Killer Crisis: Tribes Fight Opioids Through Cultural Treatment

By Grace Pastoor

When Ryan Neadeau Sr. started his journey toward sobriety, he found motivation and comfort in his cultural roots.

“What pushed me to get clean was believing in our culture, believing that there is a solution to this epidemic, and to saving our people by the culture,” said Neadeau, a 26-year-old member of Red Lake Nation. “The cure is the culture.”

Neadeau, who is now 13 months sober, got clean through a Native-based treatment center in St. Paul. It was there that he met James Cross, a former drug dealer who founded the group Natives Against Heroin after he was released from jail in 2005.

Through Cross, Neadeau became involved with the group and started reaching out to addicts in his own community. The Red Lake chapter of NAH held a Walk Against Substance Abuse in July — shortly after the band’s tribal council declared a state of emergency because of the large number of overdoses on the reservation.

Minnesota’s Native American communities — from the Red Lake and Leech Lake reservations in northwest Minnesota, to the Fond du Lac band near Duluth, to the Native community in the Twin Cities — have been hit particularly hard by the opioid epidemic overwhelming the nation.

According to the Minnesota Department of Health, Native American Minnesotans were five times more likely than white Minnesotans to die from a drug overdose — including from opioids, cocaine, methamphetamine and benzodiazepines — in 2015. While American Indians make up just 1.5 percent of Minnesota’s total population, they represent 6 percent of the state’s drug overdose deaths, the MDH reported.

Advocates and professionals on the ground in Native communities cite a variety of reasons for the disparity, from racism to lack of funding to the overprescription of pain pills.

“The epidemic is still rapid on our reservation due to, you know, less funding for the reservations,” Cross said. “As Native people we are classified as second-class people today, not first-class people. We are forgotten.”

According to Leech Lake Police Chief Ken Washington, the consequences of opioid addiction have hit Leech Lake hard in the past six months, with between three and five band members dying of overdoses. Police and ambulance personnel on the reservation have had to administer about 50 doses of Narcan — a drug that can counteract the effects of an overdose — in that same time. Some opioid users require multiple doses to bring them back.

White Earth Nation, north of Detroit Lakes, and like the Leech Lake police, White Earth officers carry Narcan. Carson Gardner, a doctor with the White Earth Nation Tribal Health Department, said the tribe has trained more than 1,000 people to use Narcan.

As an example of how serious the reservation overdose problem is, White Earth police reported on Dec. 18 that in the 48 previous hours the Mahnomen County Sheriff’s Department responded to seven overdoses, two fatal. Heroin is the major problem there.

On Dec. 19, the White Earth Overdose Response Team traveled the reservation providing Narcan and training people on how to use it.

Members of Natives Against Heroin have begun traveling to homes on the Fond du Lac Reservation in northeast Minnesota that they say are “known drug houses” to let the occupants know that resources are available to help them turn away from drugs.

Cross, who founded Natives Against Heroin, said the process of obtaining a chemical dependency assessment, being drug tested and meeting with professionals can be time consuming, sometimes triggering withdrawals and preventing people from getting help.

“At that time, they’re in withdrawal, full withdrawal without no help … so they have to go to detox or to the hospital to get comfort meds,” Cross said. “But the triggers and cravings are still there, so they go back to what they know best, and that’s calling the dope man.”

Leech Lake’s Human Services director, Earl Robinson, said the tribe has hired more people to perform chemical dependency assessments, and placed assessors in other areas, such as in Leech Lake’s child welfare program.

The tribe also is working to incorporate Native American culture into treatment programs, something Neadeau and Cross say is key to helping Minnesota’s American Indian communities overcome addiction.

“The treatment design today is still made for a non-native 40-year-old alcoholic from back in the day,” Cross said. “What we have to do is upgrade it.”

Tribes such as Leech Lake and the Mille Lacs Band of Ojibwe are working to do just that.

In February, the Minnesota Department of Human Services and the Mille Lacs band agreed to preserve a culturally relevant substance abuse treatment program, which will be operated by the tribe.

Red Lake Nation also began work in July to offer medication-assisted treatment on the reservation.

Robinson said that Leech Lake outpatient treatment programs and halfway houses have worked with a medicine man and filled cultural coordinator positions.

The White Earth Cultural Division has also implemented multiple spiritual and cultural support interventions.

Neadeau, who is working to put together a second Walk Against Substance Abuse, hopes Natives affected by opioids can heal through their heritage.

“We’re just working one day at a time, trying to bring people into the culture,” he said. “Recovery is possible for our indigenous people.”

Mille Lacs dispute brings new problem

By Zach Kayser

The leader of a small tribe of Ojibwe in northern Minnesota thinks an increase in drug overdose deaths is due in part to county officials removing authority from her tribal police.

The Mille Lacs Band of Ojibwe reservation sits mostly within the geographic boundary of Mille Lacs County, where county officials last year ended a police cooperation agreement. That ended tribal police authority on most parts of the reservation to enforce state laws, such as those dealing with illegal drugs.

“People now show up on our reservation because they believe it is a police-free zone,” band Chief Executive Melanie Benjamin told a November rally in support of reservation police at the state Capitol.

The band blames the jurisdiction dispute for a significant drug overdose increase.

“In 2015, we had seven overdoses,” Benjamin said via news release. “Since the county revoked the agreement in July 2016, we have had 66 overdoses on the Mille Lacs Reservation, 13 of them fatal.”
Despite the involvement of federal and state officials, the two sides could not come to terms.

Benjamin says that the band is “a sovereign, self-governing Indian tribe, (and) we do not negotiate with a gun to our head,”

The band has sued the county in federal court.

According to court documents, Mille Lacs County had the highest crime rate of any Minnesota county in 2015 and 2016, and a “disproportionate amount” of crime occurs within the reservation.  

As of December, the number of overdoses had gone up to 73 since the county ended the agreement, according to band officials. About 1,850 band members live on the reservation.

Mille Lacs County Attorney Joe Walsh said the increase in drug-related offenses started between 2014 and 2015, before the cooperative agreement was dissolved.

“Available statistics tend to show that the genesis of increased opioid use in Mille Lacs County occurred in 2015 or before,” Walsh said.

Walsh, a defendant in the lawsuit, declined to respond to Benjamin’s overdose statistic.

Mille Lacs County Administrator Pat Oman said when the county board unanimously ended its contract with the band that “it is clear that tribal government prioritized tribal law over and above Minnesota law.”

Walsh said the county successfully applied for National Drug Court Planning Initiative to implement a diversionary drug court to help drug addicts, but the funding to set up the court was rejected by the Minnesota Legislature.

Benjamin and Rep. Peggy Flanagan, D-St. Louis Park, said the Legislature needs to change state law to help Mille Lacs and other tribes that could face similar situations. The Legislature ot returns to session Feb. 20

Mille Lacs County had an average of 1,124.3 opioid prescriptions per 1,000 residents in 2016, according to the Minnesota Board of Pharmacy, far higher than the statewide numbers.

The county was one of the four highest in the state in admissions for heroin substance use disorder treatment in 2016, according to the Minnesota Department of Human Services.  

The Mille Lacs Reservation was the scene of several demonstrations against opioids late in 2017.