Category: Health
WA Statewide Suicide Prevention Plan Community Meeting, April 22
The medical marijuana business could save Native American reservations
By Jacqueline Keeler, Quartz
At the very first Tribal Marijuana Conference held last weekend in Tulalip, WA, the former chairman of the Moapa Paiute tribe, William Anderson, tall and dignified and walking with a cane, explained to me what brought him: “I was just laying in bed in pain. I couldn’t get up, I couldn’t get up to go to the bathroom or go to the kitchen because I was in so much pain.”
An infection in his foot had spread to his spine and deteriorated the bone, exposing nerves. Doctors replaced the bone with titanium steel. For two years, the infection, even with prescription creams and antibiotics, kept coming back. The Indian Health Service recommended amputation of his foot.
“I just prayed to the Great Creator, ‘Please, help me with my pain. Please, help me get up so I can function as a normal human being.’”
Then he remembered a documentary he had seen years earlier about medical marijuana, and how it was used by cancer patients for pain relief. He ordered a topical cannabis ointment, and when he applied it he felt immediate relief.
The conference brought together some 75 tribal representatives, along with hundreds from the state and federal level in addition to cannabis industry leaders on the Tulalip tribe’s $200 million resort and casino in Washington state. This was in response to a Department of Justice memo directing US attorneys nationwide not to prosecute federally-recognized tribes conducting marijuana-related businesses on reservation land—so long as they meet nine criteria, including the prevention of criminal elements from profiting from marijuana sales, and keeping cannabis products away from minors.
While most of the presentations at the conference addressed the legal, infrastructural, and financial concerns of running a marijuana business on the reservation, Anderson’s story highlights the incredible medical needs faced by many tribal members.
Native Americans have the highest rates of high-risk drinking and suicide of any American ethnic group, according to research from the NIH and CDC, respectively. In the past two decades, opioid deaths and cancer rates have continued to climb. On Anderson’s reservation, tribal members’ health had been harmed by a coal power plant that blew coal ash through their community; its waste ponds poisoning their ground water. They fought back and shut down the plant, but this story is all too common throughout “Indian Country;” Native American communities pay a heavy price, both in regards to environmental and public health, for US energy development.
Amanda Reiman, manager of marijuana law and policy at the Drug Policy Alliance, assured tribal leaders at the conference that cannabis could actually help Native American communities battling addiction. A recent study (paywall) found that marijuana acts not as a “gateway drug,” as it is often characterized, but as a less harmful replacement for alcohol. In states that have legalized medical marijuana, the researchers found that the number of alcohol-related traffic fatalities per year decreased by as much as 11%. It is estimated that, in the United States, alcohol-related deaths total 88,000 per year. The statistics are even more dire for Native American communities: nearly 11.7% of Native American deaths are alcohol-related, compared to 3.3% for all Americans.
Another study published just last year in JAMA Internal Medicine found that opioid mortality rates were lower by 25% in states that had legalized medical marijuana. Native Americans have seen opioid-related (prescription painkiller) deaths increase since 2000 to a rate that is 3 times that of African-Americans and Hispanics, according to the CDC. Nationally, these drugs now kill more people than car crashes.
As the medical establishment has reigned in opioid over-prescription, patients who had become addicted to painkillers have increasingly turned to heroin—once associated with big cities, but now a booming trade in poorer, rural areas. Last week, the Saginaw Chippewa tribe in Michigan banished two tribal members for trafficking in heroin. On Feb. 20, a couple from the Lummi tribe in Washington state were sentenced to prison for conspiracy to distribute heroin and methamphetamine.
“Heroin and methamphetamine trafficking has no place in any of our communities, least of all on tribal lands,” said acting US attorney for the Western district of Washington, Annette L. Hayes. “Last week I convened a heroin summit to focus community resources on battling what has become a growing epidemic of opioid abuse. I commend the work of our tribal partners, the Lummi, to lead in the effort to prevent heroin use and overdose deaths.”
Meanwhile, yet another study made headlines after finding marijuana to be 114 times less deadly than alcohol. Alcohol, followed by heroin and cocaine, was found to be the most dangerous recreational drug. Tobacco came in fourth, and cannabis a distant last.
