Programming, Services & Support

• Culturally-based models of understanding addiction and opioid use create trust.
• Culturally-based youth programming (hunting, fishing, having conversations, teaching traditional language, etc.), including culture camps, where youth can participate in these cultural activities.
• Host coming of age ceremonies.
• Auntie and Uncle societies.
  Create belonging for members of the communities, including support for all ages (as adults can be overlooked, given the focus on youth and Elders)
• Incorporate harm reduction messaging into cultural practices (e.g., beaded lanyards with harm reduction messages.).
• Talking Circles
• Drum-Assisted Recovery Therapy for Native Americans (DARTNA)
• MICUNAY
  Motivational Interviewing and Culture for Native American Youth.
• Contingency management (CM)
  “A type of behavioral therapy in which individuals are ‘reinforced’, or rewarded, for evidence of positive behavioral change”. CM may include participants receiving a reward for attending talking circles or completing personal goals related to substance use, and some programs may reward demonstrated abstinence from drugs, such as negative drug screens.

• Family Spirit Program
• National Indian Child Welfare Association: Positive Indian Parenting Training
• Native American Parent Technical Assistance Center (NAPTAC)
• The Coeur d’Alene Tribe’s Couer Center
  Youth activity offerings and provides behavioral health supports within a tribally-run recreation center.
• Language nest programs
  Language and cultural immersion for Indigenous babies and children. An example of this is the Dakhódiapi Wahóȟpi – Dakota Language Nest, which focuses on “returning their Dakota language to the children through play, outdoor exploration, art, and loving interactions”.
• Early Years Ermineskin Cree Nation Families Program and it’s First Steps
• Tailoring Opioid Overdose Prevention for Diverse Groups within Tribal and Urban Indian Settings
  A life skills and substance abuse prevention curriculum for use with tribal youth from The Seven Directions. It’s a toolkit for Providers and Community Organizations Serving American Indian/Alaska Native Communities’ (p.48-49) and includes communication considerations, provider planning strategies to ensure inclusive services, and provider implementation strategies to take into consideration when creating services for Native youth.

• Safety First: Real Drug Education for Teens
• Indigenizing Harm Reduction
  From the Native Youth Sexual Health Network.
• Healing of the Canoe
  A life skills and substance abuse prevention curriculum for use with tribal youth.
• Safe in the Village
  Designed to start conversations about healthy relationships, and safe behaviors with Alaska Native youth.

• NHRC’s Native Harm Reduction Toolkit
• Natives for Narcan
  An educational video on how to use Narcan (naloxone).
• Provision of naloxone
  Community-wide naloxone distribution that is part of the Tribal opioid settlements, so it is ideal for Tribes to consider means of increasing distribution.
• Knock for Naloxone program
  Squamish Nation hosted a community walk through their territory, with drumming and singing, and they distributed naloxone kits and signs that said “knock for naloxone”, to let community members know that they can pick up naloxone with anyone who has a sign up.
• Expanding The Circle of Care
  A Practical Guide to Syringe Services for Tribal and Rural Communities.
• Technical Assistance for Tribal and Urban Indian Programs
  Free Technical Assistance for Programs Working on Opioid Overdose Prevention

Culturally based programs offering medications for opioid use disorder (MOUD)

• Quapaw’s Methadone Services
  Offering counseling in conjunction with medication assisted treatment (MAT) (Tipps, et al., 2018).
• Muckleshoot’s Buprenorphine Treatment Program
  Offering Vivitrol and suboxone with a contingency management model, alongside cultural services such as music lessons, beading classes, hosting a drum at local dances and feasts, connecting clients to volunteer with tribal Elders (p. 430, Tipps et al., 2018). As part of their treatment services, the Tribe also offers linkages to employment, education, and church-organizations, as well as linkages to sober housing.
• Ninilchik Traditional Council
  Offering an extended release buprenorphine program (XRBUP).
• The Cowlitz MAT program
  A non-abstinence based, low barrier, medication first treatment model, which includes cultural supports, case management referrals and a walk-in clinic.

Tribal syringe service programs (SSPs):

• Expanding The Circle of Care:
  A Practical Guide to Syringe Services for Tribal and Rural Communities.
• Primary Integrated Care Syringe Service Program offered by Lummi Nation.
• NASTAD hosts a monthly Tribal SSP call

• Great Lakes Recovery Center: Adolescent Recovery Center
• Center for Wabanaki Healing & Recovery

• Welcoming home ceremonies.
• Create new housing policies, provide recovery residency for those in recovery, include wrap-around care.
• Supportive housing services.
  Community members that are using opioids, community members that want to make changes to their opioid use, and community members who are in recovery from opioid use require access to housing. Each person requires different housing support based on their goals around their opioid use.
• Native-American re-entry programs
  Support community members who are transitioning from incarceration back into community.
• Pages 6-9 of the Approved Uses
  Treatment options for people who use opioids, including: “support mobile intervention, treatment, and recovery services, treatment of trauma for people with opioid use disorder; provide comprehensive wrap-around services to individuals with OUD and any co occurring SUD/MH conditions, including housing, transportation, education, job placement, job training, or childcare, and; provide or support transportation to treatment or recovery programs or services for persons with OUD and any co-occurring SUD/MH conditions”.
• ​​Pages 10-11 of the Approved uses
  Suggested supports for community members transitioning out of the criminal justice system, including “provide evidence-informed treatment, including MAT, recovery support, harm reduction, or other appropriate services to individuals with OUD and any co occurring SUD/MH conditions who are leaving jail or prison have recently left jail or prison, are on probation or parole, are under community corrections supervision, or are in reentry programs or facilities”.
• Haa Latseen Community Project
  Sealaska Heritage offers Northwest Coast art workshops, including mask carving and moccasin making, for community members who are recently incarcerated or have been recently released.

• Healing to Wellness/Tribal Drug Courts
  Support tribal community members who use opioids to access culturally-appropriate treatment services and medical treatment, to avoid punitive criminal proceedings (Tipps et al., 2018).
• Nishnawbe-Aski Legal Services Corporation Restorative Justice Programs

• Alternative medicine programs, such as massage therapy, chiropractic treatments, acupuncture, reiki and yoga.
• Tools on how to destress, such as mindful meditation
• Grief and loss groups
• Low-barrier/no-barrier services (e.g., walk-in appointments)
• Have meals and snacks available when offering services
• Cultural and healing supports for service providers
• The Two Feathers Native American Family Services: A.C.O.R.N program
  This program provides opportunities for Native American youth to learn about “cultural values and how they apply physically, mentally, spiritually, and culturally throughout our everyday lives.
• Integrate Indigenous healing model into medical services
• Native Behavioral Health Therapy
  Sometimes called Indigenous Focused Therapy, it integrates culture into all aspects of counseling, and may include walking in nature, doing beadwork while receiving counseling services, or smudging prior to a session.
• Behavioral Health Aide
  Training tailored to tribal communities, such as the Alaska Native Tribal Health Consortium’s training program.