Background and Objective:
Connection is critical to the health and wellbeing of Indigenous Peoples who use drugs (IPWUD) - connection to family, cultural supports, and circles of care. During the COVID-19 pandemic, urban IPWUD are more likely to face multiple harms from ongoing opioid and housing crises in British Columbia, Canada. Despite early, effective Indigenous community-mobilized responses to protect against COVID-19 infection, many urban Indigenous Peoples were disconnected from that support as a result of blanket colonial responses. Indigenous Peoples have always found ways to survive through emergency situations, and this paper uplifts the experiences of urban IPWUD navigating respective colonial responses to COVID-19.

Methods:
Nineteen semi-structured interviews were completed with Indigenous Peoples enrolled in the Cedar Project COVID-19 Study in Vancouver (n=9) and Prince George (n=10), Canada. Interpretive description was adapted to identify themes across participants’ stories. Emerging themes were brought back to participants for member checking using iterative, arts-based techniques.

Results:
Interviews were conducted in-person between March-May 2022. Median age of participants was 36, with 37% male and 63% female. Four broad themes were identified: 1) colonial responses to COVID-19 have not aligned with the needs of urban IPWUD, forcing people into crisis situations; 2) People in crisis frequently have no place to go: to eat, sleep, for ceremony, to live safely; 3) Connection is protection against the stresses of precarity and isolation; 4) Emotional responses to COVID-19 are rooted in intergenerational trauma, connected to the Indian Act and colonialism.

Conclusion:
Urban IPWUD face emergencies that threaten daily security, safety, and health. This study amplifies that Indigenous Peoples are the experts in determining how to best survive and thrive through these health emergencies. Further research will inform Indigenous-specific and Indigenous-led responses, and incorporate these findings into quantitative analyses to better understand how to uplift urban IPWUD going forward.