Prenatal Opioid Exposure and Neonatal Abstinence Syndrome: A Research Project with 13 First Nations Communities in Ontario (POE-NAS)

Looking back:
our work in Phase 1

Our project team is working with 13 First Nations to answer community-driven questions about prenatal opioid exposure. This year, we have focused on completing quantitative and qualitative data analyses and preparing to report our findings. For the quantitative arm of our research project, we determined the rates and trends over time of prenatal opioid exposure and neonatal abstinence syndrome for each participating First Nation, as well as the aggregated rates and trends for all 13 communities. We also looked at characteristics of mothers and babies.  

We have finalized the data analysis for the qualitative arm. Data was generated from focus groups and interviews with community members such as parents, grandparents, caregivers, leaders, health and social service providers, educators, and Elders. After completing the initial analysis, we worked with our community partners and research participants to ensure the findings reflected what people shared. 

In all our work this past year and throughout Phase 1, we have grounded ourselves in Indigenous understandings of wellness and a strengths-based approach to research to support First Nations in their efforts to shift from patterns of intergenerational trauma to intergenerational healing. 

An eye to the future: what Phase 2 has in store for us

Community partner involvement and engagement will continue to be at the centre of our Phase 2 work. Participating First Nations have already expressed great interest in Phase 2 based on preliminary discussions. As we move into the action component of the community-engaged participatory action research cycle, we will work with participating First Nations to determine how they want to use their Phase 1 findings to address prenatal opioid exposure in their communities.  

In this phase, we are prioritizing an approach to research funding autonomy that is increasingly becoming an important feature of community-engaged research. Participating First Nations will each be given funds to support the development and implementation of community-specific knowledge mobilization plans. This approach to fiscal relationships with Indigenous communities aligns with Indigenous communities’ rights to self-determination and Indigenous-led knowledge mobilization.  

The effects of the opioid epidemic, especially during the COVID-19 pandemic, continue to make themselves felt; there is growing concern in Canada regarding opioid-related harm and deaths among Indigenous peoples, seniors, pregnant women, and youth. It is important to understand the impacts of prenatal opioid exposure in the context of an Indigenous determinants of health framework, which acknowledges that this disruption of Indigenous knowledges, governance systems, identities, family structures, and lands have contributed to intergenerational trauma and disrupted individual and community wellness. The recent discovery of unmarked graves at former residential school sites may also negatively impact the health and well-being of First Nations people in Canada.  

There is still so much to learn about prenatal opioid exposure and its impacts, and research on emerging topics does not always include First Nations people. By sharing insights into the impacts of prenatal opioid exposure in First Nations in Ontario and strategies to better support children and families, we hope our work will fill an important gap in the literature and benefit communities across Canada and globally.