With all the research and evidence regarding the safety and innocuousness of marijuana piling up, it is no wonder that the federal government has taken baby steps to revise its once harsh prohibition of the drug. For example, a US district judge in Sacramento, CA, heard the final arguments on Feb. 11 on a hearing regarding the constitutionality of the 1970 Controlled Substances Act that classified marijuana as a Schedule 1 drug. This is the first reconsideration of the act’s claims that marijuana has “no accepted medical use”—a rather foolish assertion considering that that 23 states and the District of Columbia now permit the distribution and consumption of medical marijuana. She is expected to rule within the next week.
Still, many Native Americans, long used to fighting addiction in their communities, see the opportunity for the sale of marijuana on their lands as yet another Trojan horse delivered by the US government. They worry about its implementation.
Troy Eid, chair of president Obama’s Indian Law and Order Commission was cautious. “I think it is very good for tribes to look at and think about how they might want to influence changes in the federal law,” he said. “Having said that, there are no changes in federal law here. I can tell you as a former US attorney, the nine different criteria that they laid out are not sufficient to provide protections to tribes or tribal members, tribal citizens. So, you are really rolling the dice.”
For Native American communities, the issue of marijuana legalization represents both unique challenges and prospects for success. It hinges on careful negotiation with multiple federal agencies, from the DEA to the IRS. The unique relationship federally-recognized tribes have with the US as “domestic dependent nations”—a designation that recognizes both the inherent sovereignty of pre-existing indigenous nations, but also reflects the power of the US to limit the exercise of that sovereignty—is a careful dance that tribes have had to conduct with the most powerful nation in the world for decades; and this new opportunity may serve as a long-awaited chance to restructure that relationship, just as casino-gaming did a generation ago.
“This issue was a historic moment for the United States,” Robert Odawi Porter of Odawi Law PLLC, a former president of the Seneca Nation of New York, and one of the organizers of the conference explained to me, “and what the Justice Department did was to invite ‘Indian Country’ to have a historical moment. No different than any other major decision our ancestors have had to make. Tribal leaders are now going to have the same opportunity to think through whether legalizing marijuana was a good thing.”
The conference ended with tribal leaders agreeing to meet again in Las Vegas on Mar. 12 at the Reservation Economic Summit to vote on a charter for a new inter-tribal cannabis trade organization.
Douglas Berman, a presenter at the conference, and a professor of law at Ohio State University, noted, “There are relatively few industries with so many novel dimensions to it that haven’t already gotten commercialized to the point it is difficult for new players to enter.”
“I think tribes can be first to market here. I really do,” said Hilary Bricken, a cannabis attorney in Washington state, and another of the organizers of the conference. She urged tribes to consider entering the marijuana banking services industry. Although Bank of America has agreed to handle Washington state’s marijuana tax income, only small credit unions have taken on lending to legal, licensed marijuana businesses. A few tribes have gotten involved as payday lenders, but full realization of reservations as “off-shore banking” magnates on the mainland US has not yet occurred. A niche banking services market like marijuana could provide the impetus.
Les Parks, vice chairman of the Tulalip tribe’s board of directors, shared a video of a local Seattle television-news report on the medical marijuana extract CBD, which is used to relieve epileptic seizures and hold big dreams for tribes in the pharmaceutical industry. “We can lead this country in CBD drug development and be the next big pharmaceutical company,” he said.
A number of Native Americans came with cannabis company partners to the conference. William Anderson was one of them. He is working with Strainz, a medical cannabis products and services company.
“This cannot just be about making a quick buck, but about economic development and being more independent, not dependent on the government, which I don’t like but is unfortunately the reality for our people,” Anderson explained.
As a former tribal chairman, he’s had experience doing just that. Under his leadership, his tribe not only got rid of the coal plant, but opened the first solar plant on any reservation in the country, and has since been approved to build a second.
But in the end Anderson is a believer in the power of medical marijuana to help Native American people deal with chronic pain. “I’m really grateful to be here today, to just talk and to shake hands with people,” he said. “This is what I want to bring to Indian people out there. To show that there are other ways to get help.”
You can follow Jacqueline on Twitter at @jfkeeler. We welcome your comments at ideas@qz.com.
Congresswoman Lee Marks National Native HIV/AIDS Awareness Day
Press Release, Congresswoman Barbara Lee
Washington, D.C. – Since 2007, National Native HIV/AIDS Awareness Day is observed each year on the first day of Spring.
