DOWAGIAC — The Pokagon Band of Potawatomi Indians is an ancient people dealing with the devastating modern problem of drug addiction.
And their behavioral health office is combating the crisis with a combination of traditional methods and cutting-edge technology that has earned them statewide recognition.
Like many other Native American tribes, and communities in other parts of the country, the Pokagons are fighting against a rising tide of drug addiction. But while deaths from opioids rose 325 percent in rural areas since 2000, the rate increased 500 percent for Native Americans and Alaskans, who are dying at almost double the rate of African-Americans and Latinos combined.
The Centers for Disease Control and Prevention confirms that addiction has hit native peoples the hardest, and surveys find higher rates of drug use among Native American youth. One study found that eighth-grade Native American students were nearly five times more likely to use marijuana than other students, and also had a higher rate of use of alcohol.
In Michigan, opioid-related deaths are nearly twice as high among tribal members compared to other groups.
Daun Bieda, the Pokagon’s behavioral health supervisor based in Dowagiac, said the local tribe mostly escaped seeing that loss of life from opioid overdoses, with two deaths experienced during her seven years in the position.
But drugs continue to be a scourge, she said, with a surge in the combination of methamphetamine and fentanyl, a synthetic drug 80 to 100 times more powerful than morphine.
For its innovative treatment efforts, the Pokagon Band of Potawatomi Indians received the Treatment and System Transformation Award from the Michigan Department of Health and Human Services, Office of Recovery Systems of Care. The award was presented at a statewide conference in November. This is the first time a Native American tribe has won the award in Michigan.
“We are a big voice in the state” among tribal leaders, Bieda said.
The program has had success through offering comprehensive and holistic treatment options that promote a “Clean Body-Clean Spirit” approach, said Communications Director Paige Risser.
That includes having a traditional healer on staff who provides herbal remedies and other methods endemic to the tribe, and hosting high-tech tele-psychiatry sessions for clients.
Their philosophy is based on the tenets of the Seven Grandfathers: wisdom, family, love, respect, courage, honesty and humility.
Why does drug addiction hit native peoples so hard?
Part of it is because many tribal lands are located in rural areas, which receive fewer government resources, Bieda explained. The Pokagon are fortunate that they are not in such an isolated region, but the native Michigan tribes receive only a small slice of state funding, Bieda said.
Another cause is the experience of trauma over generations, Risser said. This stems from the genocidal treatment of Native Americans and the loss of their land, and extends to families caught in a cycle of abuse.
Bieda estimated that 85 to 90 percent of their clients have experienced some type of trauma, such as physical abuse. The program has seen an increase in female opioid users, many of whom have been sexually abused, she said.
Their approach to wellness is to bolster the cultural identity that has been suppressed for so long, Risser said.
How it works
The tele-psychiatry program was started in November, after two years of study and research. The technology saves clients the time and expense of traveling to see a doctor in South Bend or Mishawaka. Bieda said the psychiatrist, based in South Carolina, is an addiction specialist with experience working with Native American populations.
“He is someone who cares,” Bieda said.
The sessions are so sought-after that they are booked through March.
A peer coach – someone who has experienced addiction and offers support in recovery – will be added to the staff of 10.
The opioid prevention program reaches out to those ages 20-35 through the internet and social media sites. On the site, those who have been successful in recovery from addiction tell their stories.
“I’m back to who I was,” offers Thomas, who has been in recovery since 2014. “If I can do it, anyone can.”
“We wanted to keep it on a level of positivity,” Bieda said. “We didn’t want to scare people. We wanted people to provide hope.”
The outreach has had an impact, with viewers saying how much it affected them.
The Red Road to Recovery offers native-oriented 12-step meetings that encourage participants to “walk the good way,” Risser said.
Recognizing the possibility of overdose, the behavioral health office provides its clients with Narcan, which can reverse the life-threatening effects of an overdose, and trains them and a family member in its use.
The office provides medically-assisted treatment with such drugs as Vivitrol, which blocks opiate receptors, short-circuiting the high users get, and suboxone, which lessens the effect of withdrawal. The office contracts with Sacred Heart in Berrien Center for clients who need detox or long-term treatment.
Bieda said that clients sometimes have to be sent away to other communities, including Texas and Wisconsin, to remove them from their previous drug-using environment. Of those who have been sent away, 85 percent have stayed away.
Other therapies offered include acupuncture, massage, aroma, light and music. Talk therapy has proven to reduce drug use by 40 percent and almost eliminate anxiety for clients, Bieda said. The therapy has been focused on smoking cessation, and has been so successful that the results are being written up in a medical journal.
An inspirational saying on the therapy room wall assures clients “You are stronger than you seem to be, you are braver than you believe you are, and you are smarter than you think you are.”
Building a community, within and outside of the Pokagon band, has been part of the cure, Bieda emphasized. Too often professionals don’t communicate with each other, something Bieda has worked to end. The Pokagons participate in inter-tribal conferences, where Bieda is chair of the behavioral health committee.
“We have torn those silos down,” she said. “You have to talk. We want to be on the map.”
The U.S. Department of Health and Human Services has awarded a new three-year $7.8 million Access to Recovery grant to the Inter-Tribal Council of Michigan. The program provides vouchers for clients to choose substance abuse treatment and recovery support services, accessed through any of the behavioral health departments operated by the tribes, including the Pokagon Band of Potawatomi.
Bieda hopes that what is working for them will benefit others, whether they are Native American or not.
“Addiction doesn’t have a face. Addiction doesn’t have a race,” Bieda said. “A life is a life.”