BELLINGHAM, Wash. — Evelyn Jefferson walks deep into a forest, littered with tents of unhoused members of the Lummi Nation tribe, and calls out names. When someone shows up, she and a nurse hand out the drug Naloxone to reverse the opioid overdose.
Jefferson, a tribal member herself, knows how crucial these kits are: Just five months ago, her own son died from an overdose of a synthetic opioid about 100 times more powerful than fentanyl. The 37-year-old’s death was the fourth opioid-related death in four days on the reservation.
“It took us eight days to bury him because we had to wait in line because there were so many funerals before him,” said Jefferson, crisis outreach supervisor for Lummi Nation. “Fentanyl has really taken over a generation of this tribe.”
A bill before the Washington Legislature would provide more state funding for tribes like Lummi, which are trying to prevent opioids from reaching the next generation. The Senate this week unanimously approved a bill that is expected to provide a total of nearly $8 million a year for Washington’s 29 federally recognized tribes, funds that will come in part from a roughly half-billion-dollar settlement between the state and the major opioid distributors.
This approach comes as Native Americans and Alaska Natives in Washington are dying from opioid overdoses that are five times the state average, according to 2021-2022 data from the Centers for Disease Control and Prevention, which includes preliminary figures included. The rate in Washington is one of the highest in the U.S. and more than three times higher than the rate nationwide — but many of the state’s indigenous nations do not have the financial or medical resources to fully address it.
Lummi Nation, like many other tribes, faces an additional challenge when it comes to keeping outside drug dealers off their land: a complicated maze of jurisdictions means that tribal police are often unable to arrest non-tribal members on the reservation .
“What should we do if we have a predatory drug dealer from a non-Lummi company with fentanyl on our reservation, driving around or on their property selling drugs?” said Anthony Hillaire, tribal chairman.
Against the backdrop, tribes like the Lummi Nation, about 100 miles (161 kilometers) north of Seattle, say the proposed funding — while appreciated — would barely scratch the surface. The tribe of about 5,300 people on the shores of the Salish Sea has already suffered nearly one overdose death per week this year.
Lummi Nation needs $12 million to fully fund a 16-bed secure medical detox facility that incorporates the tribe’s culture, Hillaire said, and money to build a new counseling center after flood damage. These costs alone far exceed the annual total that would be allocated to tribes under the legislation. The Senate has proposed allocating $12 million in its capital budget to the facility.
“We are a sovereign nation. We are a self-governing tribe. We want to take care of ourselves because we know how to take care of ourselves,” he said. “And so mostly all we need is funding and legislative changes – good policy.”
The proposed measure would set aside funds deposited into an opioid settlement account, including money from the state’s $518 million 2022 settlement with the nation’s three largest opioid distributors, for tribes battling addiction. Tribes are expected to receive annually $7.75 million or 20% of the funds deposited into the account the previous fiscal year – whichever amount is greater.
Republican Sen. John Braun, one of the bill’s sponsors, has said he envisions the funds being distributed through a grant program.
“If this ends up being the wrong amount or if we distribute it unfairly, I would like to settle this,” he said. in our hands, waiting for the problem to solve itself.”
Opioid overdose deaths among Native Americans and Alaska Natives have increased dramatically in Washington in recent years, with at least 100 in 2022 — 75 more than in 2019, according to the most recent figures available from the Washington State Department of Health.
In September, Lummi Nation declared a state of emergency over fentanyl, added drug-sniffing dogs and checkpoints, while revoking bail on drug-related charges.
The tribe has also opened a seven-bed facility to help members with withdrawal symptoms and provide them with medications for opioid use disorder, while providing access to an adjacent cultural space where they work with cedarwood and sage. In its first five months, the facility treated 63 people, the majority of whom are still on the medication regimen, said Dr. Jesse Davis, medical director of the Lummi Healing Spirit Opioid Treatment program.
But truly thwarting this crisis must go beyond Lummi Nation working on its own, said Lummi Councilor Nickolaus Lewis.
“We can do everything in our power to protect our people. But if they go into Bellingham, anywhere off the reservation, what good is it if they have different laws and different policies, different barriers?” he said.
The tribe has urged Washington Governor Jay Inslee and President Joe Biden to declare a state of emergency in response to the opioid crisis to create a larger safety net and attract additional vital resources to the problem.
At the Bellingham encampment, Jefferson estimates there are more than sixty tribe members, some of whom she recognizes as her son’s friends, while others are Lummi elders. She suspects many of them left the reservation to avoid the tribe’s crackdown on opioids.
When she visits them, her van filled with food, hand warmers and clothes to hand out, she wears the shirt her niece gave her the day after her son died. It reads: “Fight fentanyl like a mother.”
“It’s a losing battle, but you know, someone has to be there to let them know – those addicts – that someone cares,” Jefferson said. “Maybe that one person will come into treatment because you are there to care.”