美国国家公共电台 NPR--Tribal leaders sound the alarm after fentanyl overdoses spike at Blackfeet Nation

Tribal¹ leaders sound the alarm after fentanyl overdoses spike² at Blackfeet Nation

Transcript³

BROWNING, Mont. — In summer 2020, as the pandemic was setting in, Justin Lee Littledog called his mom to tell her he was moving from Texas back home to the Blackfeet Indian Reservation in Montana. And he was taking his girlfriend, stepson and son.

This story was produced in partnership⁴ with Kaiser Health News.

But things began to unravel⁵ over the next year and a half. Friends and relatives saw Littledog's 6-year-old stepson walking around town alone. Then last fall, Ollinger received a call from another one of her adult sons. He was frightened because he was briefly⁶ unable to wake Littledog's girlfriend. Ollinger says she could hear one of Littledog's children crying in the background.

After that incident, Ollinger asked Littledog whether he and his girlfriend were using drugs. She says Littledog denied it. He explained to his mom that people on the reservation were using a drug she had never heard about: fentanyl, a synthetic⁷ opioid that is up to 100 times as potent⁸ as morphine. He said he would never use something so dangerous and reassured⁹ his mom everything was fine. Ollinger backed off, fearing that any more confrontation¹⁰ would push her son away.

Then in March, Ollinger woke up to screams. She left her grandchildren, who were sleeping in her bed, and went into the next room. "My son was lying on the floor," she says. Littledog wasn't breathing.

After calling 911, she drove behind the ambulance into Browning. He was pronounced dead shortly after the ambulance arrived at the local hospital.

Littledog was one of four people who died from a fentanyl overdose on the reservation on the second week of March, according to Blackfeet health officials. An additional 13 people on the reservation survived overdoses that week, making a startling total for an Indigenous¹¹ population of about 10,000 people.

Falling prey¹² to fentanyl

During the pandemic, fentanyl took root in Montana and communities across the Mountain West region, says Keith Humphreys of the Stanford-Lancet Commission on the North American Opioid Crisis. Previously¹³, the drug was prevalent east of the Mississippi River.

Montana law enforcement officials have intercepted¹⁴ record numbers of pale blue pills made to look like prescription¹⁵ opioids such as OxyContin. In the first three months of 2022, the Montana Highway Patrol seized over 12,000 fentanyl pills, more than three times the number from 2021.

Nationwide, at least 103,000 people have died from drug overdoses in 2021, a 45% increase from 2019, according to data from the Centers for Disease Control and Prevention. About 7 of every 10 of those deaths were from synthetic opioids, primarily fentanyl.

Overdose deaths disproportionately affect Native Americans. The overdose death rate among Indigenous people was the highest of all racial groups in the first year of the pandemic — and was about 30% higher than the rate among white people, according to a March study published in JAMA Psychiatry¹⁶, co-authored by Joe Friedman, a researcher at the University of California, Los Angeles.

In Montana, the opioid overdose death rate for Indigenous people was twice that of white people from 2019 to 2021, according to the state's Department of Public Health and Human Services.

Part of the reason why this is happening is that Native Americans have relatively¹⁷ less access to health care resources, Friedman says. "With the drug supply becoming so dangerous and toxic¹⁸, it requires resources and knowledge and skills and funds [for people] to stay safe," he says. "It requires access to harm reduction, health care, medications."

The Indian Health Service, which is responsible for providing health care to many Indigenous people, has been chronically¹⁹ underfunded. According to a 2018 report from the U.S. Commission on Civil Rights, IHS per patient expenditures²⁰ are significantly less than those of other federal health programs.

"What we're seeing now is deep-seated disparities and social determinants of health kind of bearing out," Friedman says, referring to the disproportionate overdose deaths among Native Americans.

Blackfeet Tribal Business Council member Stacey Keller says she has experienced the lack of resources firsthand while trying to get a family member into treatment. She says just finding a facility for detoxing was difficult, let alone finding one for treatment.

"Our treatment facility here, they're not equipped to deal with opioid addiction²¹, so [people] are usually referred" to facilities outside of the reservation, she says. "Some of the struggles we've seen throughout the state and even the western part of the United States is that a lot of the treatment centers are at capacity."

The local treatment center doesn't have the medical expertise²² to supervise someone going through opioid withdrawal²³. Only two detox beds are available at the local IHS hospital, Keller says, and they are often occupied. The health care system on the reservation also doesn't offer drugs used to treat opioid addictions²⁴. The nearest locations to get buprenorphine or methadone, for example, are 30 to 100 miles away. That can be a burden to patients who are required by federal rules to take those meds to manage their treatment on a daily or weekly basis.

Finding treatment for Indigenous communities

Keller says tribal leaders have requested assistance from IHS to build treatment centers and procure²⁵ other substance use resources, like detox beds and medication, in the community — with no results.

IHS Alcohol and Substance Abuse Program consultant²⁶ JB Kinlacheeny says the agency has largely shifted to appropriating funds directly to tribes to run their own health care programs.

