Project Abstract
The Fort Hall Indian Reservation is located in Southern Idaho and is the home of the Shoshone-Bannock Tribes. There are 6,000 enrolled members of the Tribes, and many other Native Americans living on the Reservation. The Four Directions Treatment Center (FDTC) is a department of Tribal Health and Human Services (the Tribal Health Department) and is the alcohol and drug treatment provider for the Reservation. Four Directions staff estimates that fifty percent of the Reservation population suffers from addiction and 100% is impacted by it. Alcohol and methamphetamine are the drugs of choice to deal with the hopelessness of historical trauma; however, opioid and other drug use is insidious and growing on the Reservation.
The Tribes’ goal is to increase capacity to provide culturally appropriate and evidence-based opioid and stimulant abuse prevention, treatment, and recovery. The Four Directions policies and personnel are in place for the current alcohol and drug treatment program; the Medication Assisted Treatment (MAT) Program was established with 2018 SAMHSA Tribal Opioid Response (TOR) funding and is incorporated into these established processes. With 2020 TOR grant funding, FDTC will build capacity for enhanced opioid and stimulant abuse treatment, capacity to provide intensive case management, recovery support, prevention, and capacity to track outcomes to evaluate and improve the MAT program. Four Directions will increase access to opioid treatment with increased case management and peer support, improved assessment for patient care with psychological evaluations, provide alternative treatments for pain, provide assistance with sober housing, and provide educational and employment opportunities for successful long-term recovery, among other practices and resources.
With community members trained on the effects of opioid and stimulant addiction, the Reservation population will have a better understanding of how chemical substances and addiction negatively affect the Tribes. With peer recovery outreach, the public will learn recovery is possible and very positive. With medication to manage cravings, and by reducing stigma and labels through outreach and recovery support, more drug abusers will come to the FDTC for treatment. This capacity will provide hope for the community to reduce drug-related crime, including domestic violence, child, and elder abuse.
Data collection will allow the Four Directions Treatment Center to analyze patient information for program evaluation, and for improvement of treatment, recovery, and prevention services. FDTC will monitor and report data to determine the impact of the MAT program on opioid use, and opioid-related morbidity and mortality.