In the wake of a landmark settlement deal with the nation’s largest drugmakers and distributors, Native American leaders told lawmakers Tuesday that the federal government must also uphold its commitments to helping tribes fight the opioid epidemic.
Leaders from the Cherokee Nation and the National Council of Urban Indian Health demanded lawmakers fulfill their legal obligation to provide health care for all tribal citizens – an obligation which Rep. Katie Porter (D-Calif.) said “the U.S. government has never delivered on.”
“American Indians and Alaska Natives have kept their cultures and governments alive through centuries of colonial violence, dispossession and forced assimilation,” said Porter, who chairs the House Natural Resources Subcommittee on Oversight and Investigations. “Today, opioids are another assault on tribal cultures – separating families, claiming lives and disrupting ways of life.”
More than 400 Native American tribes and tribal organizations have accused Johnson & Johnson and major U.S. drug distributors McKesson, Cardinal Health and AmerisourceBergen of intentionally funneling opioids into their communities.
The distributors agreed in February to pay the tribes nearly $440 million over seven years, according to court documents, after agreeing to pay the Cherokee Nation about $75 million in a similar settlement deal. Johnson & Johnson agreed to pay the tribes $150 million over two years.
Principal Chief Chuck Hoskin Jr. of the Cherokee Nation said his administration plans to spend at least $15 million of their settlement money on construction costs for new drug treatment facilities. Additional government funding, he said, would allow the Cherokee Nation to train more of its own addiction counselors and invest in youth drug prevention programs.
“These treatment centers will help bring about transformational change and provide some measure of justice by bringing healing to our people, using funds from the very industry that injured us,” Hoskin said. “But the settlement funds alone will not be enough to end the opioid crisis.”
As fatal overdoses have reached a record high in the U.S. – with annual overdose deaths exceeding 100,000 in 2021, according to provisional data from the Centers for Disease Control and Prevention – Native communities have suffered disproportionate losses.
According to the CDC, American Indians and Alaska Natives had the highest rate of drug overdose deaths of any ethnic group in 2020: 42.5 deaths per 100,000 people, compared to 28.3 deaths per 100,000 people in the general population.
Though the opioid crisis is just as pervasive in urban Native communities as on reservations, Maureen Rosette, a board member of the National Council of Urban Indian Health, said Urban Indian Organizations, known as UIOs, are often left out of funding allocations.
“When UIOs are not explicitly stated as eligible entities, we are excluded from critical resources and grants, which is a violation of the trust obligation,” said Rosette, a citizen of the Chippewa Cree Nation, referring to the law compelling the U.S. government to support Native tribes.
Nearly 70% of American Indians and Alaska Natives live in urban or suburban communities, according to the Indian Health Service (IHS), but only about 1% of the annual $8.5 billion IHS budget funds UIOs.
“It’s the obligation of the United States government to provide these resources for American Indians and Alaska Natives residing in urban areas,” Rosette said. “We urge Congress to take this obligation seriously and provide UIOs with all the resources necessary to protect the lives of the entirety of the American Indian and Alaska Native population, regardless of where they live.”
Rep. Blake Moore (R-Utah) asserted that the disproportionate impact of the opioid crisis on Native communities is not the result of a funding problem, but rather a border security problem that he blamed on President Biden.
According to the U.S. Drug Enforcement Administration’s 2020 National Drug Threat Assessment, transnational crime organizations often smuggle drugs through reservations along U.S. borders. Poverty and high unemployment rates contribute to the Native community’s increased susceptibility to addiction and exploitation by drug traffickers, the report states.
“The point we’re trying to make today,” Moore said, “is that no amount of additional spending, no additional advertising or physicians being more hyper-focused on this with their individual patients, can overcome the amount of volume [of drugs] that we’ve seen in our borders over the last year.”