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Oregon's First Tribally-Run Opioid Clinic Prepares To Make A Difference

Brian Bull

The opioid epidemic has hurt Native American communities more than any other demographic.  A CDC study shows a more than 500 percent spike in opioid-related deaths for native people between 1999 and 2015. To fight this trend, the Confederated Tribes of the Grand Ronde is opening Oregon’s first tribally-owned opioid treatment program. 

The Great Circle Recovery Opioid Treatment Program will open in downtown Salem.  Operations director Jennifer Worth said they’re going to be seeing people who are,  “in the deep end of the pool.”

Credit Brian Bull / KLCC
Exterior sign for the Great Circle Recovery Opioid Treatment program.

“We’re going to be seeing people who are really struggling, they might have multiple systems involved in their lives: criminal justice, child welfare, they may have a lot going on.”

Someone who has seen the problem firsthand is Kelly Rowe, executive director of health services for the Confederated Tribes of the Grand Ronde.

“The tribe has invested millions of dollars in sending our members to treatment programs, and there’s a lot of recidivism and a lot of relapse," Rowe told KLCC. 

"We’ve lost tribal members through opioid use disorder. And it’s devastating to small communities, and for our tribal community, we’re all related. We are a family.  This is heartbreaking.”

Rowe said her tribe serves a six-county area, which includes Marion County. She said officials wanted a site for the opioid recovery program that’d be accessible, so people wouldn’t have to travel all the way to the tribal clinic in Grand Ronde. 

Credit Brian Bull / KLCC
Jennifer Worth, operations director for the Great Recovery Opioid Treatment program (left); Kelly Rowe, executive director of health services for the Confederated Tribes of the Grand Ronde (right)

“It was exciting for us because we’re very close to areas that a have homeless population," continued Rowe, describing the location in Salem. 

"Union Gospel mission is building their new facility a couple of blocks over. So being able to make partnerships with any of those agencies or non-profits that also serve the same populations, it was huge for us.” )

The Grand Ronde Tribe is awaiting final certification from the Substance Abuse and Mental Health Services Administration. Once approved, they expect to open by month’s end.

Tribal art and tiles featuring camas flowers will accent the entrance, to make tribal patients feel comfortable. 

“When you walk in to other opioid treatment programs, sometimes it’s not such a nice feeling. You’ll see minimal furniture, it almost has an institutional feeling," said Worth.  "And we wanted people to feel warmth and cared for and valued.  There’s a pretty amazing energy here. We had two tribal elders come, and there was singing and they blessed the site and the staff.”

Credit Brian Bull / KLCC
An exam room at the Great Recovery Opioid Treatment Program in Salem.

The ceremonial burning of sage – called “smudging” in Native American culture – is also offered for patients.  Art therapy includes making dreamcatchers, while principles of an Indigenous-based model called “Wellbriety” are also used alongside current practices and medications.

"We are going to be doing methadone, we are going to be doing suboxone, we’re going to do medication-assisted treatment therapy, and case management are a big part of that.”

A 2017 Oregon report says culturally-attuned treatment benefits Native Americans more than standard models. 

One in full agreement, is Dan Cable.  He’s acting behavioral director with the Muckleshoot Tribe located in Washington state.

"We’ve been doing medication-assisted treatment for about eleven years. Any time you have that kind of closeness with your clients, it’s better.”

Cable says not only is there better familiarity with clients, but his staff understands the tribe’s customs, values, and calendar.

Credit Sent by Misty Jones-Stewart
Misty Jones-Stewart, who benefited from the Muckleshoot Tribe's culture-based recovery program.

“For the Muckleshoot Tribe, we have a canoe journey every year. And we know that clients may not come in to the office, because they’re going to be on a journey.  So, we may have the medical providers prescribe suboxone for a month versus a week.  So they can be with their family and tribe on the canoe journey.

"Or when fishing season starts, we know that fisherman get up early in the morning, they work all day, and come home to sleep, and do it all again.”

One recovering addict who values the integration of culture and recovery is Misty Jones-Stewart. A member of the Port Gamble S’Kllalam tribe, she struggled with drinking and heroin addiction for years.  She got into the Muckleshoot’s program because her husband and children are members of the tribe.   Jones-Stewart shared what conceps helped her. 

“For me, the Medicine Wheel worked really great.  And the medicine wheel, everything is inter-related. So your entire medicine will have to be taken care of, which is the physical, mental, emotional, and spiritual.  So to be able to connect with our culture, hand-in-hand with a recovery program, is tremendous.”

[FADE UP JENNIFER WORTH LEADING A TOUR:] “…so this is where counseling, case management, and groups will happen on this side of the building…”

Credit Brian Bull / KLCC
Front entrance/reception area for the Great Circle Recovery Opioid Treatment program.

Back at Great Circle Recovery, Kelly Rowe acknowledged the challenges ahead. A report in the American Journal of Drug and Alcohol Abuse shows Native Americans are twice as likely to become addicted to drugs and alcohol than the general population, and three times more likely to die of an overdose. 

Complicating things is the COVID-19 pandemic, which can leave addicts feeling isolated and vulnerable.

“You need to be able to talk about things, you need to be able to have that back and forth," explained Rowe.  "And isolation…it helps the addiction take over.  There’s this sense of losing hope again. And so with COVID, we’ve seen rates of everything going up.”

But the Grand Ronde Tribe is intent on making this program work, to better protect their members and their community.

“We want people to be able to seek these services and know that there is hope,” added Rowe.

Copyright 2021, KLCC.

Brian Bull joined the KLCC News Team in June 2016. In his 25+ years as a public media journalist, he's worked at NPR, Twin Cities Public Television, South Dakota Public Broadcasting, Wisconsin Public Radio, and ideastream in Cleveland. His reporting has netted dozens of accolades, including four national Edward R. Murrow Awards (19 regional), the Ohio Associated Press' Best Reporter Award, Best Radio Reporter from the Native American Journalists Association, and the PRNDI/NEFE Award for Excellence in Consumer Finance Reporting.
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