Project Grant H79TI087899

TULE RIVER TOR PROJECT - THE TULE RIVER INDIAN HEALTH CENTER, INC. (TRIHCI) WILL IMPLEMENT THE TULE RIVER TOR PROJECT, WHICH WILL EXPAND/ENHANCE THE ORGANIZATION'S EFFORTS IN THE FIGHT AGAINST OPIOID AND OTHER STIMULANT MISUSE AMONG NATIVE AMERICAN INDIVIDUALS LIVING IN TULARE COUNTY, CALIFORNIA. THE TULE RIVER TOR PROJECT WILL BUILD UPON THE EXISTING FOUNDATION OF TRIHCI SERVICES. THE PROJECT WILL HELP IDENTIFY MORE TRIBAL MEMBERS WHO MISUSE OPIOIDS/OTHER STIMULANTS, AND EXPAND/ENHANCE THE NUMBER OF OPIOID/STIMULANT USE DISORDER PATIENTS WHO RECEIVE THE FULL SPECTRUM OF TREATMENT, RECOVERY SUPPORT, AND HARM REDUCTION SERVICES. PEER RECOVERY SUPPORT SERVICES: TO LAUNCH THIS EVIDENCE-BASED PRACTICE, THE TRIHCI WILL HIRE A TULE RIVER TRIBAL MEMBER (MALE OR FEMALE) WITH LIVED EXPERIENCE WHO HAS BEEN/IS IN RECOVERY TO RECEIVE THE TRAINING NEEDED TO BECOME A CERTIFIED PEER RECOVERY SPECIALIST. THE PEER RECOVERY SPECIALIST WILL SERVE AS A MENTOR/ROLE MODEL, HELP FACILITATE NARCOTICS ANONYMOUS AND OTHER SUPPORT GROUPS, PROVIDE TRANSPORTATION AND ENCOURAGEMENT TO HELP PATIENTS GET TO NEEDED TREATMENT, AND SUPPORT HARM REDUCTION ACTIVITIES. SUBSTANCE ABUSE COUNSELING SERVICES: A NEW FULL-TIME SUBSTANCE ABUSE COUNSELOR WILL BE HIRED WHO WILL PROVIDE IN-DEPTH ASSESSMENT SERVICES TO DETERMINE MAT AND OTHER MOUD ELIGIBILITY. THE SUBSTANCE ABUSE COUNSELOR WILL DEVELOP A TREATMENT PLAN; PROVIDE ONE-ON-ONE SUBSTANCE ABUSE COUNSELING; REFER ELIGIBLE PATIENTS TO MAT, OTHER MOUD TREATMENTS, CULTURALLY-RELEVANT GROUPS DESIGNED FOR NATIVE AMERICANS, AND YOUTH SERVICES; AND WILL TRACK THE CLIENTS' PROGRESS AND PERSISTENCE IN THOSE SERVICES. TRIBAL SUPPORT SERVICES: PATIENTS WITH OUD/STIMULANT USE DISORDER SERVED THROUGH THE TULE RIVER TOR PROJECT WILL BE REFERRED TO A VARIETY OF TRIBAL SUPPORT SERVICES, INCLUDING: NARCOTICS ANONYMOUS/ALCOHOLIC ANONYMOUS SUPPORT GROUPS USING THE WHITE BISON MEDICINE WHEEL AND WELLBRIETY 12 STEPS, A CULTURALLY-DRIVEN TRIBAL PROGRAM THAT EXPLORES THE HISTORICAL ROOTS OF ADDICTION WITHIN THE NATIVE POPULATION; AND TALKING CIRCLES, A TRAUMA-INFORMED CULTURAL PRACTICE THAT FOSTERS POSITIVE PSYCHOLOGY THROUGH PEER SUPPORT FOR TRIBAL PARTICIPANTS. TRIBAL SUPPORT SERVICES FOR YOUTH: YOUTH (AGES 12-24) IMPACTED BY OPIOID AND OTHER STIMULANT MISUSE PARTICIPATE IN ACTIVITIES, WHICH INCLUDE: THE WEEKLY YETCHA MI YETI YOUTH GROUP THAT ENCOURAGES HEALTHY CHOICES AND SOBRIETY, YOUTH GATHERINGS OF NATIVE AMERICANS (GONAS), AND SPECIAL EVENTS. THERAPEUTIC COUNSELING SERVICES WILL BE PROVIDED IN-KIND BY AN MSW INTERN, SUPERVISED BY A TRIHCI CLINICAL SUPERVISOR. THESE SERVICES INCLUDE: SCREENING AND ASSESSMENT; DIAGNOSIS; INDIVIDUAL, GROUP, AND FAMILY THERAPY; CASE MANAGEMENT; REFERRALS; AND CONSULTATION/COLLABORATION WITH OUTSIDE AGENCIES. THERAPEUTIC SERVICES WILL BE PROVIDED USING POWERFUL, EVIDENCE-BASED MENTAL HEALTH TREATMENT TECHNIQUES FOR INDIVIDUALS WITH A HISTORY OF TRAUMA TO HELP PATIENTS RELIEVE THE STRESS OF PAST TRAUMA THAT LED THEM TO ADDICTION AND SHIFT THEIR COGNITIVE PROCESSES TO MORE PRODUCTIVE PATTERNS. IF NEEDED, A CLINICAL PSYCHOLOGIST WILL PROVIDE AN ADDITIONAL PSYCHOLOGICAL ASSESSMENT, DIAGNOSIS AND FOLLOW-UP TO ACUTE, CHRONIC, OR MODERATELY DISTURBED SEVERELY MENTALLY ILL CLIENTS AND/OR PATIENTS. PURCHASE AND DISTRIBUTE ADDITIONAL MOUDS AND TESTING SUPPLIES: TO DECREASE THE POSSIBILITY OF A FATAL OVERDOSE UNTIL THESE PATIENTS ARE READY TO ADDRESS THEIR OPIOID/STIMULANT ADDITION, THE TOR PROJECT TEAM WILL OFFER AN OVERDOSE KIT TO THEIR FAMILY MEMBERS. EACH KIT WILL CONTAIN A CANVAS BAG WITH NALOXONE NASAL SPRAY, COMBINATION TESTING STRIPS FOR FENTANYL AND XYLAZINE, INSTRUCTIONS, AND AN INFORMATIONAL BROCHURE. COUNTYWIDE NALOXONE DISTRIBUTION: THE SUBSTANCE ABUSE COUNSELOR AND THE PEER RECOVERY SPECIALIST WILL EXPAND THE ORGANIZATION'S COUNTYWIDE NALOXONE DISTRIBUTION. LOCK BOX DISTRIBUTION: EACH TOR PATIENT'S FAMILY WILL RECEIVE A LOCK-BOX AND TAUGHT THE IMPORTANCE OF SECURING MEDICATIONS AND NEVER SHARING PRESCRIPTION MEDICATIONS.