Ka Wai Ola - Office of Hawaiian Affairs, Volume 39, Number 10, 1 October 2022 — Harm Reduction Toolkit for Native Hawaiian Communities [ARTICLE+ILLUSTRATION]

Harm Reduction Toolkit for Native Hawaiian Communities

_V I OLA LOKAHI V ^ TOTHRIVETOGETHER IN UNITY "

By Lilinoe Kauahikaua Papa Ola Lōkahi and Hawai'i Health & Harm Reduction Center (H3RC) are releasing a harm reduction toolkit for our Native Hawaiian eommunities in October. 1his approach to harm reduction focuses on reducing the harms caused by colonization in Hawai'i, developing a community understanding ofharmreduction, and a cultural approach to reducing harm and promoting healing. H3RC funded the project with illustrations by loeal Native Hawaiian artist Kimo Apaka. The toolkit was developed through ongoing conversations with First Nations Heahh Authority (FNHA) and Native Hawaiian eommunities throughout Hawai'i about the current concerns, strengths, and needs regarding substance use, harm reduction, and cultural healing. There emerged the need to create culturally responsive materials for communities that acknowledge historical trauma while uplifting the cultural strengths of the lāhui. Common examples of western harm reduction in substance use include safer supplies, naloxone, peer support, education, expanded medication-assisted treatment, and housing options. In addition to providing essential services and supplies, harm reduction in Hawai'i includes the attitudes, actions, and understandings that we, as kānaka, 'ohana, community members, and heakh care service providers, hold. It is also a way to acknowledge the harmful impacts of colonization while creating space

for healing conversations, culture, and connections. Western harm reduction models focus on behavioral risks rather than examining the systemic changes required to support people on their healing journey. An Indigenous approach requires us to address the systemic inequities and racism that have caused harm in our communities. Historical and ongoing racism, intergenerational trauma, colonialism, and barriers to accessing heahh care and social services are some of the root causes of substance use and addiction. Harm reduction through a kānaka lens embraces "ho'i i ka piko," returning to the source. It is a process to elevate Hawaiian ways of knowing and being, whieh are strongly eonnected to (w)holism, spirituality, and relationship to aina. According to FNHA, "It recognizes that culture is a medicine that ean help us heal and calls for us to look at ways that everyone ean participate in culture, whether or not they are using substances. In exploring culture as a strength, a source of resilience, a way to connect, and as medicine, we must consider how we ean include people who use substances within our work by increasing access to culture." This will look different as every community has unique cultures and traditions. The toolkit contains sections on cultural healing, dispelling myths, kūpuna and opioids, opio and substances, and more. Culture and building wellness should be accessible to all kānaka, regardless of whether they use substances. These practices are vital to keep those we care about safe. ■ Lilinoe Kauahikaua, MSW, is a population heahh specialist - addictions, mental heahh, socialjustice with Papa Ola Lōkahi.