Nationwide, Native Americans are at least twice as likely as the general population to become addicted to drugs and alcohol, and three times as likely to die of a drug overdose. In Washington state, Indians die of drug overdoses at a rate of 29 in 100,000, compared to a rate of 12 for whites, 11 for blacks, 3 for Hispanics and 2 for Asians, according to the state Health Department.
Compounding the problem, the majority of the nation’s 2.9 million Indians living on and off reservations have little to no access to health care, much less mental health and addiction services. The Muckleshoot and a handful of other affluent tribes in the Northwest and across the country are becoming exceptions. With money from casinos and other businesses, some tribes, mostly near major cities, have been able to build world-class health care systems on their reservations that include addiction treatment programs.
In addition, Washington is one of 32 states and the District of Columbia that have expanded Medicaid to cover able-bodied adults. The federal-state health care program for low-income people pays the bill for treatment.
On the Muckleshoot reservation, population 3,500, a behavioral health center currently treats 170 people for opioid addiction. At least 85 percent of those patients are covered by Medicaid, said Dan Cable, the program’s manager. The rest are covered by a tribal health insurance plan. Developed seven years ago, the Muckleshoot treatment center and recovery housing have so far served everyone in need, with no waiting lists.
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