The Sisseton-Wahpeton Oyate Tribal Opioid Response Project will increase access to FDA-approved medications for the treatment of opioid use disorder (MOUD) for American Indian citizens residing on the Lake Traverse Reservation. The guiding principle for the project, rooted in Dakotah values. is Wou¿s¿da Owicayakiye Kte – Help one another with compassion. Expanded access will be accomplished through mobilization of SWO’s new, Asniyapi field health primary care clinic that will set aside one day a week for MOUD. The clinic will be staffed by SWO’s Advance Practice Nurse who has an X-Waiver certificate through the Drug Enforcement Administration and the TOR Nurse. Lack of timely access to MOUD with a trusted community medical provider has been a major barrier since inception of TOR. Fifty people will be served.
The TOR Nurse will continue with the Nurse Care Connector best practice to connect people with services, including individual assistance, navigation of complex systems and confusing processes, advocacy aimed at removing barriers and improving access to care, management of co-occurring conditions, information counseling, motivational interviewing, referrals to other programs that will benefit and aid in recovery, and wrap-around, non-clinical supports. Each participant admitted for care coordination will receive a medication safe, healing journal, Northern Plains traditional sage bundle, assistance for transportation assistance, and educational materials. The target is to admit 50 people for care connection services, whether or not they are prescribed MOUD at the Asniyapi clinic or with other community providers of their choice.
TOR focuses on training first responders, the workforce, people with substance use disorders, and “good neighbors” to recognize the signs of opioid overdose and how to access the opioid reversal antidote naloxone (Narcan®). One hundred and fifty first responders, 150 workforce members, and 200 community members will be trained or retrained through the grant.
TOR will continue community and workforce education through weekly social media posts, tabling events, lunch and learns, and arranging at least three motivational speakers during the project period. We will continue to promote the National Prescription Drug Take-Back Days annually in October and April, as well as similar campaigns.
The population of focus is 7,302 American Indians users of the Sisseton Indian Health Service, specifically those who are diagnosed with Opioid use Disorder, with or without coexisting polysubstance misuse. The subpopulation of focus is young adults, ages 25-34, which comprised 67% of overdoses from 2011-202, according to the South Dakota Department of Health Vital Statistics. An age group of concern is from 15-24 years, because recent 2021-22 overdose deaths and reversals have exceeded the 10-year average for this group.
The TOR Project is integrated within the SWO Tribal Action Plan (TAP) 2021-2025 that was approved by Tribal Council Resolution SWO-21-095 and, specifically, health status priorities 2) Substance Use Disorders; 8) Suicide and Self-inflicted Injury, including intentional overdose; and 11) Chronic Liver Disease and Cirrhosis. The Tribal Council authorized submission of TOR through passage of Resolution No. SWO-22-028. TOR is organizationally connected with the experienced and State-accredited substance use disorder treatment program, Dakotah Pride Center, which has a fifty-year, continuous history of work in this field. SWO has an Indian Self-Determination and Educational Assistance Title I contract with the Indian Health Service, which is accredited through the Joint Commission. The TOR project and contract programs are co-located with IHS. SWO is also an IHS grantee and has relationships described in various collaborative agreements. IHS has provided a Letter of Fact for this project.