To address the methamphetamine and overdose crisis in the Fairbanks North Star Borough (FNSB) of Alaska, Fairbanks Native Association (FNA) has developed Pathways to Recovery (Pathways). Pathways will support the continuum of services for opioid use disorder (OUD), provide treatment for stimulant use disorders, and implement stimulant, overdose, and fentanyl prevention and harm reduction.
The population of focus is American Indians and Alaska Natives (AI/AN) adults (18 and over) with stimulant use disorders and those at risk of overdose in the geographic catchment area of the Fairbanks North Star Borough (FNSB) located in the Interior Region of Alaska. Alaska is experiencing the largest substance use and overdose epidemic in history, exacerbated by the COVID-19 pandemic, and driven by the proliferation of synthetic opioids containing fentanyl and other analogues. Between 2020 and 2021, Alaska experienced a 68% increase in drug overdose deaths. According to the State of Alaska, fentanyl is behind the increase in opioid deaths. In 2021, nearly 60% of drug overdose deaths involved fentanyl.
Alaska is also experiencing a surge in methamphetamine (meth) use and meth-related overdose mortality. The rate of meth-related deaths in Alaska’s Interior (which includes the FNSB) is one of the highest in the state. Meth is the illegal drug of choice for the FNA BHS consumers. Alaksa’s AI/AN have the highest rate of meth-related deaths of any ethnicity. AI/AN also have the highest percentage of meth-related emergency services transportation to hospitals, the highest rate of meth-related hospital care, and the highest rate of newborns diagnosed with Neonatal Abstinence Syndrome in Alaska.
FNA provides the only meth prevention, treatment, and recovery support services for AI/AN in the FNSB, but it is not enough to meet the immense need for these services documented above. There are also no agencies providing culturally resonant fentanyl or overdose prevention services in the FNSB. As meth is the illegal substance primarily abused by the target population, Pathways is primarily focused on improving meth outcomes as well as reducing overdose deaths and deaths due to fentanyl.
The Pathways Treatment Goal is to reduce stimulant misuse and use among AI/AN in the FNSB. To accomplish this, the Pathways Meth Counselor will provide treatment through break-out sessions in two FNA adult residential treatment units for OUD, co-occurring SUD, and stimulant misuse and use disorders. Outcomes include a 40% reduction in meth use and abuse. The Pathways Prevention Goal is to increase awareness of the risks of overdose, fentanyl, and meth use/abuse. To accomplish this, Pathways will develop and facilitate quarterly meth, overdose, and fentanyl prevention and education trainings in FNA residential units, for ITC agencies, and in the community. The Pathways Harm Prevention/Reduction Goal is to decrease overdose deaths and deaths attributed to fentanyl. Pathways will accomplish this by distributing 50 naloxone overdose kits and 100 fentanyl test strips per year. Outcomes include a 20% decrease in overdose deaths and a 20% decrease in deaths attributed to fentanyl.
Pathways will provide treatment services to 45 consumers in year one and 60 in year two for a total of 105 unduplicated consumers over the two year life of this project.