Tribal opioid response - opioid use and misuse are on the rise in the yukon kuskokwim (YK) region of southwest alaska

The popularity of opioids is on the rise due to its low cost of production, ease of transportation and affordability for the user. The yukon kuskokwim health corporation's (YKHC) tribal opioid response (TOR) program will provide residential and outpatient opioid treatment, and community outreach and education to our many tribal communities. The YK region in southwest alaska is home to 58 federally-recognized tribal communities, more than 10% of the 566 federally-recognized tribes in the united states. Our region is in a very rural setting where no road system exists and air travel is the standard method of transportation, with some villages accessible by boat during the summer and fall months and an ICE road during the winter months. The population of 28,623 residents is scattered over 75,000 square miles, an area larger than the state of oregon. The villages we will be servicing with this grant has 25,107 residents according to the IHS active user population report with the date coming from the draft 2024 report for IHS native active users. YKHC, a consortium of tribes, is the sole direct service provider for the communities in the YK region, one of the poorest regions in the state. YKHC is a member of the alaska tribal health compact, which is made up of the 12 region tribal health organizations that serve the state of alaska. The communities of the YK region were once healthy and self-sufficient, free from alcohol, drugs and diabetes, but today they suffer a highly disproportionate rate of substance abuse, suicide and depression, domestic violence, stds, and poverty. The history of oppression, colonization, epidemics and boarding schools devastated our villages, and resulted in severe social issues that continue to destroy our people. The opioid epidemic is an added threat to the livelihood of our people, our families and our children. The YKHC TOR program will 1) allow the current opioid treatment program to more than double the current number of clients we serve, 2) expand existing interdisciplinary services available to the patient. 3) strengthen our opioid community outreach and education program in the villages to teach young people and adults about the dangers and realities of opioid abuse, and to get to know and build a network of community-based providers and advocates who can refer clients in for treatment, and 4) implement peer-support specialists to provide services and advocate for the clients. The clients we serve can be broken down into two categories: inpatient/outpatient opioid treatment and community outreach and education. During year 1 of the grant we will serve 20 new inpatient/outpatient opioid treatment clients, and 100 participants in the opioid outreach and education activities. In year 2 we will increase to 25 inpatient/outpatient treatment clients, and outreach and education will increase to 150. During years 3, 4, and 5, we foresee bring the number for clients served up by 5 additional clients per year and outreach and education up by an additional 50 community members per year. Over the five years we plan to serve at least 150 new clients and provide education and outreach to a minimum of 1,000 individuals.