The geographic catchment area for our Native Village of Tyonek’s TOR project will include the village of Tyonek (Qaggeyshlat in Dena’ina Athabascan) and surrounding 68 square mile region with a population of 3731. The village is located 40 air miles southwest of Alaska’s largest city, Anchorage, along the west bank of the Cook Inlet. The village is only accessible by air or water and as a result access depends on weather conditions. In our current TOR grant, there is a service gap as there is no worker who can help connect these individuals for treatment. The grant will fill that gap. There are currently no programs that provide drug prevention, intervention and postvention services in Tyonek. The lack of steady behavioral health services in the village of Tyonek means that the majority of at-risk members with identified substance use issues are unable to access treatment and services designed to promote mental health and reduce the risk. The Native Village of Tyonek is currently experiencing prescription pain medications and methamphetamine problems. While we have had a TOR grant for a year and half, our funding was small (54,537.00), and it only allows community education and we are now going to expand to add an outreach specialist, who can create direct referrals for treatment. Our population of focus will be adults 18 and over with opioid or stimulant use disorders.
The evidence based medication we will use in our TOR program is Buprenorphine (suboxone). Buprenorphine in its sublingual form retains patients in treatment and reduces illicit opioid use more effectively than placebo. It also reduces HIV risk behaviors. One evidence based way we will address healthcare disparities among AI/AN communities and members is through increasing access to quality behavioral health services through telehealth/telemental health in ways that are holistic, cost-effective, and culturally respectful. The Tyonek Tribal Opioid Response program will promote and increase substance abuse prevention activities in the community by expanding the current tribal health center capacity and implementing the following evidence-based practices: Screening, Brief Intervention, and Referral to Treatment (SBIRT), Drum-Assisted Recovery Therapy for Native Americans, and Learning Circles. All are evidenced-based practices included in SAMHSA’s National Registry of Evidence-based Programs & Practices (NREPP). The unduplicated number of individuals we propose to serve (annually and over the entire project period) with grant funds is: Prevention/education/cultural and traditional practices = 25 in year 1 and 25 in year 2. Engagement and treatment - given our small village we anticipate 5 in year one and 5 in year two.
Because of our small population size and our small proposed budget our three staff will include; a part-time project director, a 70 percent program coordinator and a 70 percent outreach specialist. Our whole Tyonek TOR team will work together to review any data we collect, identify any barriers and any improvements that are needed and will make every effort to implement those improvements going forward.
1 United States Census Bureau, American FactFinder, https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml?src=bkmk#