In November, the U.S. Senate Committee on Indian Affairs examined the impacts of fentanyl on Native communities.
Senators took testimony from Native leaders and health experts to look at how to address the growing crisis, including the need for more federal support to fight fentanyl abuse and addiction.
Jamie Azure, chairman of the Turtle Mountain Band of Chippewa in North Dakota, testified about the impacts on Native youth.
“The committee needs to remember that we voted to sit in the chairs we sit in for the next generation," Azure said. "We as tribal leaders refuse to allow a generation to be lost.”
Dr. Claradina Soto, an associate professor at the University of Southern California's Department of Population and Public Health Sciences, also weighed in. She says there are a number of issues involved in fentanyl use.
“This is based on our community-based research work, with community organizations, tribal governments, Indian health clinics, and our community advisory boards," said Soto, who is Navajo and Jemez Pueblo. "We understand that effective change requires a deep understanding of both the challenges and faced by and restraints inherent to our Native communities.”
Soto made four recommendations.
- Increase the number of residential treatment centers.
- Incorporate Native culture into treatment such as healing circles.
- Focus on Native youth to provide more education, as well as prevention, treatment and mental health services.
- Obtain reliable data about Native peoples, particularly in urban areas, closing the data gap by collaborating with tribal governments.
Another issue discussed at the hearing is the lack of police in rural areas, targeted by illegal drug dealers.
In a follow-up hearing in early December, the committee heard federal perspectives on the growing crisis.
Roselyn Tso, director of the Indian Health Service, talked about the mortality rates within Native communities and the need to treat fentanyl addiction.
“I and my senior leadership, and all of Indian Health Services, recognize the importance of working side by side, with tribes and tribal leaders to develop comprehensive plans for addressing the opioid crisis in Indian country," Tso said. "But we also recognize that each community plan includes strategies that work for each community.”
Senator Lisa Murkowski says that the call for policy changes and resources in this crisis has been heard nationwide. In this hearing, she focused on the vulnerability of rural Alaskan communities.
“Drug traffickers are targeting our Native communities," she said. "They know these communities are more rural. They know that there is less law enforcement presence, and they know they can make more money off of our Native people.”
Murkowski says the Indian Affairs Committee's goal is to better understand the current actions being taken by agencies, when it comes to investigations and providing more resources.
Tribal leaders and senators say this is only the beginning of discussions on how to combat the growing number of fentanyl overdoses in Native communities.
Fentanyl was originally introduced more than 60 years ago and was created for pain management for several reasons. It is inexpensive to synthesize, has a short onset of action and duration for effect, can be used in a multitude of ways including orally, intravenously, or through the skin, according to health professionals.
There are two types of fentanyl: pharmaceutical fentanyl and illegally made fentanyl.
Pharmaceutical fentanyl is traditionally prescribed for cancer patients with chronic pain, who have developed opioid tolerance.
Fentanyl is a potent, synthetic opioid and has led to unprecedented rates of opioid overdose. It is up to 100 times stronger than morphine, according to the Centers for Disease Control and Prevention, which says what makes the drug even more dangerous is its ability to camouflage as other drugs in powdered form.
