The Project will address the opioid crises in Tribal communities by developing and expanding community cultural education/awareness of prevention, treatment and recovery for opioid misuse/disorder. - ABSTRACT: NARA NW, an Urban Indian Organization (UIO), is submitting its proposal for the five-year Community Opioid Intervention Prevention Program grant to address the opioid crisis in the AI/AN community it serves in the Portland, Oregon metropolitan area. The proposed program will expand culturally appropriate and family focused resources to strengthen the support system for the Portland Urban Indian Community in the battle to overcome the opioid epidemic where, in 2021, 779 overdose deaths (67% of all overdose deaths in Oregon) were attributed to opioids. Goals and objectives of the Prevention Program are: To develop and expand community education and awareness of prevention, treatment, and recovery activities for opioid misuse and opioid use disorder; to increase knowledge and use of culturally appropriate interventions to encourage increased use of medication-assisted treatment and medications of opioid use disorder; to support and strengthen Tribal and Urban communities in their effort in provide culturally appropriate prevention, treatment and recovery services to address the impact of the opioid crisis; and to increase harm reduction strategies in Tribal and Urban Indian communities. Social determinates affecting Native and Tribal communities in the Portland metro area and directly contributing to the opioid crisis include poverty, poor education, incarceration, lack of housing, and insufficient access to medical care. The Prevention Program will increase awareness of opioid prevention and treatment strategies for providers and community through education/training, expand MAT/MOUD services, and strengthen support/recovery systems for families/individuals struggling with opioid misuse and OUD. Collaborations between NARA NW, its partners and the community will increase access to needed services and provide information to continue the battle against the opioid epidemic. Founded in 1970 by community Tribal leaders, the Native American Rehabilitation Association of the Northwest was initially established to address the unmet needs of Urban Indians facing substance use disorders. The establishment of successful outpatient programs led to the expansion in scope of services and in 1980 the Residential Treatment Center opened. NARA NW’s proven success continued and in 1993 the Indian Health Clinic in the Portland metro area began serving Urban Indians and others in need. Today, NARA NW facilities include: Adult Residential Treatment Center with capacity to serve 70 adults & 12 children; Indian Health Clinic and Wellness Center (both offer primary care, behavioral health service, and pharmaceutical services); Youth Prevention Program; Child, Youth and Family Services; Youth Residential Treatment Center with capacity to serve 24 youth; Youth Prevention Program, Outpatient Treatment Center & Recovery Services Program; Tate Topo Adult Mental Health & Housing Services; Oyate; and Totem Lodge Community Center. Services for victims of domestic violence are also offered through the Oswego Home; a center operated and managed by NARA NW. Polysubstance overdoses accounted for over 50% of all 2021 overdoses and unintentional overdose death rates were highest among AI/AN. Illicit substance use, particularly methamphetamine, synthetic opioids, and fentanyl, accounted for the largest increases since 2019, while the rise in the use of both synthetic opioids and fentanyl resulted in an 83% increase in overdose deaths from 2020-2021. Overdose deaths from synthetic opioids increased by 533% in Multnomah County from 2018-2022. AI/ANs saw the highest rate of overdose at 43/100K, three times greater than Whites. Opioids accounted for nearly 1/3 of all ED visits for overdoses in 2021; while synthetic opioid ED visits increased by 160% from 2018-2021. Fentanyl was a factor in 36 homeless deaths (32%) in 2021, a stark rise over 4 deaths in 2020. Of all homeless deaths, opioids contributed to 50%.
