Canadian Journal of Public Health

, Volume 108, Issue 5–6, pp e616–e620 | Cite as

Opioid use in pregnancy and parenting: An Indigenous-based, collaborative framework for Northwestern Ontario

  • Naana Afua JumahEmail author
  • Lisa Bishop
  • Mike Franklyn
  • Janet Gordon
  • Len Kelly
  • Sol Mamakwa
  • Terry O’Driscoll
  • Brieanne Olibris
  • Cynthia Olsen
  • Natalie Paavola
  • Susan Pilatzke
  • Brenda Small
  • Meldon Kahan
Innovations in Policy and Practice - Commentary


Opioid use affects up to 30% of pregnancies in Northwestern Ontario. Health care providers in Northwestern Ontario have varying comfort levels providing care to substance-involved pregnant women. Furthermore, health care practitioners, social service agencies and community groups in Northwestern Ontario often work in isolation with little multidisciplinary communication and collaboration. This article describes two workshops that brought together health and social service providers, community organizations, as well as academic institutions and professional organizations involved in the care of substance-involved pregnant and parenting women. The initial workshop presented best practices and local experience in the management of opioid dependence in pregnancy while the second workshop asked participants to apply a local Indigenous worldview to the implementation of clinical, research and program priorities that were identified in the first workshop. Consensus statements developed by workshop participants identified improved transitions in care, facilitated access to buprenorphine treatment, stable funding models for addiction programs and a focus on Indigenous-led programming. Participants identified a critical need for a national strategy to address the effects of opioid use in pregnancy from a culturally safe, trauma-informed perspective that takes into account the health and well-being of the woman, her infant, her family and her community.

Key words

Opiate dependence pregnancy Indigenous health services rural population 


La consommation d’opioïdes affecte jusqu’à 30 % des grossesses dans le Nord-Ouest de l’Ontario. Le personnel soignant du Nord-Ouest ontarien est plus ou moins à l’aise d’offrir des soins aux femmes enceintes qui consomment des substances. De plus, les professionnels de la santé, les services sociaux et les groupes communautaires du Nord-Ouest de l’Ontario travaillent souvent isolément et ont peu de communications et de liens de collaboration multidisciplinaires. Notre article décrit deux ateliers qui ont rassemblé des dispensateurs de services sociaux et de santé, des organismes communautaires, des établissements d’enseignement et des associations professionnelles intervenant dans les soins aux femmes enceintes et aux mères qui consomment des substances. Le premier atelier a présenté des pratiques exemplaires et l’expérience locale de prise en charge de la dépendance aux opioïdes durant la grossesse; dans le second, les participants ont appliqué une vision du monde autochtone locale à la mise en œuvre des priorités (cliniques, de recherche et de programme) définies durant le premier atelier. Les déclarations de consensus élaborées par les participants ont mentionné l’amélioration des transitions dans les soins, la facilitation de l’accès au traitement à la buprenorphine, des modèles de financement stables pour les programmes de lutte contre les toxicomanies et un accent sur les programmes dirigés par les Autochtones. Les participants ont défini le besoin urgent d’une stratégie nationale pour aborder les effets de la consommation d’opioïdes pendant la grossesse selon une perspective culturellement sûre et sensible aux traumatismes, qui tienne compte de la santé et du bien-être de la femme, de son nourrisson, de sa famille et de sa communauté.

Mots clés

dépendance aux opiacés grossesse services de santé autochtone population rurale 


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Copyright information

© The Canadian Public Health Association 2017

Authors and Affiliations

  • Naana Afua Jumah
    • 1
    • 2
    • 3
    Email author
  • Lisa Bishop
    • 2
    • 4
  • Mike Franklyn
    • 5
  • Janet Gordon
    • 6
  • Len Kelly
    • 7
  • Sol Mamakwa
    • 8
  • Terry O’Driscoll
    • 9
  • Brieanne Olibris
    • 2
  • Cynthia Olsen
    • 10
  • Natalie Paavola
    • 4
  • Susan Pilatzke
    • 11
  • Brenda Small
    • 12
  • Meldon Kahan
    • 3
  1. 1.Northern Ontario School of MedicineThunder BayCanada
  2. 2.Thunder Bay Regional Health Research InstituteThunder BayCanada
  3. 3.University of TorontoTorontoCanada
  4. 4.Dilico Anishinabek Family Care, Fort William First NationCanada
  5. 5.Northern Ontario School of MedicineSudburyCanada
  6. 6.Sioux Lookout First Nations Health AuthoritySioux LookoutCanada
  7. 7.Anishinaabe Bimaadiziwin Research ProgramSioux LookoutCanada
  8. 8.Nishnawbe Aski NationThunder BayCanada
  9. 9.Sioux Lookout Meno Ya Win Health CentreSioux LookoutCanada
  10. 10.Thunder Bay Drug StrategyThunder BayCanada
  11. 11.Northwest Local Health Integration NetworkThunder BayCanada
  12. 12.Confederation CollegeThunder BayCanada

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