California Looks to Work Alongside Native American Communities on Fentanyl Crisis

As the overdose epidemic roils across California, Native American community leaders are calling on state agencies to do more to slow the effects of the devastating crisis.

“This effort seems to be grassroots for us, so to see representatives here, it means we are all trying to work together to come to some sort of solution for this problem,” John Christman, Chairman of the Viejas Band of Kumeyaay Indians, told members of the California State Assembly Select Committee on Fentanyl, Opioid Addiction and Overdose Prevention, at a hearing on Friday.

Christman shared how fentanyl-related deaths have devastated communities like his, which has 400 members and is located near the California-Mexico border.

Native American and Alaska Native residents in California had the highest rate of opioid-overdose death compared to any other racial group from 2017 to 2022, according to the most recent data available from the California Department of Public Health.

Community members and health leaders have tried a multitude of strategies, from opening up a vending machine where locals can pick up the opioid overdose-reversal medicine Narcan, to increasing talking circles and new wellness clinics. But it hasn’t been enough for many resource-strapped families navigating the crisis at home.

One particular challenge that Christman and others have encountered is stigma around seeking and accepting treatment. How to reduce those barriers so people can enter and have success in treatment is a critical question as the Viejas community looks to open up a new state-of-the-art health and addiction treatment facility called Revive Pathway.

“When you go to the wellness center, everyone knows what you’re doing there. Some of these things are embarrassing. And inpatient treatment does not always work,” Christman told the legislative committee.

Lawmakers from across the state who had come to hear their testimonies echoed the tribal leaders’ concerns and shared many of their frustrations with the status quo.

“We are learning the depth and the scope of this tragedy and it is hitting so many of us and those we care about,” said Assemblymember Jim Patterson (R-Fresno). “This is an area that is dear to me because Fresno, California, by its centralized location and being triangulated by the most traveled interstate freeways in California, is a place for fentanyl distribution.”

San Diego County Sheriff Kelly Martinez spoke about efforts by law enforcement to respond to overdose deaths in the same way that they would approach homicides. For example, she said, by seizing the cell phone of someone who died and looking for who their dealer was.

Many speakers underscored that getting buy-in and cooperation from law enforcement around effective solutions would be critical to making progress on slowing overdose deaths and drug dealing.

Christman, however, said that’s been a challenge for his community working with law enforcement agencies in the past.

“We have been in discussions at length since I got back into office in 2019 with the sheriff’s department. That open dialogue didn’t exist in the beginning of my council tenure. And it has not [borne] any fruit yet, I have to be honest about that,” the chairman said. “But I’m hoping we can have this dialogue. I don’t know that we can eradicate this, but we need some sort of solution to make these numbers go down.”

Chair of the committee Assemblymember Matt Haney (D-San Francisco) brought up expanding access to medication-assisted treatment, and other health or housing services to help stabilize individuals struggling with addiction.

“We are forging a path together towards healing and recovery,” said Haney. “This is affecting every corner of our state.”

Some speakers at the hearing questioned the effectiveness of supply-side interventions and asked tribal council leaders for ways that communities could reduce demand.

Christman shared that deep-seeded traumas from violence against his community remain and often fuel the disparate impact that Native American communities face when it comes to the current overdose epidemic.

He recalled painful memories of watching and protesting threats to the tribe’s historic burial grounds. “What would that do to you? What would that do to anyone? It’s a vicious cycle. Poverty is part of that, and we lived it,” Christman said. “We were able to find a way to provide more for our people, but those scars from trauma still exist in our community.”

Greg Greenberg, chief medical officer at OneTogether Solutions, which provides overdose prevention and addiction treatment for rural tribal communities, said that the biggest issue he encounters among patients is a lack of available treatment and prevention services that people can easily access.

“The biggest issue I see is barriers to treatment,” Greenberg said. “Our current paradigm, we have people with substance abuse making their own appointments, and it’s hard to make and keep an appointment when you have a fentanyl or methamphetamine addiction. And it’s hard to engage in treatment when you have untreated psychiatric services as well.”

Geography and proximity to fully staffed and resourced health clinics is a major challenge for members of the Tule River Tribe, according to Shine Nieto, vice chairman. The community is based about 16 miles away from the nearest hospital. And while Tule River has its own wellness center with counselors and psychologists, the need is greater than what the clinic currently has resources for.

In the meantime, he and others have started up small groups and talking circles to try to bring healing around addiction, its causes, and the impacts that overdoses leave behind.

The talking circles are an important part of shifting narratives and understandings about each other and addiction. But tragedy still followed. Four of the group’s nearly 40 members died of opioid-related overdoses, Nieto said.

“I don’t like politics, but when it comes to this we are all in the same boat,” said Nieto. “This drug is killing people and destroying our state. We’re all in this state together. If this wipes out any town, it will just keep moving and moving. This is why I’m here, I want to help fight this and slow it down.”