The day began as a way to increase local and global awareness about the impact of HIV/AIDS on American Indian and Alaska Native people.
“The HIV/AIDS epidemic continues to affect all of our communities, including American Indians and Alaska Natives. While we are seeing lower rates of new infections within these communities, we must continue to ensure that the culturally and linguistically-competent education, counseling, testing and care are available to all,” said Congresswoman Barbara Lee, co-chair of the Congressional HIV/AIDS Caucus.
“HIV/AIDS is a rising threat to our native populations; Tribal and Indian Health priority must be increased access to HIV screening and consistent education efforts for everyone,” said Gayle Dine’Chacon, MD, Medical Director at the Pueblo of Sandia Health Center and Former Surgeon General of the Navajo Nation.
According to the Centers for Disease Control and Prevention (CDC), 18.9 percent of the American Indians and Alaska Natives living with HIV are undiagnosed. This undiagnosed rate is significantly greater than the overall average of 14 percent.
“This National Native HIV/AIDS Awareness Day, I encourage everyone to get educated and tested. It’s on us to take our health in our own hands,” added Congresswoman Lee.
Puyallup tribe buys Seattle-area cancer clinic; will move operation to Fife
BY C.R. ROBERTS, The News Tribune
Cancer, beware. A new player has joined the fight.
The Puyallup Tribe of Indians has purchased the Seattle Cancer Treatment & Wellness Center, a Renton clinic owned by Cancer Treatment Centers of America. The tribe will move the operation to Fife.
The new facility — at the Trans-Pacific Trade Center at 3700 Pacific Highway E. — will offer traditional and alternative methods of treatment to native and non-native patients.
“If there’s any way to fight this disease, we’ll do it,” said Puyallup Tribe Chairman Bill Sterud during a recent tour of the building.
“This may be the most important thing I’ve been involved with,” said Alan Shelton, clinical director and a veteran medical adviser with the tribe.
“We’re not saying conventional medicine is no good,” he said. “We want to include that.”
According to the tribe, this will be the “first tribal-owned cancer care center in Indian Country and the United States.”
The facility will initially occupy part of the building’s first floor and will be known as the Salish Integrative Oncology Care Center.
BEGINNINGS
As Shelton tells the story, Cancer Treatment Centers of America had been trying, unsuccessfully, to secure approval to build a hospital in the Puget Sound area.
The company contacted the tribe, Shelton said, with an idea to build a facility on reservation or trust land controlled by the tribe.
Shelton recalls something Sterud said during a tour of a CTCA hospital in Arizona some two years ago.
“We can do this,” Sterud said.
“I felt we could do it by ourselves,” Sterud said last week. “There’s always room for another place to fight cancer.”
The tribe will not reveal the price paid to buy the CTCA operation. Records from the Pierce County Auditor’s Office indicate the tribe bought the Trans-Pacific Trade Center in June 2014 for $11.9 million. The tribe has paid for the project with revenues from various tribal enterprises, including profits earned by the Emerald Queen Casino.
The tribe will host an opening ceremony April 7, and doors will open to patients April 13.
Treatments will be offered on an outpatient basis only and will combine traditional chemotherapy and other, alternative therapies.
“We have a strong ancestral bond with nature and creation,” Sterud stated in a news release announcing the center.
“We believe that natural healing through traditional roots, berries, herbs and traditional healing can blend with modern oncology practices. We are building upon traditional oncology — chemotherapy, radiation and other pharmaceutical treatments — with whole person integrative medicine, such as naturopathy, Native American treatments, acupuncture and Chinese medicine,” he said.
DETAILS
Kim Sunner, slated to act as administrator at SIOCC, said last week that many details are still being identified and solved.
“There’s a lot of things up in the air right now,” she said.
She said she expects perhaps 17 employees to join the Fife operation after working in Renton. Positions in Fife include physicians, naturopaths, nurses and nurse practitioners, and pharmacy workers, technicians and administrative support staff.
She said there has been outreach to current patients, including focus groups, and that the reaction has been generally positive.
She said the new clinic will likely be able to accept more insurance programs than were available to patients in Renton, and that contracts with insurance carriers were still being negotiated.
