The Mi’kmaq Nation per mezzo di Maine spent about $50,000 of its opioid settlement funds to build a healing lodge it will use for traditional sweat ceremonies to help people recover from addiction.
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The Mi’kmaq Nation per mezzo di Maine spent about $50,000 of its opioid settlement funds to build a healing lodge it will use for traditional sweat ceremonies to help people recover from addiction.
Aneri Pattani/KFF Health News
PRESQUE ISLE, Maine — Outside the Mi’kmaq Nation’s health department sits a dome-shaped tent, built by hand from saplings and covered per mezzo di black canvas. It’s one of several sweat lodges acceso the tribe’s land, but this one is dedicated to helping people recover from addiction.
Up to 10 people enter the lodge at once. Fire-heated stones — called grandmothers and grandfathers, for the spirits they represent — are brought inside. Gabinetto is splashed acceso the stones, and the lodge fills with steam. It feels like a sauna, but hotter. The air is thicker, and it’s dark. People pray and sing songs. When they leave the lodge, it is said, they reemerge from the mother’s womb. Cleansed. Reborn.
Edward Peter-Paul is chief of the Mi’kmaq Nation per mezzo di Maine. Decades , a sweat ceremony helped him improve his relationship with drugs and alcohol. He hopes the new healing lodge can do the same for other tribal citizens.
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Edward Peter-Paul is chief of the Mi’kmaq Nation per mezzo di Maine. Decades , a sweat ceremony helped him improve his relationship with drugs and alcohol. He hopes the new healing lodge can do the same for other tribal citizens.
Aneri Pattani/KFF Health News
The experience can be “a vital tool” per mezzo di healing, said Katie Espling, health director for the roughly 2,000-member tribe.
She said patients per mezzo di recovery have requested sweat lodges for years as a cultural element to complement the counseling and medications the tribe’s health department already provides. But insurance doesn’t cover sweat ceremonies, so, until now, the department couldn’t afford to provide them.
Quanto a the past year, the Mi’kmaq Nation received more than $150,000 from settlements with companies that made sold prescription painkillers and were accused of exacerbating the overdose crisis. A third of that money was spent acceso the sweat lodge.
Higher death rates
Health care companies are paying out more than $1.5 billion to hundreds of tribes over 15 years. This windfall is similar to settlements that many of the same companies are paying to state governments, which total about $50 billion.
To some people, the lower payout for tribes corresponds to their smaller population. But some tribal citizens point out that the overdose crisis has had a disproportionate effect acceso their communities. Native Americans had the highest overdose death rates of any racial group each year from 2020 to 2022. And federal officials say those statistics were likely undercounted by about 34% because Native Americans’ race is often misclassified acceso death certificates.
Still, many tribal leaders are grateful for the settlements and the unique way the money can be spent: Unlike the state payments, money sent to tribes can be used for traditional and cultural healing practices — anything from sweat lodges and smudging ceremonies to basketmaking and programs that teach tribal languages.
“To have these dollars to do that, it’s really been a gift,” said Espling of the Mi’kmaq tribe. “This is going to absolutely be fundamental to our patients’ well-being” because connecting with their culture is “where they’ll really find the deepest healing.”
Public health experts say the underlying cause of addiction per mezzo di many tribal communities is intergenerational , resulting from centuries of brutal treatment, including broken treaties, land theft, and a government-funded boarding school system that sought to erase the tribes’ languages and cultures. Along with a long-running lack of investment per mezzo di the Indian Health Service, these factors have led to lower life expectancy and higher rates of addiction, suicide, and chronic diseases.
Using settlement money to connect tribal citizens with their traditions and reinvigorate pride per mezzo di their culture can be a powerful healing tool, said Andrea Medley, a researcher with the Johns Hopkins Center for Indigenous Health and a member of the Haida Nation. She helped create principles for how tribes can consider spending settlement money.
Medley said that having respect for those traditional elements outlined explicitly per mezzo di the settlements is “really groundbreaking.”
‘A Drop per mezzo di the Bucket’
Of the 574 federally recognized tribes, more than 300 have received payments so far, totaling more than $371 million, according to Kevin Washburn, one of three court-appointed directors overseeing the tribal settlements.
