The Catawba Nation Tribal Opioid Response (CNTOR) Program aims to reduce the number of overdoses and deaths resulting from opioid and co-occurring substance use disorders among Tribal members. The program will increase access to FDA-approved medications and provide evidence-based and culturally appropriate treatment and support services that incorporate more than 6,000 years of Catawba Indian cultural knowledge, wisdom, ceremony, and practices.
There are over 4,000 enrolled members of the Catawba Indian Nation, which is the only federally recognized Indian Tribe in South Carolina. Currently, approximately 75% of Tribal members live on or less than 3 hours from the 1,012-acre Reservation in rural York County, South Carolina. The overall poverty rate on the Reservation is 21%, and more than 50% of Green Earth Public Housing residents live below the poverty line.
The growing opioid epidemic is having an increasingly devastating impact on the Catawba Indian Nation. Approximately 90% of Catawba Indian child welfare cases involve caregiver substance use, mental health issues, or a combination of both, as do the majority of intimate partner violence incidents. The rate of opioid-related overdoses and deaths among Tribal members is expected to nearly double this year. In 2023, there were a total of 11 overdoses, with one fatality. In the first six months of 2024 alone, there were 11 overdoses, two of which were fatal.
Building on the foundation of current programs, the CNTOR Program will implement an integrated care model that utilizes culturally responsive and evidence-based practices to provide treatment, recovery support, prevention, and harm reduction services. The Catawba Nation Behavioral Health Department, which employs Indigenous staff, has significant experience serving the Tribal community. The department actively cultivates partnerships with multiple highly qualified external organizations to provide inpatient and outpatient treatment, transitional homes, and recovery support services.
On the Reservation, the department operates an Intensive Outpatient Program and provides recovery support through White Bison, a native-informed substance misuse program that incorporates traditional Tribal teachings. Utilizing traditional practices in the treatment and recovery journey encourages Tribal members to connect with their culture and traditions. Prevention activities focus on overdose awareness, Narcan training, and substance misuse information through community education and social media campaigns, and the department actively collaborates with partners to share and deploy proven harm reduction strategies.
Through these and other activities, the CNTOR Program anticipates serving more than 800 unduplicated Tribal members over the next five years, steadily increasing annual service numbers from just over 100 in Year 1 to more than 200 in Year 5. Our vision is the elimination of opioid and related substance-use overdoses and fatalities among members of the Catawba Nation.