Shelton was in the Washington, D.C., area last week to discuss details with the Indian Health Service, and he said in a phone interview that he expected eligible patients would be able to use Medicare and Medicare coverage to help bear the cost of treatment.
For the tribe, the clinic will be a nonprofit enterprise, he said.
Sunner noted that as many as 85 percent of patients at the Renton clinic were living with a diagnosis of at least Stage 4 cancer. She said she hoped eventually to be able to provide care to patients living at all levels of diagnoses.
“I really hope we have the opportunity to serve patients at an earlier stage,” she said.
Subir Mukerjee, Fife city manager, said last week of the new clinic, “We welcome it. It’s a good medical facility in our community. Having a medical facility is always a good thing. It adds a mix of use, not just retail. It adds to easier access to medical facilities for our residents.”
The American Cancer Society, in the “Native American Healing” section of its website, says that “the communal support provided by this approach to health care can have some worthwhile physical, emotional, and spiritual benefits.”
“Although Native American healing has not been proven to cure disease, individual reports suggest that it can reduce pain and stress and improve quality of life. The communal and spiritual support provided by this type of healing could have helpful effects.
“Like other complementary therapies, Native American healing practices may be used in relieving certain symptoms of cancer and side effects of cancer treatment,” according to the website. “People with cancer and other chronic conditions should talk to their doctors before using purification rituals or herbal remedies.”
PHILOSOPHY
“We’ll have physicians working side-by-side with naturopaths, acupuncturists, traditional healers. These people meet as a team,” Shelton said. “We’re very interested in having not just the conventional medicine, but also spirit work. The team will refer patients needing radiation therapy or surgery to local hospitals or specialists.”
Osteopathic residents from the Puyallup tribal clinic might also rotate through the facility, he said.
“There’s just a general feeling that this is special, needed, wanted,” he said. “Everybody knows somebody who has suffered from cancer. If there is a better way, we want to explore it. We expect that in Indian Country there will be a lot of people interested in this.”
“With the success of our facility, I would hope to see other tribes join the fight against cancer,” Sterud said. “This is a head-on attack. It makes me proud. It makes me happy. It also makes me emotional. It might save a life, or two, or 1,200. If we save one life, that’s a giant success.”
Sterud said he sees the clinic as a tribute to other struggles, other “battles that our elders fought in years past. Our success is based on their endurance in dealing with adversity. It’s an honor to be able to bring a cancer treatment center to the public in their memory.”
“I’ve had this vision for a long time,” he said. “The tribal council has been nothing but supportive, and all the staff, and the membership. It’s almost like it’s been blessed. Everything seems to be working out.”
Read more here: http://www.thenewstribune.com/2015/03/12/3685165_puyallup-tribe-buys-seattle-area.html?rh=1#storylink=cpy
Diabetes Day at the Karen I. Fryberg Tulalip Health Clinic, March 17
Teen Girls Create Award-Winning App In Hopes Of Preventing School Shootings
By Taylor Pittman, Huffington Post
In October 2014, high school freshman Jaylen Fryberg shot five students and then himself in Washington state. To help cope with this tragedy in their community, a group of teenage girls jumped to action.
Chloe Westphal, Marina Stepanov, Stephanie Lopez, Genesis Saucedo and Amanda Arellano, who are all students at Tri-Tech Skills Center in Kennewick, Wash., designed an app to help teens manage stress and deal with depression as a result of the shooting. Called Safe and Sound, the app features a journal for users to express their thoughts and descriptions about different kinds of anxiety and depression and their corresponding symptoms.
In an email to The Huffington Post, one of the students explained that the idea for the app was in reaction to Fryberg’s actions.
“The Seattle Times did an article on how he [Fryberg] had been posting his feelings to Twitter for months with no one really listening,” Chloe said. “This sad example of how serious the situation can get really motivated us to create an app that could prevent this kind of thing in the future.”
Safe and Sound went on to win the Verizon Innovative App Challenge, which means its designers will meet with Massachusetts Institute of Technology trainers in a few weeks to build the app.
Though the project started as a submission in a competition, the students have bigger plans for the finished product. Amanda said the team wants Safe and Sound to go beyond the typical apps teens use today.
“Our hope is that Safe and Sound will be more than just a stress management app, but a light in the darkness that is anxiety and depression.”
