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Tribal council funds programs for kids, approves opioid policy

PABLO – Two issues supporting health were on the agenda during the Confederated Salish and Kootenai Tribal Council meeting on Thursday, Nov. 1. The first issue was about children and the second focused on reducing addiction. 

Brandon Burke, program manager for the Reason to Live Native suicide prevention program, took a seat in front of the council and thanked them for approving four $30,000 grants for after-school programs to support children across the Flathead Indian Reservation. 

The goal of the programs is to provide children with activities offering protection from suicidal behavior and overall wellness. The programs begin in November and run until June of 2019.

“This is about getting kids involved in their community, building relationships and providing them with opportunities,” Burke said. 

The grants will be disbursed to Two Eagle River School, Dixon Elementary School, Hot Springs schools and Nkwusm in Arlee. Each school will utilize the funding to develop programs based on their needs.

At Two Eagle River, the school plans to host evening programs on Fridays and on the weekends to bring community and family together for meals and open gym nights. The program in Hot Springs will focus on a community garden and developing a radio station in the school to bring people together. The Dixon school already has an afterschool program and will use the funding to recruit and hire upperclassmen from local high schools to assist with the program. At the Nkwusm language school, they will use the funds to purchase culturally-based tools for education, training for staff and to hire assistants to help with after school activities. 

“Each school will begin improving their daily programming and after school programming,” Burke said. 

The next program on the council’s agenda involved the prevention of opioid addiction. The Tribal Council adopted a resolution in support of a Controlled Substance Utilization and Dispensing Limitation Policy for Tribal Health Department pharmacies in an effort to limit the amount of opioids dispensed on the reservation. The policy takes effect on Jan. 1, 2019. 

Four women presented the policy to the Council, including University of Montana Clinical Assistant Professor of Pharmacy Jessi Cahoon; Tribal Health Department Head Teresa Wall-McDonald; Anna Whiting-Sorrell with the Tribal Health Department; and Allied Health Services Division Director Brandy Couture. 

The new policy follows national guidelines provided by the Centers for Disease Control and limits the amount of prescription opioids to 90MME with a seven-day limit. This policy does not apply to people experiencing cancer pain or end-of-life care. The policy requires Tribal Health Pharmacists to contact prescribing physicians who are recommending quantities of controlled substances over the CDC limitations. 

Cahoon said opioid prescriptions that go beyond seven-days increases a person’s susceptibility to becoming dependent. She later said the United States is in an “opioid epidemic” and limiting opioid prescriptions is a step towards changing the problem. 

The Council looked at graphs examining the local controlled substance use on the Reservation. The Tribal Health Department in the St. Ignatius pharmacy reports that nine percent of their prescription drug revenue comes from controlled substances with three percent of that coming from opiates. The graph outlining the numbers for the Polson Tribal Health pharmacy was similar with three percent of the revenue coming from opiates, six percent from other controlled substances and 91 percent from other prescription drugs. 

CSKT Vice Chairman Leonard Gray called the analysis with a low opioid percentage “good news” but said there is still more work to be done to help individuals struggling with drug addiction. 

Council member Carole Lankford said the policy was a positive move in the right direction. “This was a longtime coming.” 

The presentation also included information about insurance companies and pharmacies distributing a limited number of opioids even if the customer has a prescription.  Cahoon said twenty-eight states have also set limits on opioid prescriptions. “Everyone is moving this direction,” she said.  

The group shared national trends from the CDC noting that approximately 46 people die every day from overdoses involving prescription opioids. Methadone, oxycodone, and hydrocodone are the most common. 

After the meeting, Wall-McDonald said CSKT received a $500,000 Tribal Opioid Response Grant from SAMHSA to be dispersed during a two-year period (2018-2019) to develop strategies to reduce opioid use on the reservation and developing the policy was part of that strategy. 

“I’d like to acknowledge the leadership of the council for taking this step,” Wall-McDonald said. She added that she has seen the devastation addiction can have on communities where leadership didn’t take a proactive position. 

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