Tony Binam for KHN
Browning, Mont. – In the summer of 2020, as the epidemic began, Justin Lee Littledog called his mother to tell her he was returning home from Texas to the Blackfit Indian Reservation in Montana. And he was taking his girlfriend, honest son and son.
They were his mother, Marla Olinger, who lived on a 300-acre farm in Rolling Prairie outside Browning – and what Olinger said was the best summer of her life. “I first met my first grandson, Arlene,” Olinger said. Another grandson was born in the spring of 2021 – and Littledog, 33, found a maintenance job at Browning’s casino to support his growing family.
But over the next year and a half, things began to unravel. Friends and relatives have spotted Littledog’s 6-year-old stepson wandering the city alone. Then last fall, Olinger received a call from one of his adult boys. He was scared because he was briefly unable to wake up Littledog’s girlfriend. Olinger says he heard a Littledog baby crying in the background.
After that incident, Olinger asked Littledog if he and his girlfriend were using drugs. He says Littledog denied it. She explained to her mother that the people in the reservation were using a drug she had never heard of: fentanyl, a synthetic opioid that was 100 times stronger than morphine. She said she would not use anything so dangerous and assured her mother that everything was fine. Olingar retreated, fearing that another collision would push his son away.
Then in March, Olinga woke up screaming. He left his grandchildren, who were sleeping in his bed, and went to the next room. “My son was lying on the floor,” she says. Littledog was not breathing.
After calling 911, he drove behind the ambulance in Browning. He was pronounced dead at the scene at the local hospital.
Littledog was one of four people killed in a fentanyl overdose at a reservation in the second week of March, according to Blackfit health officials. An additional 13 people in reservations survived the overdose that week, creating a staggering total for the approximately 10,000 indigenous population.
Being a victim of fentanyl
During the epidemic, fentanyl took root in communities across the Montana and Mountain West regions, said Keith Humphreys of the Stanford-Lancet Commission on the North American Opioid Crisis. Previously, the drug was prevalent along the Mississippi River.
Montana law enforcement officers have seized a record number of pale blue pills that look like prescription opioids like oxycodone. In the first three months of 2022, Montana Highway Patrol seized more than 12,000 fentanyl pills, more than three times as much as in 2021.
Nationwide, at least 103,000 people died of drug overdoses in 2021, an increase of 45% from 2019, according to data from the Centers for Disease Control and Prevention. About 7 out of every 10 people died from synthetic opioids, primarily fentanyl.
Excessive deaths disproportionately affect Native Americans. The death toll among indigenous peoples was the highest among all ethnic groups in the first year of the epidemic – and about 30% higher than among whites, according to a survey published in March. Clothing psychiatryCo-author Joe Friedman, a researcher at the University of California, Los Angeles.
According to the state Department of Public Health and Human Services, in Montana, between 2019 and 2021, opioid overdose mortality rates for indigenous people were twice as high as for whites.
This is one of the reasons why this is happening Friedman says Native Americans have relatively little access to healthcare. “When the drug supply becomes so dangerous and toxic, it requires resources and knowledge and skills and funding. [for people] To stay safe, “he said,” it requires harm reduction, healthcare, access to medicine. “
The Indian health service, which is responsible for providing healthcare to many indigenous peoples, has become meaningless in the long run. According to a 2018 report by the US Commission on Civil Rights, the cost per patient of IHS is significantly lower than that of other federal health programs.
“What we’re seeing now is deep-seated inequality and social determinants of health,” Friedman said, referring to unequal overdose deaths among Native Americans.
Stacey Keller, a member of the Blackfit Tribal Business Council, said she felt short of resources while trying to treat a family member. He said it was difficult to find a benefit for detoxing alone, let alone find one for treatment.
“Our treatment facilities here, they are not equipped to deal with opioid addiction, so [people] The facilities outside the reservation are usually mentioned, he said “Some of the struggles we’ve seen across the state, even across the western part of the United States, are that many medical centers have capacity.”
Tony Binam for KHN
There is no medical specialist at the local medical center to oversee the passage of opioid withdrawal. Only two detox beds are available at the local IHS hospital, Keller says, and they are often occupied. The reservation healthcare system does not recommend drugs used to treat opioid addiction. The closest locations to get buprenorphine or methadone, for example, 30 to 100 miles away. This can be a burden for patients who have to take these drugs to manage their treatment on a daily or weekly basis according to federal regulations.
Seeking treatment for indigenous communities
Keller said tribal leaders have asked the IHS for help in building medical centers and raising funds for the use of other substances in the community, such as detox beds and medicines – without any results.
JB Kinlachini, IHS Alcohol and Substance Abuse Program Consultant, says the organization has moved to allocate funds directly to the tribes to run their own healthcare programs.
The Rocky Mountain Tribal Leaders Council, a consortium of Montana and Wyoming tribes, is working with the Montana Healthcare Foundation to study the feasibility of a residential treatment center run by the tribes, especially for tribal members. Tribes in both states, including Blackfit, have passed resolutions supporting the effort.
On March 14, Blackfit political leaders declared a state of emergency following a fentanyl overdose. Two weeks later, some children of Timothy Davis, chairman of the Tribal Council, were arrested on suspicion of selling fentanyl outside Davis’ home. The council removed Davis from office in early April.
Tribes have created a task force to identify both short- and long-term needs to respond to the opioid crisis. Blackfit Tribal Police investigator Misty Laplant is helping lead that effort.
Driving around Browning, Laplant said he plans to train more people on reservations for managing naloxone, a drug that contrasts opioid overdoses. He wants more needle exchange host tribes. There is also hope, he said, that the restructuring of the Department of Tribal Health will create a one-stop shop for Blackfit Nation residents to find drug addiction resources on and off conservation.
However, he says it is critical to address some of the underlying issues – such as poverty, housing and food insecurity – that put communities like Blackfit Nation at risk for the ongoing fentanyl crisis. These problems can motivate people to use drugs – and low-income communities are usually easy targets for drug traffickers, she says. Solving that problem is a huge undertaking that will not end soon, he says.
Olinger, meanwhile, is optimistic that his son’s death, among others, will speed up the fight against opioid and fentanyl addiction. She hopes that sharing her story will support more resources so that no one else has to live through her experience.
“It’s heartbreaking to see your kids die unnecessarily,” she says
This story is part of a partnership that includes Montana Public Radio, NPR And KHN.
KHN (Kaiser Health News) is a national newsroom that creates in-depth journalism about health issues. KHN is one of the three major operating programs, including policy analysis and polling KFF (Kaiser Family Foundation). KFF is a non-profit organization that provides health information to the nation.