Utilizing recovery support, harm reduction and revitilization of cultural practices for healing - The Passamaquoddy Tribe is the eastern most tribe in the United States. Tucked away in the northeastern coastal corner of Maine, Washington County is home to 2,000 Passamaquoddy Tribal members. Pleasant Point Health Center, the implementer, has 45 years of experience serving the Pleasant Point community where 60% of the population makes less than $24k/year and the not-employed rate often exceeds 50%. 60% of Pleasant Point’s community is also under the age of 35. The population of focus for this project be those aged 49 and younger given that overdose rates are highest among this particular populationi in addition to youth for preventive purposes. The MOUD component will focus on high risk individuals including those who have recently overdosed, those currently using, pregnant aged women, Hepatitis C or HIV positive, recently incarnated, and/or suicidal. “With just 2 percent of Maine's population, Washington County currently accounts for 19.5 percent of pending homicide cases in the state”: all of these homicides were drug related.1 In 2019, overdose deaths in Maine were at a rate of 39.7 deaths per 100,000 persons, nearly double the national rate of 21.6 deaths per 100,000.ii In one year fatal overdoses rose 33% in Maine from 380 in 2019 to 504 drug deaths occurring in 2020. Of those 504, 83% were caused by opioids, nearly always in combination with other drugs or alcohol. Adults between the ages of 26 and 35 had the highest rate of deaths due to substance abuse or overdose during 2016, followed closely by 36 to 49 year olds. Substance abuse and overdose death rates among age groups between 18 and 35 have been steadily increasing for the past several years. To counter these disturbing trends the already existing MOUD program which provides comprehensive care will be fortified with a Patient advocate (PA) through this project. The PA will assist with administrative duties, alleviating these burdens to the Nurse Practitioner who directs the program allowing him to focus on high risk clients. This PA will also facilitate and track client’s progress, address basic needs, and connect them to recovery services including vocational support while facilitating adapted contingency management. A full time recovery coach funded under this project will assist in supporting and growing the recovery community by managing safe spaces to meet and facilitating community healing events honoring the TBHA. A partner, Vocational Rebab, will also provide those in recovery and seeking treatment with work opportunities while also facilitating training and connections for employment. Prevention activities will provide activates for youth connecting them to their culture, natural environment, language, and healing substances in collaboration with the Museum Director and Woluhke program. We will also work to move the community toward more natural ways of pain management through massage, alternative healing techniques and by empowering the community to seek healing by creating their own natural medicines when appropriate. Harm reduction will include training Health Center staff and tribal council members in overdose prevention including the administration of narcan. The safe space for the recovery community will be located in the same facility as the maker’s space or Woluhke that will be used to teach traditional native arts to youth and those in recovery. This will also be available for the larger community to share information to allow for a sense of connection and togetherness instrumental for healing.