Community Recovery Team Launches Website
Marysville School District
The landing page of the new community recovery team website reads: “We’re All in This Together”. The website is the product of a joint collaboration between the Tulalip Tribes, City of Marysville, and the Marysville School District.
The purpose of the website is to provide stakeholders across the Marysville and Tulalip communities with a common place to find information and resources on healing, hosted events, trainings and details on the larger recovery efforts in the aftermath of the tragic murder/suicide that occurred at the Marysville-Pilchuck High School campus on October 24, 2014.
Since the tragedy, the Tribes, City, School District, and the Marysville and Tulalip leaders, community members, and members in the field of post-trauma events have been meeting regularly to plan and coordinate efforts for the Marysville and Tulalip communities. Through this work, a Community Recovery Team developed and is comprised of members from all three entities including area-wide representation from Victims Support Services, the Ministerial Association, Volunteers of America, American Red Cross, Marysville YMCA, United Way of Snohomish County, and so many more who have come together in support of our youth and communities. The work of the committee has included coordinating trainings, providing resources, holding community meetings, and providing support for the families and victims of the tragedy and others. The website will now consolidate all the information generated by this team into a single website for community members to access.
The website is shared by the Tribes, the City, and the District, and will be updated regularly with new information and events as they are scheduled, resources, and other pertinent information.
We are Marysville/Tulalip United – visit us at www.mtunited.org
E-cigarette use outpacing cigarette use among teens
Governor Jay Inslee gives sobering statistics for Washington youth
Snohomish County Health District
SNOHOMISH COUNTY, Wash. – At a press conference Thursday morning, Governor Jay Inslee released preliminary data from the 2014 Healthy Youth Survey in which 23 percent of Washington’s high school seniors reported using e-cigarettes. Furthermore, high school sophomores were vaping at twice the rate of regular cigarettes. This represents a significant increase in e-cigarette use since the 2012 survey.
“What we’re seeing is alarming,” said Dr. Gary Goldbaum, health officer and director at the Snohomish Health District. “The companies marketing these products are zeroing in on youth with ads featuring celebrities and other social media campaigns telling them that vaping is cool and safe. These are dangerous messages to send to our kids.”
Electronic cigarettes, also known as e-cigarettes or vaping devices, represent a market that has grown exponentially since they were first introduced in mid-2000s. They are typically equipped with a battery, an atomizer, and a cartridge for liquid nicotine. There are more than 400 different brands of e-cigarettes and the liquid nicotine comes in more than 7,000 flavors, all of which can be purchased online. The devices can also be used with marijuana, heroin, and other drugs.
The devices are not regulated by the Federal Drug Administration, so manufacturers are not required to disclose product ingredients. In addition to the nicotine, vaping may expose users and by-standers to harmful toxins like lead and formaldehyde. It will take decades to fully understand long-term effects of e-cigarettes and exposure to vaporized nicotine and other drugs.
“Nicotine is nicotine, regardless if smoked or vaped. We can’t afford to let years go by before acting to protect teens from a lifetime of health problems,” said Goldbaum. “This is a drug that the U.S. Surgeon General has noted is just as addictive as cocaine and heroin. We need to do more to protect our children–it’s critical that our legislators do what is in their power to keep these harmful devices off limits to Washington’s youth.”
A bill is currently under consideration during this legislative session. If approved, it would require retailers obtain licensing for the sale of vaping devices, prohibit internet sales, ensure child-safe packaging, and restrict marketing and sales activities targeted at youth. It would also impose a tax on vaping products that would be on par with other addictive substances like alcohol and tobacco. Taxing tobacco products has proven to be one of the most effective strategies to reduce the use of harmful and addicting substances, particularly among youth.
The final 2014 Healthy Youth Survey data and reports will be released by the Washington State Department of Health next month.
Snohomish Health District works for a safer and healthier community through disease prevention, health promotion, and protection from environmental threats. To read more about the District and for important health information, visit www.snohd.org.
“What we’re seeing is alarming,” said Dr. Gary Goldbaum, health officer and director at the Snohomish Health District. “The companies marketing these products are zeroing in on youth with ads featuring celebrities and other social media campaigns telling them that vaping is cool and safe. These are dangerous messages to send to our kids.”