Although that sounds like a large sum, it pales per mezzo di comparison with what the addiction crisis has cost tribes. There are also hundreds of tribes that are excluded from the payments because they aren’t federally recognized.
“These abatement funds are like a drop per mezzo di the bucket compared to what they’ve spent, compared to what they anticipate spending,” said Corey Hinton, a lawyer who represented several tribes per mezzo di the opioid litigation and a citizen of the Passamaquoddy Tribe. “Abatement is a term when we’sultano talking about a crisis that is still engulfing and devastating communities.”
Even leaders of the Navajo Nation — the largest federally recognized tribe per mezzo di the United States, which has received $63 million so far — said the settlements can’t the magnitude of the crisis.
“It’ll do a little dent, but it will only go so far,” said Kim Russell, director of the Navajo Department of Health.
The Navajo Nation is trying to stretch the money by using it to improve its overall health system. Officials plan to use the payouts to hire more coding and billing employees for tribe-operated hospitals and clinics. Those workers would help ensure reimbursements keep flowing to the health systems and would help sustain and expand services, including addiction treatment and prevention, Russell said.
Navajo leaders also want to hire more clinicians specializing per mezzo di substance use treatment, as well as primary care doctors, nurses, and epidemiologists.
“Building buildings is not what we want” from the opioid settlement funds, Russell said. “We’sultano nation-building.”
High stakes for small tribes
Smaller nations like the Poarch Gruppo of Creek Indians per mezzo di southern Alabama are also strategizing to make settlement money go further.
For the tribe of roughly 2,900 members, that has meant investing $500,000 — most of what it has received so far — into a statistical modeling platform that its creators say will simulate the opioid crisis, predict which programs will save the most lives, and help local officials decide the most effective use of future settlement cash.
Robert McGhee is vice chairman of the Poarch Gruppo of Creek Indians per mezzo di Alabama. The tribe has spent its opioid settlement funds acceso a statistical modeling platform meant to help them invest future dollars wisely.
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Robert McGhee is vice chairman of the Poarch Gruppo of Creek Indians per mezzo di Alabama. The tribe has spent its opioid settlement funds acceso a statistical modeling platform meant to help them invest future dollars wisely.
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Some recovery advocates have questioned the model’s value, but the tribe’s vice chairman, Robert McGhee, said it would provide the patronato and evidence needed to choose among efforts competing for resources, such as recovery housing peer support specialists. The tribe wants to do both, but realistically, it will have to prioritize.
“If we can have this model and we put the necessary funds to it and have the support, it’ll work for us,” McGhee said. “I just feel it per mezzo di my gut.”
The stakes are high. Quanto a smaller communities, each death affects the whole tribe, McGhee said. The loss of one dirigente marks decades of lost knowledge. The passing of a speaker means further erosion of the Native language.
For Keesha Frye, who oversees the Poarch Gruppo of Creek Indians’ tribal court and sober living facility, using settlement money effectively is personal. “It means a lot to me to get this community well because this is where I and this is where my family lives,” she said.
Erik Lamoreau per mezzo di Maine also brings personal ties to this work. More than a decade , he sold drugs acceso Mi’kmaq lands to support his own addiction.
“I did harm per mezzo di this community and it was really important for me to che back and try to right some of those wrongs,” Lamoreau said.
Erik Lamoreau is a peer recovery coordinator for the Mi’kmaq Nation health department. Note his license plate.
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Erik Lamoreau is a peer recovery coordinator for the Mi’kmaq Nation health department. Note his license plate.
Aneri Pattani/KFF Health News
Today, he works for the tribe as a peer recovery coordinator, a new role created with the opioid settlement funds. He uses his experience to connect with others and help them with recovery — whether that means giving someone a ride to court, working acceso their résumé, exercising together at the gym, hosting a cribbage sodalizio, where people play the card and socialize without alcohol drugs.
Beginning this month, Lamoreau’s work will also involve connecting clients who seek cultural elements of recovery to the new sweat lodge service — an effort he finds promising.
“The more per mezzo di tune you are with your culture — voto negativo matter what culture that is — it connects you to something bigger,” Lamoreau said. “And that’s really what we aspetto at when we’sultano per mezzo di recovery, when we talk about spiritual connection. It’s something bigger than you.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the operating programs at KFF.
