The Fort Hall Indian Reservation is located in Southern Idaho and is the home of the Shoshone-Bannock Tribes. There are more than 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, methamphetamine, and opioids are the drugs of choice to deal with the hopelessness of historical trauma; however, fentanyl drug abuse is insidious, with the result of accidental drug overdoses, and illegal drug abuse is growing on the Reservation. The Fort Hall Emergency Medical Services responded to forty-four opioid overdoses from June 2021 to January 2022; due to high opioid overdose rates the Tribal leadership gave directives to prioritize strategies and direct services to combat the opioid epidemic on the Reservation.
The Tribes’ goal is to increase capacity and outreach to individuals suffering with opioid or polysubstance use addiction and to provide evidence-based opioid and stimulant treatment, peer recovery support, and prevention. The Four Directions policies and personnel are in place for the current alcohol and drug treatment program; the Medicated Assisted Treatment (MAT) Program was established with 2018 SAMHSA Tribal Opioid Response (TOR) funding and is incorporated into these established processes.
With 2022 TOR grant funding, FDTC will build capacity for enhanced opioid, fentanyl, polysubstance and co-occurring treatment, capacity to provide intensive case management, recovery support, prevention, and improve 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 recovery support, incorporate opioid overdose outreach, improve the behavioral health comprehensive diagnostic assessment for patient care with mental health and substance use disorder, provide alternative treatments for pain, incorporate cultural practice and teaching for healing, provide assistance with primary residential treatment and sober housing, provide educational and employment opportunities for successful long-term recovery.
With health care providers and the community members trained on the effects of opioid and stimulant addiction, and how to prevent and intervene with an opioid overdose, the Reservation population will have a better understanding of how chemical substances, addiction and illegal drugs negatively affect the Tribes. With peer recovery outreach, the public will learn recovery is possible with medicated assisted treatment and other treatment such as substance use and mental health services, culturally appropriate practices, support groups, life skills, and healthy recovery activities. With medication to help manage cravings, and by reducing stigma and labels through outreach and recovery support, more drug abusers will seek help with FDTC for treatment. This capacity will provide hope for the community to reduce drug-related death and crime, opioid overdoses, domestic violence, child and elder abuse.
Improved data collection will allow the Four Directions Treatment Center to analyze patient information for program evaluation, improvement of treatment, recovery, and prevention services.