Tackling Opioid Addiction in Indian Country

The opioid crisis has hit America hard. It has hit many tribal nations even harder.

Per capita, Native American people are more likely than any other race to suffer from opioid addiction. In recent months, hundreds of cities, states and counties in the U.S. have sued pharmaceutical companies for their role in contributing to the opioid crisis, and in April, the Cherokee Nation in Oklahoma became the first federally recognized tribe in the U.S. to do so. Since then, a handful of tribes have followed suit, including several in South Dakota, Minnesota, North Carolina and Wisconsin.

The pharmaceutical companies, tribes say, have been negligent, complacent and altogether corrupt regarding opioid distribution on reservations and in Indian Health Service facilities. For these Native Americans and their attorneys, tackling opioid addiction through the courts, with the ultimate goal of making these drugs less abundant on reservations, might be an effective way to quell the issue.

But, of course, just as the damages inflicted on tribes due to the opioid epidemic are widespread and far-reaching, so is the root of the issue. It runs much deeper than corporate negligence. To solve the problem—to decrease the availability of opioids on reservations and prevent the conditions that make addiction more likely—the issue must be addressed in a multifaceted manner. Suing the courts is one way to tackle the problem, but all concerned parties should remember that even a victory in the justice system will solve only so much.

History, first and foremost, should be taken into account. Like all other hardships faced by Native American people today, there is a long legacy of racial genocide, cultural genocide, loss of land, loss of language, loss of resources and numerous other losses that have damaged the spirit and livelihood of Native peoples for over 500 years of settler colonialism. Of course, at this point, nothing can be done about this history except to learn it, understand it and acknowledge its applicability to today’s issues, including the opioid crisis.

Then there are socioeconomics. As a result of this history, many Native people live in impoverished areas with few job opportunities. The link between unemployment and opioid use has been well documented. Tribal leaders and individuals in Native communities have made immense progress toward trying to resolve this issue, but the scope of its severity is something that cannot be underestimated, which is why the problem has not yet been eradicated. Until unemployment decreases and economic development surges in Indian country, the propensity toward high rates of addiction are likely to remain.

Native American people are not susceptible to opioid addiction due to a fault in genetics or DNA. They are susceptible to addiction due to a devastating history, which resulted in the current state of economic challenges that are proving nearly impossible to overcome. The attorneys arguing on behalf of the tribes recognize this, as is apparent in court documents, but so should everyone else who is trying to understand the issue.

There is a term—historical trauma—that is well understood, yet remains controversial. While many Americans recognize how historical trauma has played a huge role in contemporary hardships on an individual and community level, many others refuse to accept its validity. If historical trauma were more widely recognized, tribes would be able to address the issue head-on. Behavioral health care funding has never been sufficient in the Indian Health Service system. This needs to change. Behavioral health care should be a top priority, but few Native people have access to alcohol and drug rehabilitation programs, much less regular counseling services.

Even though there is much work to be done, remember that Native peoples are uniquely situated to heal, thrive and emerge from the opioid crisis, and from all other crises affecting Native communities. Without a sense of optimism and belief in the strength of Native cultural practices and traditional healing methods, these problems will not be solved.

Only recently have Native people turned to pills and narcotics to self-medicate. For thousands of years, prayer, socializing, nutritional foods, a clean environment, strong governing systems and an overall reverence for balance and self-respect kept Native communities healthy. Pharmaceutical companies should be held accountable for their role in further damaging Native peoples’ well-being, but that’s only the beginning.

Editor’s note: Because a word was dropped in an earlier version of this article,  a sentence suggested that Native Americans are susceptible to addiction because of a genetic problem. The affected paragraph, corrected in the article above, now reads as follows: “Native American people are not susceptible to opioid addiction due to a fault in genetics or DNA. They are susceptible to addiction due to a devastating history, which resulted in the current state of economic challenges that are proving nearly impossible to overcome. The attorneys arguing on behalf of the tribes recognize this, as is apparent in court documents, but so should everyone else who is trying to understand the issue.”