Dell Colleen Anne, Roberts Gary, Kilty Jennifer, Taylor Kelli, Daschuk Mitch, Hopkins Carol, Dell Debra
University of Saskatchewan, Department of Sociology and School of Public Health, Saskatoon, Saskatchewan, Canada.
Subst Abuse. 2012;6:23-31. doi: 10.4137/SART.S9247. Epub 2012 Mar 28.
The intentional misuse of psychotropic drugs is recognized as a significant public health concern in Canada, although there is a lack of empirical research detailing this. Even less research has been documented on the misuse of prescription drugs among First Nations in Canada. In the past, Western biomedical and individual-based approaches to researching Indigenous health have been applied, whereas First Nations' understandings of health are founded on a holistic view of wellbeing. Recognition of this disjuncture, alongside the protective influence of First Nations traditional culture, is foundational to establishing an empirical understanding of and comprehensive response to prescription drug misuse. We propose health promotion as a framework from which to begin to explore this. Our work with a health promotion framework has conveyed its potential to support the consideration of Western and Indigenous worldviews together in an 'ethical space', with illustrations provided. Health promotion also allots for the consideration of Canada's colonial history of knowledge production in public health and supports First Nations' self-determination. Based on this, we recommend three immediate ways in which a health promotion framework can advance research on prescription drug misuse among First Nations in Canada.
在加拿大,精神药物的故意滥用被视为一个重大的公共卫生问题,尽管缺乏详细说明这一情况的实证研究。关于加拿大原住民中处方药滥用的研究记录更少。过去,西方生物医学和基于个体的方法被用于研究原住民健康,而原住民对健康的理解建立在整体幸福观之上。认识到这种脱节,以及原住民传统文化的保护作用,是建立对处方药滥用的实证理解和全面应对措施的基础。我们建议将健康促进作为一个开始探索这一问题的框架。我们运用健康促进框架的工作已经表明,它有潜力在一个“伦理空间”中支持同时考虑西方和原住民世界观,并给出了相关示例。健康促进还允许考虑加拿大在公共卫生知识生产方面的殖民历史,并支持原住民的自决权。基于此,我们建议通过三种直接的方式,利用健康促进框架推进对加拿大原住民处方药滥用问题的研究。