Native populations and the opioid crisis: forging a path to recovery

Abstract

American Indian/Alaska Native (AI/AN) populations have proven particularly susceptible to the opioid crisis in the USA, but the White House’s 2019 national opioid policy roadmap is not structured to address AI/AN vulnerabilities. The concept of resilience, usually considered a positive system attribute, can be applied to complex systems to understand the larger compensatory interactions that restore systems to previous structures despite disruptions or interventions. The opioid crisis is a case of detrimental resilience because even effective interventions have not succeeded in eradicating opioid abuses. Resilience-based systemic interventions are needed to disrupt various aspects of systems while enhancing the social and cognitive abilities of affected populations to withstand the threat. This paper examines community characteristics, healthcare, and law enforcement within the context of AI/AN populations to emphasize the mechanisms that promote undesirable resilience for the opioid crisis. A research agenda bringing together systems science and management is needed to coordinate sectoral interventions and establish strategies to disrupt the resilient cycle of opioid addiction.

An Inquiry into People’s Use of Substances, Views on Substances, and How Substances Have Affected Them

“…The Native American respondents in this study claimed that they never had problems with substances or received treatment. This would not be representative of the larger Native American population, as endless studies and practical work in clinical settings have consistently shown that this population has among the highest rates of substance use/abuse and deaths from overdose (e.g., Running Bear et al, 2017;Soto et al, 2022;Whelshula et al, 2021). Further research focusing entirely on Native Americans and use/abuse of substances and treatment is clearly warranted.…”

Tribally-led mobile outreach: improving access to harm reduction services in one rural reservation community

“…Structural racism, including poor working conditions, lack of economic opportunities, and limited social capital in communities, are the primary drivers of opioid misuse ( 7 ). These factors, coupled with unregulated opioid prescribing practices, systemic issues with healthcare facilities and health service delivery in Indian country, and unfair marketing practices targeting AI/AN populations, have resulted in a significant drug crisis ( 8 ).…”

Researching Gambling: Have we learned nothing from Big Tobacco’s overt manipulation of science?

“…How do we stop opioid abuse in tribal communities? (28) In my experience as a Tribal Attorney for 10 years, it often comes in the form of providing consequences to those abusing drugs. Consequences include going to jail, the removal of children, job loss, and being ordered to attend treatment.…”

“…If abusers are not able to get out of the cycle of addiction they will likely end up in jail, or overdose, or end up dead. However, even when people want to get clean and sober the continuing challenges of finding employment, housing and accessing outpatient treatment programs can be significant barriers (28). However, we are now seeing illicit opioids like heroin becoming more accessible.…”