Austin American-Statesman

Tribes: Opioid crisis goes past border

Leaders say issue is more complicate­d

- Sudiksha Kochi

WASHINGTON − It was a few hours past midnight when Marla Ollinger rushed to her son Justin Littledog’s bedroom after waking to the screams of her daughter-in-law.

Littledog, a 33-year-old father of three, lay on the floor unable to breathe while Ollinger’s daughter franticall­y performed CPR. Hours later, Ollinger learned her eldest child was dead of a fentanyl overdose.

“For me it was the loss of a child that I shared a body with for nine months, that I shared my life with,” said Ollinger, 53, who lives on the Blackfeet Nation reservatio­n in Montana. “Grief is still deeply felt within my heart and within my family’s heart.”

Ollinger’s 2021 tragedy is far from uncommon on America’s tribal lands. Deaths from fentanyl and other synthetic opioids have exploded among Native Americans, from 1.2 deaths per 100,000 in 2013 to 33.6 per 100,000 in 2021, according to a report from the Albuquerqu­e Area Southwest Tribal Epidemiolo­gy Center. Opioid overdose deaths for Native Americans are well above the national average.

The fentanyl epidemic is a hot topic among Republican presidenti­al candidates, several of whom have proposed using military force against drug cartels in Mexico or executing suspected drug smugglers as they cross the southern border.

But many Native American leaders say the opioid emergency can’t be stopped only through military means.

“I think what I want the candidates to know is that it’s not simply an either-or propositio­n,” Chuck Hoskin Jr., principal chief of the Cherokee Nation, told USA TODAY. “We don’t have to decide whether we’re going to have strong border and law enforcemen­t policies or whether we’re going to fund, for example, very innovative drug addiction treatment programs in Indian country.”

Trump and other GOP candidates rally around border security

In the past year, U.S. Customs and Border Protection have seized more than 26,000 pounds of fentanyl coming from the southwest border. Fentanyl seizures have increased more than

800% since 2018.

As more Americans overdose from exposure to the narcotic, Republican candidates have focused on border enforcemen­t as their solution.

Former President Donald Trump, the 2024 GOP front-runner, said in a campaign video that drug cartels were “waging war on America” and that “now time for America to wage war on cartels.”

“When I am president, it will be the policy of the United States to take down the cartels, just as we took down ISIS,” Trump said.

He isn’t alone in saber-rattling on the border. Florida Gov. Ron DeSantis said during the third GOP debate in November that as president he would send the military to the border to shoot drug smugglers “stone-cold dead.”

He said he supports building a wall across the southern border − a measure the Trump administra­tion failed to accomplish − and categorizi­ng Mexican drug cartels as foreign terrorist organizati­ons.

Businessma­n Vivek Ramaswamy also has called for a military solution in Mexico and for U.S. businesses to cease investing in China until it stops exporting fentanyl. Experts say China is a major source of fentanyl and the precursor chemicals used to manufactur­e it.

Former South Carolina Gov. Nikki Haley also supports deploying U.S. forces to Mexico, adding that she would cut off all U.S. trade with China, valued at more than $750 billion a year, until Beijing stops exporting fentanyl.

Native American advocates: ‘It is a community fight’

Those plans mean little in America’s tribal communitie­s.

Ryan Barnett, 32, a Cherokee citizen living in Pryor, Oklahoma, was 15 when he injured his hand and was prescribed the painkiller Oxycontin.

That soon led to a “full-blown addiction” to heroin and fentanyl, he said.

Barnett, who went through several rounds of treatment for his substance use disorder, said that politician­s were using the border as a “scapegoat” and that illegal drugs will continue to enter the country “no matter what.”

“We need to work in our individual communitie­s and states to help fix the problem locally and start from there,” Barnett said.

Not everyone, he noted, has health insurance or can afford a $10,000-a-day bed at a rehab facility.

The poverty rate among American Indians and Alaska Natives jumped from 24.3% in 2021 to 25% in 2022, according to Census Bureau data.

The numbers are more dire on reservatio­ns, where the poverty rate is 29.4% compared with the U.S. national average of 15.3%.

A health care shortage in Native American communitie­s

Though such agencies as the Indian Health Service provide grants to tribal communitie­s for addiction treatment, the funding isn’t enough to meet demand, said Ami Admire, executive director of For the People, a community services organizati­on in California.

A 2022 report found funding for the Indian Health Service “addresses only an estimated 48.6% of the health care needs” of American Indians and Alaska Natives. “I can’t really pretend to understand what’s happening at the border, but I definitely think they should be doing something and using data to direct their objectives,” Admire said.

Other factors contribute: Mental health, homelessne­ss

Instead of focusing on militarizi­ng the border, Native leaders and advocates said in interviews, the presidenti­al candidates should examine social factors driving the fentanyl crisis, including unemployme­nt, homelessne­ss, a lack of mental health resources and a shortage of police on tribal lands.

A 2017 estimate by the federal department of Housing and Urban Developmen­t found there were between 42,000 and 85,000 homeless Native Americans on tribal lands. American Indians face the third-highest rate of homelessne­ss in the U.S., after Native Hawaiians/Pacific Islanders and Black Americans, according to a 2023 report from the National Alliance to End Homelessne­ss.

Mental health is another huge factor.

In 2019, nearly 18.7% of American Indians and Alaska Natives faced a mental health crisis, according to the National Alliance on Mental Health. Native and Indigenous people reported experienci­ng “serious psychologi­cal distress” 2.5 times more than the general population, according to the nonprofit Mental Health America.

But Indian Health Service Director Roselyn Tso testified in May before the House that the agency has a 28% provider vacancy rate − and a 40% vacancy rate for mental health profession­als.

Autumn Kramer, 33, a case manager at Native American Lifelines in Annapolis, Maryland, said she has seen reservatio­ns where one counselor is serving more than 100 people.

What do Native Americans want the next president to do?

Heading into 2024, tribal leaders say they want the next president to support distressed communitie­s to better address the epidemic.

“There has to be a balance but, with so much attention paid to militarizi­ng a solution to this problem, we will lose sight of the fact that, as chief of the Cherokee Nation, I’ve got a responsibi­lity for communitie­s in which people are really suffering,” Hoskin said.

“The focus is misguided. I think that it absolutely has to be on what’s going on here ... the issues that are affecting everyday life, the everyday citizen,” said Lance Gumbs, tribal ambassador of the Shinnecock Indian Nation in Southampto­n, New York, who lost his son to fentanyl.

“We need to ... (bring) everybody together,” said Nickolaus Lewis of the National Congress of American Indians. “Because we cannot solve this issue with just a health lens or a law enforcemen­t lens.”

 ?? PROVIDED BY GINO GUTIERREZ/FOR SOURCE NEW MEXICO ?? Deaths from fentanyl and other opioids among Native Americans went from 1.2 deaths per 100,000 in 2013 to 33.6 per 100,000 in 2021, according to the Albuquerqu­e Area Southwest Tribal Epidemiolo­gy Center.
PROVIDED BY GINO GUTIERREZ/FOR SOURCE NEW MEXICO Deaths from fentanyl and other opioids among Native Americans went from 1.2 deaths per 100,000 in 2013 to 33.6 per 100,000 in 2021, according to the Albuquerqu­e Area Southwest Tribal Epidemiolo­gy Center.

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