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When the doors close at night at the administration office at Yukon’s Carcross Tagish First Nation, a van hits the road and drives through the communities to offer naloxone to reverse overdoses, drug testing kits, food and even a friendly face to help those struggling because of the opioid crisis.

The nation's director of health and wellness, Stacey Robinson-Brown, said the new outreach van — a common tool in larger Canadian urban centres — is run three days a week to get more "boots on the ground" after-hours and connect with people who might need support in the communities with a population of just over 700 people.

"Not all crises happen before 5 p.m." she said.

Robinson-Brown said they want to meet people where they are and perhaps help pull them back from deep waters to start a healthier life.

"Even if we could change the lives of some people in terms of maybe some of their use, I think that would make a world of difference."

While Yukon faces Canada's highest per capita death rate from illicit drugs, First Nations in the territory say toxic drugs are disproportionately affecting their people. Two nations have declared states of emergency as their members overdose and die.

Carcross Tagish First Nation declared a state of emergency over the opioid crisis in January 2022, when three citizens died of overdoses in the span of six days, Robinson-Brown said. At the same time, there were a lot of non-fatal overdoses that just "never make the news."

The Yukon government declared a "substance use health emergency" not long after, and earlier this year the First Nation of Nacho Nyak Dun in Mayo declared its own opioid emergency over a situation that was "terrorizing" citizens and families with violence, crime, overdoses and death.

Yukon chief coroner Heather Jones reported 25 deaths last year attributed to toxic substances, 20 of which involved opioids in the territory of about 43,000 people. On a per capita basis, that rate is worse than in B.C., which had the country's highest death toll last year with 2,272 suspected illicit drug toxicity deaths.

'It's going to take the community': #Yukon faces Canada's worst toxic drug death rate. #OpioidCrisis #OverdoseCrisis #IllicitDrugs

Of the 20 opioid-related deaths, Jones said 17 happened in Whitehorse, but Robinson-Brown believes that since the coroner only records where a person is when they die — not where they lived — those numbers under-represent the amount of people in communities outside Whitehorse who are struggling.

"I'm speculating at this point, but the majority of people who are struggling with or going through an overdose make their way, either by ambulance, or someone else brings them, to Whitehorse because it's the only general hospital close enough," she said.

It's a crisis that can look different in smaller communities compared with urban centres, Robinson-Brown said.

Her department of about 25 people offers everything from social assistance to outreach, justice and other programs to the First Nation's citizens, a third of whom live on traditional territory.

That means staff often have multiple "different hats" when someone asks for help, she said.

On top of that, many families in the small communities are connected and have known each other their entire lives.

"We've hired several staff who have made comments like, 'Wow, I never knew these people in this way,' And it's difficult to see them because they recall them as being, you know, happy, carefree youth," she said.

"So, I think it's really eye-opening when you consider all of the family ties and as well as just being in the community and knowing them in a different capacity."

For some, being able to seek help from someone they know makes the process easier, Robinson-Brown said, while others might be reluctant to share their struggles with someone they have a history with.

Across the territory, First Nations are overrepresented in the opioid crisis. Of the 25 deaths from toxic drugs reported last year, 17 — or about two-thirds — identified as First Nations, Jones said. The Yukon Bureau of Statistics pegs the territory's overall population as 22.3 per cent Indigenous.

Last week, First Nations from around the territory held marches and lit sacred fires following the First Nation of Nacho Nyak Dun's emergency declaration and two murders in the community.

Shadelle Chambers, executive director of the Council of Yukon First Nations, said such vigils are meant to keep the crisis in the public eye, show solidarity and allow people to process their grief over everything that has been lost.

She said the territorial emergency declaration — which the council pushed for — preceded changes including the expansion of and research into harm reduction options, the expansion of Whitehorse's safe consumption site to include an area for inhaled substances and research being done on safe supply.

"This is a very complex issue and so we can't expect one government to be able to do this. It's going to take the community, it's going to take Yukon First Nations, it's going to take all levels of government to really look at how we can help address this crisis and work toward solutions," she said.

The council is near completion of a business case for a proposed Yukon First Nations healing centre, she said. It has also sent almost 300 people to private treatment outside Yukon and is working with hundreds of families in programs specifically designed to keep their children out of the foster system.

Chambers said a strategy is needed to work with youth and families to prevent trauma and look at issues including problems around housing and the cost of living.

"You can't address the opioid crisis without looking at all of the other socioeconomic factors."

She said the territory is dealing with some similar opioid use issues as Vancouver's Downtown Eastside, including crime, gang activity and the victimization of First Nations women, but on a smaller scale.

"We would hope that because it is a smaller jurisdiction, that we would be able to be more nimble and quick to respond to things but this is a complicated issue. I don't believe that there's one quick solution," she said.

Chambers said there needs to be more financial and human resource supports both in Whitehorse and communities outside of the capital.

While Whitehorse residents have access to a program offering a medically prescribed safe supply of opioids, they need to be administered by a pharmacist, which is not an option in rural communities.

"So, how do we look at virtual options? Expansion of these things? How do we ensure that there's safe drug testing kits available in each community, not just from 9 to 5? We need to support organizations … to do more work in the communities," she said.

Tracy-Anne McPhee, Yukon's minister of health and social services, said the territory's promised substance use health emergency strategy is in its final stages of development and will be released "as soon as possible" along with recommendations.

"This substance use health emergency … is not going to go away any time soon. It's certainly not going to go away during my lifetime in this chair," she said.

She said the government is collaborating with each community to identify their specific needs and tailor its approach accordingly.

The First Nation of Nacho Nyak Dun met with government officials and the RCMP following its emergency declaration.

Since then, Premier Ranj Pillai has written to Chief Simon Mervyn to offer a series of potential supports including making more councillors available and development of community-led restorative justice initiatives.

McPhee said the territory has been working with all communities to expand drug testing capabilities including through local health centres.

"We've been working tirelessly with Yukon First Nations, with our community partners and other governments to co-ordinate a response, to implement the harm reduction strategies … to expand access to treatment and recovery services and to increase the public education and awareness about the dangers of substance use," she said.

Chambers said she believes the situation will improve, while she also recognizes that there are systemic issues that First Nations have faced for generations.

"The solutions might take decades and generations as well, but it's really important that we see these small wins every day and that keeps us going."

This report by The Canadian Press was first published March 30, 2023.

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