Project Abstract
The Eastern Shoshone Tribe is in central Wyoming on the Wind River Reservation (WRR). With more than 2.2 million acres of land, the WRR is home to the Eastern Shoshone and Northern Arapaho tribes. With separate governance structures, tribes operate independently of one another—the Doya Natsu Healing Center (DNHC) of the Eastern Shoshone Tribe developed this proposal. Of the10,368 total WRR tribal population, the proposed DNHC Tribal Opioid Response 4 (TOR4) project will reach 2,200 unduplicated individuals on the WRR through evidence-based services and practices.
Opioid overdoses in Fremont County are the highest in the state, at a rate of 17.2 per 100,000 vs the state rate of 10.2 per 100,000. The state of Wyoming prescribes more opioids than the national average (711 per 1,000 persons compared with 665 per 1,000 US). A March 2022 DNHC survey found that the top three health concerns on the WRR are opioid use, unresolved trauma, and alcohol use. This same survey asked how people stay healthy and deal with stress on the WRR; the #1 response was spiritual activities followed by exercise and cultural activities/ceremonies. Only 15% of TOR3 relatives are employed, and most do not have enough money to meet their needs. Notably, 95% have children. Although most are housed, they are not satisfied with their living conditions, and 22% live with someone who uses alcohol and other substances, 100% report serious depression in the past 30 days, 62% have serious anxiety, and 64% report they have never been to treatment before coming to DNHC.
Using treatment, recovery, and prevention services, DNHC will implement the required TOR4 activities and meet the four goals:
Goal 1: Increase access to culturally driven evidence-based models for treating Opioid Use Disorder (OUD) on the WRR for 75 tribal members served by DNHC by September 29, 2029.
Goal 2: Increase access to recovery support services on the WRR by offering a broad range of services and support to assist individuals and families in initiating, stabilizing, and maintaining long-term Substance Use Disorder (SUD) recovery.
Goal 3: Increase access to prevention and education services on the WRR through culturally informed strategies, training, and outreach.
Goal 4: Increase harm prevention and reduction services on the WRR through village-specific community outreach with the mobile outreach van unit (MOV).