Fact Checked By:
Dr. Patricia Sullivan MD MPH on 6/29/2021
How the Opioid Epidemic is Decimating Native American Communities
The statistics on how the opioid epidemic is affecting Native Americans in rural areas of the United States is truly alarming. For a people who have been through generations and generations of trauma, this seems to be yet another blow. Native Americans deserve to have access to drug and alcohol treatment for substance use disorders. Unfortunately, due to the fact that reservations are largely pushed out to rural and remote areas, this isn’t always possible. However, the Native American leaders continue to fight for their people.
Read on to learn about the opioid epidemic and the Native American people.
Native Americans Facing the Opioid Crisis
Throughout the ongoing opioid epidemic, Native Americans have been affected especially hard. The rate of opioid overdose deaths among Native Americans is the second-highest in the nation.
According to the U.S Department of Health and Human Services Office of Minority Health, Native Americans make up 1.7 percent of the total population of the United States. Still, the U.S. Centers for Disease Control and Prevention reports that for 10 years starting in 2003, overdose death rates for Native Americans were higher than any other group in the nation.
The CDC also reports that in 2018, Native American overdose deaths were miscalculated and are much higher. In 2000, opioid overdose deaths were six times higher than originally reported. From 2003 to 2014, opioid overdose deaths doubled, claiming 350 lives a year out of a population of 375,000 Native Americans Stacy Leeds is dean of the University of Arkansas School of Law and an expert in Native American law. She is also a former justice for the Cherokee Nation Supreme Court. According to an article by the Pew Charitable Trust, Leeds sums up the opioid threat tribal nations face.
“When you’re talking about a tribe where the entire population is 800 people, the overdose deaths of 20 people in one year is not just a public health crisis; it has ramifications for their very existence.”
The Major Challenges Facing Native Americans
Many of the nation’s Native Americans face poverty, high unemployment, lack of health insurance, and limited education. Experts consider these factors as major contributors to the opioid crisis facing Native Americans.
A Washington Post article found that among the opioid epidemic “is one demographic group that has been profoundly affected by the crisis: Native Americans living on reservations.”
Rural areas are often the backdrop for reservations.
Tahlequah, Oklahoma, is the location of the new government formed by the Cherokee Nation. The Indian Removal Act of 1830 was responsible for Native Americans taking to rural America after being forced out of their original lands by President Andrew Jackson. These areas are now rampant with opioid use, abuse, and overdose deaths.
Economic instability is a major factor in the opioid epidemic.
The median income for Native American households is around $45,000 annually, while non-Hispanic white Americans average around $65,000 and greater. The poverty level among Native Americans is almost double that of white Americans. Native Americans struggle with a 21 percent poverty level, while white Americans consist of around 9 percent.
Even further, management opportunities are imbalanced among races. Native Americans make up 30 percent of the management and professional workforce, while white Americans make up 42 percent in the same category. Diversity in leadership and professional environments is important to bring cultural awareness to the workforce.
Removal and Separation of Native American Children
“We’ve almost lost a generation of Cherokee children,” says former Cherokee Attorney General Todd Hembree in the PEW article.
Native American children have been removed from their homes due to the opioid epidemic and substance abuse. Of the 1,700 Cherokee children in the custody of both tribal members and state, a minimum of 40 percent is in direct result of opioid use.
These numbers from the former head of Cherokee Child Welfare Agency Nikki Baker-Limore have only scratched the surface of the effects of the drug crisis on Indian Country. Current Cherokee Nation Attorney General Sara Hill says that almost everyone in their tribal government has claimed responsibility for at least one child. She goes on to explain how that is not enough given the number of tribal children in need.
Cultural identity and spirituality are of the utmost importance to Native American tribes.
They learn the ways of their ancestors inside tribal homes and families. The number of children who experience separation or complete removal from their families is devastating to Native American communities. The added pain comes from the children who find placement in non-native homes as they struggle to stay connected to their cultural identities, spiritual guidance, and traditional tribal customs.
It’s a traumatizing experience, especially for younger children who cannot fully grasp the circumstances.
Generational Trauma Continues
Col. Richard Henry Pratt established the Carlisle Indian School in 1879. Native Americans remember these boarding schools as a time of children being abused and being stripped of their identities. “A mid-19th century federal program that attempted to assimilate Native Americans into the rest of the nation’s culture by shipping thousands of American Indian children to boarding schools across the country. Many of the children were abused, and lost their cultural identities.”
The Indian Removal Act of 1830 and the collection of Native American children to abusive boarding schools has caused generational trauma that is a highly ranked reason substance abuse disorder is so widely seen in Native Americans and their communities.
Gloria Malone is a substance abuse counselor for a long-term recovery house based on a reservation. In an interview with Post, she shared that every one of her patients “struggles with brokenness and sorrow from the past.”
