The primary network in place to respond to First Nations substance use issues is the National Native Alcohol and Drug Abuse Program (NNADAP). NNADAP was one of the first programs developed in response to community needs. It evolved from the National Native Alcohol Abuse Program (a pilot project which began in December 1974) to a Cabinet-approved program in 1982. This network of on-reserve addiction services has since evolved into 49 NNADAP alcohol and drug abuse treatment centres, more than 550 NNADAP community-based prevention programs, and since 1995, a network of National Youth Solvent Abuse Program (NYSAP) residential treatment centres, which now includes 9 centres across Canada. In the North, NNADAP funding is transferred to the Governments of Northwest Territories and Nunavut under the 1988 Northwest Territories Health Transfer Agreement and through the creation of Nunavut in 1999. Yukon First Nations receive funding for the prevention and treatment components of NNADAP; some through contribution agreements and some through their authority as self-governing First Nations. Northern First Nations and Inuit either attend an alcohol and drug treatment centre operated by the respective territorial government or are transported to the closest appropriate treatment centre South of 60, as per Non-Insured Health Benefits (NIHB) policy. In addition to NNADAP/NYSAP, First Nations people also access a wide range of substance use-related services from other sectors within the health care system both on- and off-reserve, as well as other systems, including social services, mental health, child welfare, justice, housing, education, and employment. With these diverse systems in place, a fundamental challenge for communities, regions, and all levels of government is to coordinate a broad range of services and supports in order to ensure that First Nations have access to a comprehensive continuum of care that is responsive to their needs. More information on NNADAP, including the directory of treatment centres, can be found at: http://www.hc-sc.gc.ca/fniah-spnia/substan/ads/nnadap-pnlaada-eng.php (URL)

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