Providing Substance Abuse Support to Tribal Nations
It’s not news that the US is still in the grips of a nationwide opioid epidemic. An estimated 10.3 million people misused opioids in 2018 alone. Provisional data CDC show 2020 is on track to become the deadliest year for U.S. drug overdose deaths in history, with opioids as a top killer.
That said, this epidemic hits different segments of our nation — both geographically and demographically — with different degrees of impact. Tribal nation communities have strikingly higher rates of prescribed opioids as this Washington Post report on Jefferson County, Oklahoma shows. With a population of 6,400, most of the county lies within the jurisdiction of the Chickasaw Nation. As the Post article relates: “From 2006 and 2014, opioid distributors shipped more than 5.4 million prescription pain pills to Jefferson County — an average of 94 pills per person each year. That is 2.5 times the national rate and more than twice the rate of the state.”
As we examine ways to curb the opioid epidemic and care for those who are suffering, it’s crucial to recognize that different communities within our nation will have different needs. Medical treatment plans for those with Opioid Use Disorder (OUD) cannot simply be “one size fits all.” Instead, healthcare providers and other stakeholders must partner with struggling communities to find the best methods of ongoing support.
Tribal Nations in Trouble
Native Americans face myriad challenges on this front. In 2020, at the confluence of the opioid epidemic and the COVID-19 pandemic, many tribes suffered significant income losses as casinos closed. High rates of generational trauma within these communities further compound the risks for opioid abuse, as Minnesota Public Radio reports. Members of First Nations often face an impossible choice: between leaving the reservations and families behind to pursue careers or education, or staying put in geographically isolated areas with limited opportunity.
Limited employment options in particular may increase the likelihood of OUD. The Washington Post, in an in-depth analysis of tribal risk factors, notes that “Native Americans have higher-than-average injury rates from work in industries such as farming, logging and fishing.” The investigation revealed that some health providers on tribal lands failed to follow required protocol in opioid dispensation, and that overall, “Native Americans have also struggled with a lack of access to quality health care and long-term, non-pharmacological treatment options.” And, along the lines of the opioid-saturated county in Oklahoma mentioned above, “opioid distributors and pharmacies for years ignored clear signs of suspicious ordering.” While several tribes do have their own behavioral healthcare resources on site, many are without them and need more external support.
Tailoring Substance Use Support to the Reservation
While tribal nations grapple with a number of unique risk factors, they also offer some creative solutions to addiction issues. We spoke with Jonathan Gross to learn more. Jonathan is Vice President of Clinical Outreach and Referral Relations at Discovery Behavioral Health, and manages teams of workers all over the country providing care and supporting others in different stages of their sobriety journeys. He continues to work with tribes across the country, focusing particularly on continuity of care. He works closely with Lucid Lane as well, introducing our services to tribal nations leadership as an extension of their medical service offerings to the community.
Jonathan’s personal story is moving. Struggling with substance abuse in his youth, he had the good fortune to be invited to spend half a year living and working with the Kalispel tribe in the Pacific Northwest. Although not a Native American himself, Jonathan was deeply affected by his close contact with the Kalispel tribe and made lifelong friends in the community. That time not only helped him get sober but also gave his career and his life focus. As Jonthan told us, his life had lacked direction and mission, but that his time on the ranch allowed him to connect with nature and find a sense of personal mission in a new way.
Detoxification and inpatient support is an important choice for many people struggling with substance abuse, but for some people, it’s unthinkable. Inpatient programs require people to leave their families and their tribes, where they may have obligations no-one else can fill.
Others may seek Medically-Assisted Treatment (MAT), utilizing medications including suboxone or methadone, which have been proven to reduce overdose death, retain people in treatment, and break free of their addictive behavior with much greater success.
Transitions are always challenging for anyone in OUD treatment. Moving from inpatient treatment to outpatient care will bring new risk factors in the form of exposure to old habits, old contacts, and old circumstances that drove them to use in the first place. Likewise, those who are in intensive outpatient programs face the same challenges as they transition to more independent lives.
Continuity of Care is Critical
Regardless of what treatments people seek for OUD, continuity of care can often make the difference between recovery and relapse. Telehealth offers a highly efficient way to ease the pain points of transition. Services like Lucid Lane match licensed counselors and addiction specialists with members who need on-demand support independent of their physical location.
Gross has frequently recommended Lucid Lane in his work with various tribes. Our counselors are adept at delivering virtual care in a comprehensive, personalized protocol tailored to medication tapering and substance abuse issues.
If you or someone you know is struggling with substance use or abuse, there are many ways to reach out to Lucid Lane. You may want to begin by taking one of our health assessments to gauge your potential needs. Regardless of the results, we encourage you to take the extra step to reach out for an initial complimentary consultation. Lucid Lane works with most insurance providers to provide the highest levels of care to all who need it.
While life within a Native American tribe is most certainly different, we believe that all people have a right to personalized support and care wherever they are and whatever the circumstances. Don’t hesitate. Reach out today and begin the next chapter of your journey.