Indian Country tribes have been through an immense amount of cultural and societal stress that is a key component to the excessive opioid abuse among tribes.
Treatment Accessibility and Programs for Native Americans
Cherokee Nation’s Assistant Attorney General John Young oversees the opioid legal cases for the tribe. Young weighs in on the responsibilities of their government for their tribal members, “We pay directly for all health care and social service needs for all of our people from the cradle to the grave”
Since the responsibility rests on tribal government shoulders, a deficit in funding made available to the sovereign Native American people means little to no resources to protect and care for their own.
Sarah Bohlen, the CEO of the National Indian Health Board, agrees about the inaccessibility of health care and treatment inside tribal nations.
HERO Project and Triple P
Of the treatment options available, tribal children have a behavioral health program called the HERO (Helping Everyone Reach Out) project. This program offers support and services to tribal families with children aged newborn to 16 years old. Group, family, and individual therapies, substance abuse, grief, and trauma counseling are among the benefits offered in the behavioral health unit for children.
Triple P (Positive Parenting Program) is a parenting program that is offered through the HERO Project. Triple P is a support system that provides prevention and treatment for emotional and behavioral issues in children and teenagers. All extensions are customizable to fit family needs.
Psychoeducation classes offer parents support. Psychoeducation is about providing information and education about mental health services to anyone searching for it. These basics are important to understanding the needs of tribal family members and offering solutions, understanding, and compassion.
Inside the HERO Project is an additional resource called HERO Builders. Once a week for 6 weeks, parents come together with one another to group parents. Group parenting is done for 90 minutes once a week. This support class allows the sharing of experiences and information to spread into other families and practices
Due to COVID-19, many of these programs and resources are limited or on hold. Social distancing will prohibit group parenting to its full capacity, and limited availability within clinics will become even more limited to adhere to COVID-19 laws.
The HERO Project has ways for anyone to assist or become involved and they can be reached at (918) 772-4004. Child Wellness Action Teams like the HERO Project are also found in Adair, Sequoyah, and Wagoner counties in Oklahoma.
With the Native American population confirmed COVID-19 cases rising daily, it is uncertain when American Indian resources and programs will be back to fully operational. Unfortunately, fully functional is still limited compared to major cities, and many tribal citizens will not get vital care amid the opioid epidemic and global pandemic.
Holding Those Responsible Accountable
In April of 2017, the Cherokee nation made history by becoming the first tribe to proactively engage a lawsuit against opioid distributors for their role in the epidemic. The Cherokee have filed a lawsuit against Walmart, CVS, Walgreens, and other drug wholesale companies” “for knowingly flooding the tribal community with prescription opioids, fueling a deadly drug epidemic that has taken hundreds of lives and cost hundreds of millions of dollars”
It is widely agreed upon throughout the tribal nations that justice and accountability are imperative to repair some of the damages caused by the opioid epidemic. Tribal leaders are furious with drug wholesalers, blaming them for adding to the problem.
Tribes have gone as far as to say the defendants should stand trial inside the tribal court and legislation. Sara Hill insists,” “We want them to come here and feel that this is their problem and that they’re going to be held responsible for making it right. It needs to be expensive for them”
The case was first filed in the District Court of the Cherokee Nation. Oklahoma federal court ruled against the tribe, claiming the charges were insufficient because the drug companies were not tribal members.
Moving forward, it will be of the utmost importance to provide proper care and treatment to the Native American tribes. If tribes do not receive adequate funding for facilities and treatment, they could face extinction.
Native Americans are at high risk for substance abuse disorder. Rural America is not well-equipped to handle excessive drug use due to a lack of facilities and proper treatment. Substance use disorders lead to a copious amount of overdose deaths among tribes.
Customized treatment for tribal members provides the best long-term results in recovery. Customizations such as language adaptability, honoring their culture and customs, and adhering to certain traditional native medicinal practices such as drum circles and sweat lodges. These respects can supply the best possible outcome for health and recovery among opioid-dependent tribal members.
About the Author
Annalise was born in Nebraska, but has spent most of her life in Arizona. She has a decade of experience writing about mental health, and believes in second chances and compassion for all, no matter the circumstances.
Have questions about drug and alcohol treatment? Submit this contact form and we’ll be in touch!
Article Reference Links
Recent Help Articles
Medical Content Disclaimer
All content found on the https://abtrs.com website, including but not limited to: text, images, audio, or other formats were created for informational purposes only. While the content is reviewed by a medical professional, it is not ever intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or hold off in seeking it because of something you have read on this website. If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately. ABTRS does not recommend or endorse any physicians or medical providers, procedures, opinions, or other information that may be mentioned on our website. Reliance on any information provided by ABTRS, ABTRS employees, contracted writers or medical professionals presenting content for publication to abtrs.com is at your own risk.