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Killer Crisis: Tribe bears down on meth, but opioid use on SD-ND reservation often overlooked

AGENCY VILLAGE, S.D.— Meth use, sometimes called an epidemic on the Sisseton-Wahpeton Oyate reservation, is getting most of the attention these days as the tribe takes on that addiction.

However, Clarice Bear Hill of the tribe's Dakota Pride Treatment Center in Sisseton thinks opioid use is often overlooked on the reservation that includes seven counties straddling the border of northeast South Dakota and southeast North Dakota..

"It is a really big problem," she said.

Whether heroin or prescription pills, she said they are seeing more abuse of those drugs lately.

"You know it used to be mostly about alcohol," said Bear Hill, who has been working at the center since 1999. "But that's changing."

It's a new kind of fight, but she said they are seeing some success as they try to teach clients how to cope with life without drugs and alcohol.

The effort isn't slowing down either as the center's 12 inpatient beds are usually full. She said there also usually about 15 people in the center's outpatient program, too.

The tribe is taking another step forward in the effort as they are starting an intensive day treatment program that has received tribal approval and is set to start likely in the spring with four counselors. It's initial target are those who are serving drug sentences in jail, although self referrals are also being accepted, according to tribal addiction counselor Shobi Zetini.

The program is modeled after another one that has been successful on the Rosebud Sioux Indian Reservation in far south-central South Dakota and was led by Dr. Gail Mason, who was previously working there but is now the Sisseton-Wahpeton tribe's behavioral health director..

Zetina said to start they will probably have about 20 clients, but hope to expand to 40 to 60 clients at a time. Over a year's time, they hope to serve about 130 people.

The program is certainly intense.

Clients will first be in a 30-day inpatient treatment program to begin skill building, then will start the intensive program by attending group and individual sessions in addition to full classes five days for a minimum of 90 days. After that, it will become a four-hour a day program where clients work on strengthening recovery skills and re-entering the workforce. Part of that effort will involve a lengthy community service aspect, a main component of a controlled substance act passed by the tribal council this past August.

The final step to the intensive program is attending a minimum of three support group meetings each week such as Alcoholics Anonymous or Narcotics Anonymous.

"Although we've had some success with our outpatient program in the past year, we know more intensive treatment is needed. It just hasn't been enough," Zetina said.

She believes tribal members and families are becoming more educated on how to handling substance abuse through the tribe's behavioral health program being spread around the reservation. However, as far as any decrease in meth, opioid and other drug use, Zetina isn't sure that progress is being made yet.

Police seeing more arrests

Tribal police chief Gary Gaikowski said drug use isn't going down as evidenced by increased arrests on the reservation, similar to what is happening across South Dakota. He also agrees with Bear Hill that although meth is getting the attention, opioids are still a "big problem" on the reservation.

While someone may be arrested for meth, oftentimes they also "test hot" for other drugs such as opioids, ecstasy and marijuana, he said.

The department has been working with pharmacies on the reservation lands to flag possible abuse of prescription opioids, Gaikowski said.

As for those arrested on drug charges, one problem is the reservation jail has been shut down by the Bureau of Indian Affairs. Thus, the tribe has to contract with North Dakota's Richland County and Roberts and Day counties in South Dakota for jail cells.

The tribe wants to secure funding for the jail and is working with the South Dakota and North Dakota congressional delegations.

"It's looking good," Gaikowski said. "It's a top priority for the tribal chairman."

Tribe OKs drug abuse act

The tribe also hopes to make progress through that recently passed substance abuse act.

The act states that meth use and trafficking "in our communities poses an imminent and serious threat to the health, safety and welfare of our people and the Sisseton Wahpeton-Oyate as a whole."

It further states that meth use "can lead to short and long-term psychological, medical and social damage to our people and communities, including increases in violent crime, anti-social behavior and child neglect and abuse."

The act also notes that drug use isn't in line with "traditional Dakota values."

The tribe's new penalties for those arrested are "fashioned in a way as to allow offenders the opportunity to make positive changes in their behavior and understand 'WoDakota' (an understanding of what it is to be Dakota and its way of life).

For example, new penalties call for shorter prison terms both for manufacturing and possessing meth, and Zetina said drug evaluations and community service is where the new intensive day treatment will come in.