The Rocky Mountain Tribal Leaders Council, a consortium of Montana and Wyoming tribes, is working with the Montana Healthcare Foundation on a feasibility study for a residential²⁷ treatment center operated by tribes, specifically for tribal members. Tribes across both states, including the Blackfeet, have passed resolutions supporting the effort.

On March 14, Blackfeet political leaders declared a state of emergency after the fentanyl overdoses. Two weeks later, some of the children of Timothy Davis, the tribal council chairman, were arrested on suspicion of selling fentanyl out of Davis' home. The council removed Davis from his position in early April.

The tribe has created a task force to identify both the short- and long-term needs to respond to the opioid crisis. Blackfeet tribal police investigator²⁸ Misty²⁹ LaPlant is helping³⁰ to lead that effort.

Driving around Browning, LaPlant says she plans to train more people on the reservation to administer naloxone, a medication that reverses opioid overdoses. She also wants the tribe to host more needle exchanges. There's also hope, she says, that a reorganization of the tribal health department will result in a one-stop shop for Blackfeet Nation residents to find drug addiction resources on and off the reservation.

However, she says, it's crucial to resolve some of the underlying³¹ issues — such as poverty, housing and food insecurity — that make communities like the Blackfeet Nation vulnerable to the ongoing³² fentanyl crisis. These problems can spur people to use drugs — and under-resourced communities are generally easier targets for drug traffickers, she says. Solving that problem is a massive undertaking³³ that won't be completed anytime soon, she says.

Meanwhile, Ollinger is feeling optimistic that momentum³⁴ is building to fight opioid and fentanyl addiction in the wake of her son's death and others. She hopes sharing her story will help advocate for more resources so no one else has to live through her experience.

"It's heartbreaking to watch your children 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 produces in-depth journalism³⁵ about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

1 tribal   

adj.部族的，种族的

参考例句：

• He became skilled in several tribal lingoes.他精通几种部族的语言。
• The country was torn apart by fierce tribal hostilities.那个国家被部落间的激烈冲突弄得四分五裂。

2 spike   

n.长钉，钉鞋；v.以大钉钉牢，使...失效

参考例句：

• The spike pierced the receipts and held them in order.那个钉子穿过那些收据并使之按顺序排列。
• They'll do anything to spike the guns of the opposition.他们会使出各种手段来挫败对手。

3 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

4 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。

5 unravel   

v.弄清楚（秘密）；拆开，解开，松开

参考例句：

• He was good with his hands and could unravel a knot or untangle yarn that others wouldn't even attempt.他的手很灵巧，其他人甚至都不敢尝试的一些难解的绳结或缠在一起的纱线，他都能解开。
• This is the attitude that led him to unravel a mystery that long puzzled Chinese historians.正是这种态度使他解决了长期以来使中国历史学家们大惑不解的谜。

6 briefly   

adv.简单地，简短地

参考例句：

• I want to touch briefly on another aspect of the problem.我想简单地谈一下这个问题的另一方面。
• He was kidnapped and briefly detained by a terrorist group.他被一个恐怖组织绑架并短暂拘禁。

7 synthetic   

adj.合成的，人工的；综合的；n.人工制品

参考例句：

• We felt the salesman's synthetic friendliness.我们感觉到那位销售员的虚情假意。
• It's a synthetic diamond.这是人造钻石。

8 potent   

adj.强有力的，有权势的；有效力的

参考例句：

• The medicine had a potent effect on your disease.这药物对你的病疗效很大。
• We must account of his potent influence.我们必须考虑他的强有力的影响。

9 reassured   

adj.使消除疑虑的；使放心的v.再保证，恢复信心( reassure的过去式和过去分词)

参考例句：

• The captain's confidence during the storm reassured the passengers. 在风暴中船长的信念使旅客们恢复了信心。 来自《现代英汉综合大词典》
• The doctor reassured the old lady. 医生叫那位老妇人放心。 来自《简明英汉词典》

10 confrontation   

n.对抗，对峙，冲突

参考例句：

• We can't risk another confrontation with the union.我们不能冒再次同工会对抗的危险。
• After years of confrontation,they finally have achieved a modus vivendi.在对抗很长时间后，他们最后达成安宁生存的非正式协议。

11 indigenous   

adj.土产的，土生土长的，本地的

参考例句：

• Each country has its own indigenous cultural tradition.每个国家都有自己本土的文化传统。
• Indians were the indigenous inhabitants of America.印第安人是美洲的土著居民。

12 prey   

n.被掠食者，牺牲者，掠食；v.捕食，掠夺，折磨

参考例句：

• Stronger animals prey on weaker ones.弱肉强食。
• The lion was hunting for its prey.狮子在寻找猎物。

13 previously   

adv.以前，先前（地）

参考例句：

• The bicycle tyre blew out at a previously damaged point.自行车胎在以前损坏过的地方又爆开了。
• Let me digress for a moment and explain what had happened previously.让我岔开一会儿，解释原先发生了什么。

14 intercepted   

拦截( intercept的过去式和过去分词 )； 截住； 截击； 拦阻

参考例句：

• Reporters intercepted him as he tried to leave the hotel. 他正要离开旅馆，记者们把他拦截住了。
• Reporters intercepted him as he tried to leave by the rear entrance. 他想从后门溜走，记者把他截住了。

