 (10)
self 59.5 (66) 56.3 (36) 68.0 (17) 47.4 (18)
other person 68.5 (76) 61.7 (37) 52.2 (12) 66.7 (24)
in past 12 months 19.5 (56) 15.6 (24) 18.5 (12) 13.6 (12)
self 50.0 (48) 54.9 (28) 63.6 (14) 46.4 (13)
other person 54.2 (52) 52.0 (26) 36.4 (8) 63.0 (17)
sexual assault ns
ever in adult life 5.0 (14) 3.9 (6)
in past 12 months
self
other person
As Perpetrator of Assault on Someone Who is Not Spouse/Partner/Boyfriend/Girlfriend
physical assault ns
in past 12 months 11.7 (33) 14.9 (23) 24.2 (16) 8.0 (7)
self 64.0 (64) 72.3 (47) 76.5 (26) 66.7 (20)
other person 69.0 (69) 71.9 (46) 73.5 (25) 69.0 (20)
in past 12 months 14.1 (40) 15.7 (24) 21.2 (14) 10.5 (9)
self 53.7 (44) 67.9 (36) 64.3 (18) 70.8 (17)
other person 57.3 (47) 66.0 (35) 65.5 (19) 65.2 (15)
sexual assault
ever in adult life
in past 12 months
self
other person

Table 16: Respondent Childhood Experiences of Physical, Psychological, and/or Sexual
Abuse 6

% (n) N = 200 % (n) % (n)
% (n)
Before Age 16: Assault by Family Member - % yes
Any Childhood Assault by Family Member(s)
% yes ns 55.6 (169) 51.6 (83) 48.5 (33) 53.3 (49)
Type of Assault - % yes ns
sexual touching 24.7 (74) 20.6 (33) 10.4 (7) 28.3 (26)
sexually assaulted 10.4 (31) 11.3 (18)
threatened physical harm 35.5 (102) 31.4 (50) 29.4 (20) 33.3 (30)
physically assaulted 41.5 (125) 38.8 (62) 37.3 (25) 39.1 (36)
threatened physical harm with an object 33.4 (96) 29.3 (46) 28.8 (19) 30.0 (27)
physically assaulted with an object 33.7 (101) 26.9 (43) 29.9 (20) 25.0 (23)
emotional/psychological abuse 46.5 (141) 43.4 (69) 36.4 (24) 47.8 (44)
Relationship to Perpetrator of Abuse - % yes ns
mother 50.6 (80) 43.0 (34) 36.4 (12) 47.8 (22)
father 48.7 (77) 49.4 (39) 66.7 (22) 37.0 (17)
step-parent 24.7 (39) 13.9 (11)
sibling 55.1 (87) 53.2 (42) 51.5 (17) 54.3 (25)
other family member 57.0 (90) 45.6 (36) 39.4 (13) 50.0 (23)
Before Age 16: Assaulted by Non-Family Member - % yes

Any Childhood Assault by Non-Family Member(s)
% yes ns 43.7 (131) 45.2 (71) 39.4 (26) 48.9 (44)
Type of Assault - % yes ns
sexual touching 23.9 (70) 20.4 (32) 10.6 (7) 27.8 (25)
sexually assaulted 14.7 (43) 11.0 (17)
threatened physical harm 24.3 (68) 28.3 (43) 27.3 (18) 28.2 (24)
physically assaulted 27.6 (81) 28.8 (45) 24.2 (16) 31.5 (28)
threatened physical harm with an object 21.3 (62) 22.7 (35) 19.7 (13) 24.1 (21)
physically assaulted with an object 21.6 (61) 21.2 (33) 18.2 (12) 22.5 (20)
emotional/psychological abuse 35.4 (105) 32.7 (51) 24.2 (16) 38.2 (34)
Relationship to Perpetrator of Abuse - % yes ns
teacher 24.8 (31) 17.9 (12) 25.0 (6) 14.0 (6)
male family friend 51.2 (64) 55.2 (37) 54.2 (13) 55.8 (24)
female family friend 25.6 (32) 31.3 (21) 29.2 (7) 32.6 (14)
own friends 20.0 (25) 13.4 (9)
misc other 42.5 (125) 43.1 (66) 37.5 (24) 47.2 (42)
6
all respondents were age 18 or older

Rainy River District Aboriginal Addiction Needs Assesment Survey Report - Couchiching First Nation

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Rainy River District Aboriginal Addiction Needs Assesment Survey Report - Couchiching First Nation

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Treatment and Support Services Project

Rainy River District Aboriginal Addiction Needs

Couchiching First Nation

Social, Prevention and Health Policy Research Department

Couchiching Treatment & Support Services Project

Ed Yerxa - Project Coordinator

Technical Working Group

Albert Calder - Couchiching First Nation

Couchiching Chief and Council

Chief Charles McPherson

Couchiching First Nation Staff

Valerie Norris – Financial Administrator

Tara Yerxa Debbie Fairbanks April Bruyere Bonnie Plourde

Addictions Foundation of Manitoba

United Native Friendship Centre (Fort Frances)

Big Grassy First Nation

Big Island First Nation

Atikokan Native Friendship Centre:

Sunset Country Métis (Fort Frances)

(Stanjikoming) Mitaanjigamiing First Nation

Respondent Sample Selection

Target Sample Completed

Couchiching First Nation 240 200

Total 800 578

The instrument is comprised of the following major components: socio-demographics; status,

The addiction needs assessment survey instrument contains standard socio-demographic

• no more than two standard drinks on any one day,

Current internationally accepted guidelines define heavy drinking as:

• women - four or more standard drinks during a single occasion, and

Alcohol Problems and Consequences of Use

Other Substance Use, and Consequences of Use

Substance Use and Criminal Behaviour

Experiences of Alcohol and Other Substance Abuse Treatment

Barriers to Substance Abuse Treatment

Tobacco Use - Smoking

Mental Health/Psychological Distress

Community Addiction/Mental Health Services

Physical, Psychological and/or Sexual Assault

“It is important to understand our history, to acknowledge the oppression we have

Substance use is a significant problem in these communities. Significant numbers of people

Heeb, J. & Gmel, G. (2005). Measuring alcohol consumption: A comparison of graduated

Reynolds Turton, C. L. (1997). Ways of knowing about health: An aboriginal perspective.

Schnarch, B. (2004). Ownership, control, access, and possession (OCAP) or self-determination

Straus, M. (2007). Conflict tactics scales. In N. Jackson (Ed.) Encyclopedia of Domestic

Total Couchiching Men Women

Data Tables Couchiching First Nation 22

Data Tables Couchiching First Nation 23

Total Couchiching Men Women

Data Tables Couchiching First Nation 24

Thoughts of Historical Events

Data Tables Couchiching First Nation 25

Total Couchiching Men Women

Data Tables Couchiching First Nation 26

Data Tables Couchiching First Nation 27

Total Couchiching Men Women

Data Tables Couchiching First Nation 28

Data Tables Couchiching First Nation 29

Total Couchiching Men Women

Data Tables Couchiching First Nation 30

Total Couchiching Men Women

Data Tables Couchiching First Nation 32

Total Couchiching Men Women

Drug Use In The Home During Childhood