Doctors sweat to discover traditions of the first nations

Many doctors see addiction as a disease of body only. If overdone, this view can lead to medicalization of addiction. Some may argue that the latest research proves addiction as a chronic brain disease. This view is supported by brain scans of people who used drugs compared to people who didn’t. The scans show a loss of dopamine neurons after heavy methamphetamine use. Although brain’s plasticity allows it to recover, we don’t know how much of this loss is permanent.

While brain researchers may not mean to reduce addiction to a purely medical condition, its psychological, social and spiritual facets get sometimes overlooked. Not only medical students do not get enough education on addiction, what they get is often focused on the biological aspect.

To bridge this gap, in June 2014, a group of eight medical doctors (five doctors in training and three staff) from Canada went on a three day journey to a remote First Nations (i.e. American Indian) community to hear stories of recovery and participate in traditional healing techniques. After the trip, the Director of their addiction training programme (, analysed the group’s experiences using qualitative research techniques and presented* the narratives at conference of the Association for Medical Education and Research in Substance Abuse.

People from the First Nations reservation shared their experience with the power of spiritual recovery tools – sweat lodges (see Figure 1), community round ups, connection to heritage, family support, and elder-guided self-reflection: “…learning came through creating bonds of friendship with people at Alkali Lake. It was through these bonds that the human face…emerge[d] and the real learning started to happen.”

Figure 1. Sweat lodge (photocredit: fellowship archive)

First Nations communities are over-represented among people with substance use disorders in Canada. Having little sense of cultural competency, clinicians can become discouraged when faced with the suffering and despair of those with substance use disorders: “…the most valuable lesson [of the field trip] was in deepening the understanding that the most effective way of being an addiction physician is by humbling ourselves, relinquishing our titles as doctors and getting to know the person behind the addiction.”

The Director encouraged programmes to “find a local community that has tackled the programme and go out to do a field trip and learn from the community members.”


*Text first published at a registration-restricted website:

Story based on a poster presented at the AMERSA conference November 5th, 2014: Lighting the ember of hope: Integrating field experience and narrative techniques into Addiction Medicine Fellowship training. By Launette Rieb (a,b), MD, MSc, CCFP, FCFP, dip. ABAM; Nitasha Puria (b), MD, CCFP; Marcia Thomson (a), MSc; and Evan Wood (a,c) MD, PhD, ABIM, FRCPC, dip. ABAM


Author affiliations:
a)St. Paul’s Hospital Goldcorp Addiction Medicine Fellowship, Vancouver, B.C., Canada. b)Department of Family Practice, and c)Division of HIV/AIDS, Faculty of Medicine, University of British Columbia, Canada

Association’s for Medical Education and Research in Substance Abuse mission is to improve health and well-being through interdisciplinary leadership in substance use education, research, clinical care and policy. Text taken from
Clinical addiction medicine training is a multidisciplinary addiction medicine fellowship that strives for excellence in clinical training, scholarship, research and advocacy and involves medical education to trainees from Psychiatry, Internal Medicine, Family Medicine and Nursing. For more details, click here.