Me Wu - Ya - Tuolumne Me Wuk Indian Health Center Medically Assisted Therapy programming - Project Abstract Deaths from opioid overdoses have increased in Tuolumne County since 2019 - our local county officials describe opioid use in our community as a crisis. Overdose death rates affirm their concern: 2017 - 5 deaths; 2018-56 deaths; 2019 - 20 deaths; 2020 - 19 deaths and 2021 - 36 deaths. 1 The increasing use of fentanyl in the county and surrounding communities along with fentanyl-laced non-opioid drugs like methamphetamine and cocaine were cited as critical factors to the increased death rates in our area. 2 In 2020, Tuolumne County was ranked first in the state for overdoses. In that year, there were 846.47 opioid prescriptions per 1,000 residents in the county - while the state average was 374.87 per 1,000 residents. Tuolumne County in 2023 - 2024 remained at the top of rankings for the most dosages prescribed per 1,000 residents.3 . In Tuolumne County, many of our patients are individuals identified as using stimulants, opioids, and other substances, many of whom are also experiencing homelessness, food insecurity, lack of access to healthcare services, social support and exposure to crime, and dual diagnoses. In keeping with the goals of the TOR 2024 funding opportunity, Over the past four years Tuolumne Me-Wuk Indian Health Center has provided culturally responsive Medically Assisted Treatment, MAT, programming promoting harm reduction and wellness to American Indians, and Alaska Natives of Tuolumne County and members of the surrounding community at large. These services have allowed individuals to access MAT without the hardships of travelling to neighboring counties to receive services. Our target populations are American Indians and Alaska Natives and community members at large. Most of these individuals are underserved and all live in a rural area. Our most recent MAT service delivery figures in 2023 reveal Caucasians followed by Native clients occupying most caseloads. Hispanics are the third highest racial/ethnic demographic - very few African Americans were served. Most of our 127 patients served in 2023 had both an opioid use disorder diagnosis as well as a stimulant use disorder diagnosis. Many are dual diagnoses with both substance use and mental health disorders. Most patients served are Medi-Cal recipients. TMWIHS is requesting $1,145,180 over (5) years to serve a projected program population of 4,730 individuals with Treatment Services, Recovery Support Services, Prevention Services, and Harm Reduction Services. We realize we cannot do this alone. Key to our success is the recruitment and retention of cross section of community leadership including County Behavioral Health, medical and treatment service providers and law enforcement and schools.
