HOOPA TRIBAL MEDICATED ASSISTED TREATMENT Culture/spirituality/treatment
People are asking why the Native specific topic regarding medicated assisted treatment • I want to give you a few examples of differences in perceptions for both culture and environmental for natives in contrast to western or modern civilization. • By show of hands Who in the room knows what MAT is • by show of hands who is supportive of this effort? • Who is unsure? • Anybody against MAT
BEAR
• Most people response to bear is fright, unless they are in are car cruising through Yosemite national park. You see a bear in your yard, or in a parking lot people have a natural reaction • When native persons see bear
RUG
JACKET/ROBE
ANCESTOR MYTHICAL CREATOR OF THE WORLD THAT WE SHARE •
Native culture verses western influence • Scenario: I pick up my phone, go to my car, call my relations and report that I am headed to ceremony. I arrive parking a good distance away as not to disturb, think about leaving my phone (rule) but end up putting it on silence (in case of an emergency) the conflict of interest is addiction to the phone.. We as natives have gotten over the transportation issue and it is part of us, ingrained and fully assimilated. Breaking tradition, keeping a secret, other skins have phones, we keep that to ourselves, seems like a small indiscretion eh.
Native culture verses western influence • Another non Native person goes to their place of worship, calls friends, drives there and parks in the handicap space, walks in and places the phone in silence mode when the service starts because that is what everybody else is doing. No conflicts, as these actions have become part of the culture. Fully assimilated. • Not a bad thing it’s a microcosm of the larger addiction picture • Is this guy crazy? Its just a phone • Its about the subtle cultural differences that make us unique and recognition of these can help us more effectively treat addiction and identifying how people culturally identify helps us treat them.
TRIBAL MAT • Literally thousands Americans died of opioid overdoses in 2018 • There is a recent lower rate of overdose • The United States continues to have an opioid crisis and Native individuals continue to have an extremely high mortality rate compared to the rest of the nation. • Native communities have been disproportionately affected by the opioid crisis ??
TRIBAL MAT • Some reasons: • Rural reservation areas lack integrated supportive services • have higher risk of opioid abuse Chronic pain and injuries are more common on reservations which a r are usually rural areas. there are a host of existing treatment barriers that are felt more acutely by Native individuals including geographic isolation, limited access to treatment programs and providers.
TRIBAL MAT • We want to be clear that we as Native treatment professional are also extremely concerned about the methamphetamine use which is in high use in our communities. • We also want to be clear that we treat addiction as a disease. • We look at cultural, environmental, and socioeconomic issues as the primary struggle. • It makes little impact to help a person recover and send him/her back to the same set of circumstances which created the addiction the first place.
TRIBAL MAT • implementation of MAT has been met with skepticism from our Native communities. • Ways for tribal MAT to improve • Include culture and spirituality in both treatment and recovery from any behavioral health disorder . • integrate MAT and Native traditional ways, and to not force standardized western MAT delivery when it conflicts with these traditions but rather integrate Western into Indigenous perspectives. • EXAMPLE: teaching Welbriety native 12 step while incorporating traditional western 12 step-(same information formatted in Native concept)
TRIBAL MAT • Despite barriers we have treated over 100 Natives in the Hoopa Valley reservation and have retained 35 clients who are in various stable stages of recovery. • We are expanding out of the primary care setting to our own MAT building hopefully by 2020
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