Tribal nations invest opioid settlement funds in traditional healing to treat addiction – Orange County Register

Aneri Pattani and Jazmin Orozco Rodriguez | (TNS) Kaiser Health News

PRESQUE ISLE, Maine — Outside the Mi’kmaq Nation Health Department sits a dome-shaped tent, hand-built from saplings and covered in black canvas. This is one of several sweat lodges located on the tribe’s land, but this one is dedicated to helping people recover from addiction.

Up to 10 people enter the lodge at one time. Fire-heated stones – called grandmothers and grandfathers, because of the spirits they represent – ​​are brought inside. Water splashes on the stones and the lodge fills with steam. It looks like a sauna, but hotter. The air is thicker and it’s dark. People pray and sing songs. When they leave the lodge, it is said, they come out of their mother’s womb. Cleaned up. Reborn.

The experience can be “a vital tool” in healing, said Katie Espling, health director for the tribe of about 2,000 members.

She said recovering patients have requested sweat lodges for years as a cultural element to supplement the counseling and medications the tribe’s health department already provides. But insurance doesn’t cover sweat ceremonies, so until now the ministry couldn’t afford to hold them.

Over the past year, the Mi’kmaq Nation has received more than $150,000 from settlements with companies that made or sold prescription painkillers and were accused of exacerbating the overdose crisis. A third of that money was spent on the sweat lodge.

Health care companies pay more than $1.5 billion to hundreds of tribes over 15 years. This windfall is similar to the settlements many of these same companies are paying to state governments, totaling about $50 billion.

For some people, the tribes’ lower payout corresponds to their smaller population. But some tribal citizens point out that the overdose crisis has had a disproportionate effect on their communities. Native Americans experienced the highest overdose death rates of any racial group each year between 2020 and 2022. And federal officials say those statistics were likely underestimated by about 34% because Native Americans’ race is often misclassified on death certificates.

Still, many tribal leaders are grateful for the settlements and the unique way the money can be spent: Unlike state payments, money sent to tribes can be used for traditional and cultural healing practices – sweat lodges and smudging ceremonies to basket weaving and programs. who teach tribal languages.

“To have this money to do this, it’s truly a gift,” said Espling of the Mi’kmaq tribe. “This is going to be absolutely fundamental to the well-being of our patients,” because it is by connecting to their culture that “that’s where they will truly find the deepest healing.”

Public health experts say the underlying cause of addiction in many tribal communities is intergenerational trauma, resulting from centuries of brutal treatment, including broken treaties, land theft and a boarding school system. funded by the government which sought to erase the languages ​​and cultures of the tribes. Combined with a long-standing lack of investment in the Indian Health Service, these factors have led to decreased life expectancy and increased rates of addiction, suicide, and chronic disease.

Using settlement money to connect tribal citizens to their traditions and reinvigorate pride in their culture can be a powerful healing tool, said Andrea Medley, a researcher at the Johns Hopkins Center for Indigenous Health and a member of the Haida Nation. She helped create principles for how tribes could consider spending settlement money.

Medley said the respect for these traditional elements explicitly described in the colonies is “truly revolutionary.”

Of the 574 federally recognized tribes, more than 300 have received payments so far, totaling more than $371 million, according to Kevin Washburn, one of three court-appointed directors overseeing the tribal settlements.

While that amount seems large, it pales in comparison to what the drug crisis has cost tribes. Hundreds of tribes are also excluded from payments because they are not federally recognized.

“These rebate funds are like a drop in the ocean compared to what they spent, compared to what they plan to spend,” said Corey Hinton, an attorney who has represented several tribes in the opioid litigation and a citizen of the Passamaquoddy tribe. “Reduction is a cheap term when we talk about a crisis that continues to engulf and devastate communities. »

Even leaders of the Navajo Nation — the largest federally recognized tribe in the United States, which has received $63 million so far — said the settlements could not match the scale of the crisis.

“It will make a small impact, but it will only go so far,” said Kim Russell, executive director of the Navajo Department of Health.

The Navajo Nation is trying to maximize money by using it to improve its overall health care system. Officials plan to use the payments to hire more coding and billing employees for tribally run hospitals and clinics. These workers would help ensure reimbursements continue to flow to health systems and help maintain and expand services, including substance abuse treatment and prevention, Russell said.

Navajo leaders also want to hire more clinicians specializing in addiction treatment, as well as primary care doctors, nurses and epidemiologists.

“Building buildings is not what we want” from opioid settlement funds, Russell said. “We are building the nation.”

Smaller nations, like the Poarch Band of Creek Indians in southern Alabama, also strategized for settlement money to go further.

For the tribe of about 2,900 members, that meant investing $500,000 — most of what it has received so far — in a statistical modeling platform that its creators said would simulate the opioid crisis, predict which programs would save the most lives and help local communities. officials decide the most efficient use of future settlement cash.

Some recovery advocates have questioned the model’s value, but the tribe’s vice chairman, Robert McGhee, said it would provide the data and evidence needed to choose among efforts competing for resources, such as recovery housing or peer support specialists. The tribe wants to do both, but in reality it will have to prioritize.

“If we can have that model and we put the money into it and we have the support, it will work for us,” McGhee said. “I just feel it in my gut.”

The stakes are high. In small communities, each death affects the entire tribe, McGhee said. The loss of a leader marks decades of loss of knowledge. The death of a speaker means further erosion of the indigenous language.

For Keesha Frye, who oversees the Poarch Band of Creek Indians’ tribal court and sober living center, using settlement money effectively is a personal matter. “It means a lot to me to do well in this community because that’s where I live and that’s where my family lives,” she said.

Erik Lamoreau of Maine also brings personal connections to this work. More than a decade ago, he sold drugs on Mi’kmaq lands to support his own addiction.

“I did wrong to this community and it was really important for me to come back and try to right some of those wrongs,” Lamoreau said.

Today, he works for the tribe as a peer recovery coordinator, a new role created with opioid settlement funds. He uses his experience to connect with others and help them recover – whether it’s taking someone to court, working on their resume, working out together at the gym or host a cribbage club, where people play cards and socialize without alcohol or drugs.

Starting this month, Lamoreau’s job will also include connecting clients who are looking for cultural elements of recovery to the new sweat lodge service — an effort he finds promising.

“The more in tune you are with your culture – whatever it is – it connects you to something bigger,” Lamoreau said. “And that’s really what we look at when we’re in recovery, when we talk about spiritual connection. It’s something bigger than you.

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