The Blackfeet Tribal Opioid Response (TOR) project will provide prevention, treatment, and recovery services to people with Opioid Use Disorder (OUD) and/or stimulant use disorders on Blackfeet Nation. This includes access to Medication Assisted Treatment (MAT), contingency management, counseling, care coordination, peer support, and cultural connection; services that were largely unavailable to the approximately 11,000 Blackfeet residents prior to TOR funding.
In 2019, the Blackfeet Tribe launched an outpatient substance use disorder facility, the Journey to Recovery Center (JTRC), under the umbrella of the Blackfeet Tribal Health Department’s (BTHD) Crystal Creek Lodge and Treatment Center. JTRC has partnered with Community Medical Services (CMS), an established SAMHSA-certified Opioid Treatment Program (OTP), to set up a medication unit within the JTRC to provide FDA-approved OUD treatment medications such as methadone, buprenorphine, and naloxone. While clients of the JTRC receive medication from CMS, they also receive services such as drug and alcohol counseling, mental health counseling, care coordination, peer support, and cultural connections directly through the JTRC. While the first round of TOR funding established many of these services, the JTRC requires continued funding to expand the current services to the large population experiencing OUD, and create a sustainable array of services for those experiencing stimulant use disorders. In 2017, 17% of Browning High School students reported taking unprescribed opioids. In a recent chart review, 31% of pregnant women at Blackfeet Community Hospital (BCH) tested positive for opioid use at the time of delivery, and 32% of infants delivered showed signs of neonatal abstinence syndrome. Additionally, 18% of women who delivered at BCH tested positive for methamphetamine use at the time of delivery. These statistics indicate high levels of substance use on Blackfeet Nation and make the work of the JTRC all the more imperative. The goals and objectives of this project are (paraphrased) as follows: (1) Increase the BTHD’s Opioid and Stimulant Use Disorder prevention and treatment capacity. (1.1) Update the OUD strategic plan. (1.2) Train each staff member in a specific workforce development area. (1.3) Implement the CONNECT secure referral system. (1.4) Assess the impact of the TOR grant. (2) Provide comprehensive, evidence-based outpatient Opioid and Stimulant Use Disorder treatment to people of the Blackfeet Nation. (2.1) Each year, provide outpatient treatment services utilizing FDA-approved MAT for 40 people with opioid use disorders. (2.2) Each year, provide evidence-based outpatient treatment services for 20 people with stimulant use disorders. (2.3) Facilitate health insurance applications and enrollment. (3) Develop an Opioid and Stimulant Use Disorder recovery program infrastructure. (3.1) Each funding year, provide peer support services to 60 people in recovery for Opioid or Stimulant Use Disorder. (3.2) Utilize at least four cultural coordinators in service delivery. With funds from this grant, we plan to serve 60 people each funding year, for a total of 120 people over the two-year funding cycle.