15 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

16 psychiatry   

n.精神病学，精神病疗法

参考例句：

• The study appeared in the Amercian science Journal of Psychiatry.这个研究发表在美国精神病学的杂志上。
• A physician is someone who specializes in psychiatry.精神病专家是专门从事精神病治疗的人。

17 relatively   

adv.比较...地，相对地

参考例句：

• The rabbit is a relatively recent introduction in Australia.兔子是相对较新引入澳大利亚的物种。
• The operation was relatively painless.手术相对来说不痛。

18 toxic   

adj.有毒的，因中毒引起的

参考例句：

• The factory had accidentally released a quantity of toxic waste into the sea.这家工厂意外泄漏大量有毒废物到海中。
• There is a risk that toxic chemicals might be blasted into the atmosphere.爆炸后有毒化学物质可能会进入大气层。

19 chronically   

ad.长期地

参考例句：

• Similarly, any pigment nevus that is chronically irritated should be excised. 同样，凡是经常受慢性刺激的各种色素痣切勿予以切除。
• People chronically exposed to chlorine develop some degree of tolerance. 人长期接触氯气可以产生某种程度的耐受性。

20 expenditures   

n.花费( expenditure的名词复数 )；使用；（尤指金钱的）支出额；（精力、时间、材料等的）耗费

参考例句：

• We have overspent.We'll have to let up our expenditures next month. 我们已经超支了，下个月一定得节约开支。 来自《简明英汉词典》
• The pension includes an allowance of fifty pounds for traffic expenditures. 年金中包括50镑交通费补贴。 来自《简明英汉词典》

21 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

22 expertise   

n.专门知识(或技能等)，专长

参考例句：

• We were amazed at his expertise on the ski slopes.他斜坡滑雪的技能使我们赞叹不已。
• You really have the technical expertise in a new breakthrough.让你真正在专业技术上有一个全新的突破。

23 withdrawal   

n.取回，提款；撤退，撤军；收回，撤销

参考例句：

• The police were forced to make a tactical withdrawal.警方被迫进行战术撤退。
• They insisted upon a withdrawal of the statement and a public apology.他们坚持要收回那些话并公开道歉。

24 addictions   

瘾( addiction的名词复数 )； 吸毒成瘾； 沉溺； 癖好

参考例句：

• He has removed the stigma of drug addictions. 他已经洗去吸毒的污点了。
• Intelligent people are good at using reason to control excessive addictions. 智慧的人善于用理性来控制过度的嗜欲。

25 procure   

vt.获得，取得，促成；vi.拉皮条

参考例句：

• Can you procure some specimens for me?你能替我弄到一些标本吗？
• I'll try my best to procure you that original French novel.我将尽全力给你搞到那本原版法国小说。

26 consultant   

n.顾问；会诊医师，专科医生

参考例句：

• He is a consultant on law affairs to the mayor.他是市长的一个法律顾问。
• Originally,Gar had agreed to come up as a consultant.原来，加尔只答应来充当我们的顾问。

27 residential   

adj.提供住宿的；居住的；住宅的

参考例句：

• The mayor inspected the residential section of the city.市长视察了该市的住宅区。
• The residential blocks were integrated with the rest of the college.住宿区与学院其他部分结合在了一起。

28 investigator   

n.研究者，调查者，审查者

参考例句：

• He was a special investigator for the FBI.他是联邦调查局的特别调查员。
• The investigator was able to deduce the crime and find the criminal.调查者能够推出犯罪过程并锁定罪犯。

29 misty   

adj.雾蒙蒙的，有雾的

参考例句：

• He crossed over to the window to see if it was still misty.他走到窗户那儿，看看是不是还有雾霭。
• The misty scene had a dreamy quality about it.雾景给人以梦幻般的感觉。

30 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。

31 underlying   

adj.在下面的，含蓄的，潜在的

参考例句：

• The underlying theme of the novel is very serious.小说隐含的主题是十分严肃的。
• This word has its underlying meaning.这个单词有它潜在的含义。

32 ongoing   

adj.进行中的，前进的

参考例句：

• The problem is ongoing.这个问题尚未解决。
• The issues raised in the report relate directly to Age Concern's ongoing work in this area.报告中提出的问题与“关心老人”组织在这方面正在做的工作有直接的关系。

33 undertaking   

n.保证，许诺，事业

参考例句：

• He gave her an undertaking that he would pay the money back with in a year.他向她做了一年内还钱的保证。
• He is too timid to venture upon an undertaking.他太胆小，不敢从事任何事业。

34 momentum   

n.动力，冲力，势头；动量

参考例句：

• We exploit the energy and momentum conservation laws in this way.我们就是这样利用能量和动量守恒定律的。
• The law of momentum conservation could supplant Newton's third law.动量守恒定律可以取代牛顿第三定律。

35 journalism   

n.新闻工作，报业

参考例句：

• He's a teacher but he does some journalism on the side.他是教师，可还兼职做一些新闻工作。
• He had an aptitude for journalism.他有从事新闻工作的才能。