Pueblo of Pojoaque TOR 2024 - Located in north-central New Mexico, the Pueblo of Pojoaque is one of the six Northern Tewa-speaking Rio Grande Pueblos. The Pueblo is in the Pojoaque Valley, 15 miles north of Santa Fe and 10 miles south of Rio Arriba County, and situated along interstate US 84/285, a major highway with more than 25,000 commuters per day. This level of traffic, and the Pueblo's proximity to Rio Arriba County, a county that has historically had one of the highest rates of drug-related deaths, makes the community vulnerable to the impacts of opioid use and overdose. The project will provide services to individuals and families of the federally recognized tribe of Pueblo of Pojoaque, the Hispanic communities in Pojoaque Valley, and the tribal communities of San Ildefonso, Nambe, Santa Clara, Tesuque, and Ohkay Owingeh. The Pueblo of Pojoaque is a rural tribal community with a land base of 13,800 acres and 525 enrolled tribal members. The population of the entire service area is primarily Native American (21%) and Hispanic (63%) (U.S. Census Bureau, 2020). Since 1990, New Mexico has seen a steady rise in drug overdose deaths, and in 2019 rates were at an all-time high of 30.4 overdose deaths per 100,000, 41% higher than the U.S. overall rate of 21.6 per 100,000 (NM-IBIS, 2021). More than 66% of overdose deaths in New Mexico in 2019 involved an opioid (prescription opioids, heroin, fentanyl) (CDC WONDER, n.d.). Between 2015 and 2019, fentanyl-involved death rates climbed seven times higher, while methamphetamine death rates doubled (2.4 times the rate in 2015) (NMDOH, 2021). Bordering the Pueblo of Pojoaque are Santa Fe and Rio Arriba County, counties with historically high rates of drug use that have increased the vulnerability of the Pueblo of Pojoaque to drugs. Between 2015-2019, Rio Arriba County had the highest opioid overdose-related emergency department visits in New Mexico, with a rate of 189.6 per 100,000 and deaths due to drug overdose at 83.6 per 100,000 (NM-IBIS, 2021). Nearly 70% of drug overdose deaths in Santa Fe County were AIAN and Hispanic with AIAN at 47.8 per 100,000, followed by Hispanic at 38.9 deaths per 100,000 (NM-IBIS, 2021). Substance use disorders (SUD) – primarily opioids and alcohol – are associated with nearly all crime, public safety problems, and child abuse/neglect incidents within the Pueblo of Pojoaque. Specifically, among domestic violence cases within the Pueblo of Pojoaque from 2018-2023, 50% involved a substance (PD Data, 2024). Over the last several years, data from the Pueblo of Pojoaque Police Department (PD) has documented a consistent rise in drug-related incidents. Statistics from the PD show a 220% increase in open drug cases between 2019 and 2023 (PD data, 2024). During this period, methamphetamines, heroin, and cocaine were the highest quantity of illicit substances seized by the PD. The PPBOH will implement the required TOR activities and meet three goals and eight objectives. The Pueblo of Pojoaque honors the National Tribal Behavioral Health Agenda and recognizes the impacts of historical and intergenerational trauma. PPBOH advocates for prevention and recovery services that meet the needs of community members living in the Pojoaque Valley. PPBOH is committed to improving behavioral health systems and supporting and increasing awareness through tribally directed communication strategies and intentions. Goal 1: Increase access to culturally driven evidence-based treatment for tribal members served by the Pueblo of Pojoaque by September 30, 2029. (Treatment) Goal 2: Decrease OUD/stimulant use disorder by implementing culturally centered prevention and education services that address trauma and behaviors that may lead to use or relapse. (Prevention) Goal 3: Prevent opioid overdoses and improve the well-being of individuals who use drugs by expanding access to harm reduction services. (Harm Reduction Activities)