Electronic cigarettes, also known as e-cigarettes or vaping devices, represent a market that has grown exponentially since they were first introduced in mid-2000s. They are typically equipped with a battery, an atomizer, and a cartridge for liquid nicotine. There are more than 400 different brands of e-cigarettes and the liquid nicotine comes in more than 7,000 flavors, all of which can be purchased online. The devices can also be used with marijuana, heroin, and other drugs.
The devices are not regulated by the Federal Drug Administration, so manufacturers are not required to disclose product ingredients. In addition to the nicotine, vaping may expose users and by-standers to harmful toxins like lead and formaldehyde. It will take decades to fully understand long-term effects of e-cigarettes and exposure to vaporized nicotine and other drugs.
“Nicotine is nicotine, regardless if smoked or vaped. We can’t afford to let years go by before acting to protect teens from a lifetime of health problems,” said Goldbaum. “This is a drug that the U.S. Surgeon General has noted is just as addictive as cocaine and heroin. We need to do more to protect our children–it’s critical that our legislators do what is in their power to keep these harmful devices off limits to Washington’s youth.”
A bill is currently under consideration during this legislative session. If approved, it would require retailers obtain licensing for the sale of vaping devices, prohibit internet sales, ensure child-safe packaging, and restrict marketing and sales activities targeted at youth. It would also impose a tax on vaping products that would be on par with other addictive substances like alcohol and tobacco. Taxing tobacco products has proven to be one of the most effective strategies to reduce the use of harmful and addicting substances, particularly among youth.
The final 2014 Healthy Youth Survey data and reports will be released by the Washington State Department of Health next month.
Snohomish Health District works for a safer and healthier community through disease prevention, health promotion, and protection from environmental threats. To read more about the District and for important health information, visit www.snohd.org.
State, tribal leaders seek to expand Insure Oklahoma program to about 40,000 tribal members
By SEAN MURPHY, Associated Press
OKLAHOMA CITY — While state leaders remain steadfastly opposed to a Medicaid expansion offered under the federal health care law, some of Oklahoma’s 39 federally recognized Native American tribes are exploring opportunities for a federal waiver that could mean health insurance for about 40,000 low-income uninsured tribal members.
Oklahoma Health Care Authority CEO Nico Gomez said talks are underway about seeking an expansion of the state’s Insure Oklahoma program to include some of the estimated 80,000 Native Americans in Oklahoma without health insurance. Gomez estimated as many as half of those tribal citizens could qualify for the program, depending on where the income threshold is set.
Although still conceptual, Gomez said the idea would involve the tribal citizen paying a portion of the health insurance premium, the tribe paying a portion, and the federal government paying the largest part.
“We’re not looking at tapping into any state revenue, not now or in the future,” Gomez said. “Frankly, if it required any state revenue, I’m not sure we’d even be having this conversation.”
Gomez said the proposal was initially discussed last week with tribal representatives, and that he plans to brief members of the Health Care Authority’s governing board during its regular meeting on Thursday. Some of the state’s largest tribes, including the Chickasaw and Cherokee nations, are involved in discussions, Gomez said.
Insure Oklahoma provides health coverage to about 18,000 low-income Oklahoma residents, mostly through a program in which the cost of premiums are shared by the state (60 percent), the employer (25 percent) and the employee (15 percent). The state portion of the program is funded through a tax on tobacco sales, but a federal waiver that allows the program to operate has only been approved through the end of the year.
Gomez said expanding the program to include a tribal option could help ensure the federal waiver continues.
Billy James, a 31-year-old University of Oklahoma student and a citizen of the Chickasaw Nation, said he wants to have health insurance but can’t afford the premiums.
“I’m trying to hold out as long as I can,” said James, who is finishing his master’s degree and currently unemployed. “I’m kind of scared about not having insurance, but I’ve got to tough it out a little while longer.”
A spokesman for Gov. Mary Fallin, a staunch supporter of the Insure Oklahoma program, said the governor is excited about the potential of a tribal expansion.
“We’re particularly excited about the fact that it would not cost the state any tax dollars, which is important as we deal with our current shortfall,” Fallin spokesman Alex Weintz said.
Currently, there are about 130,000 Native Americans in the state’s Medicaid program, which is about 16 percent of the overall Medicaid population in Oklahoma.