BEMIDJI, Minn. - When Ryan Neadeau Sr. started his journey toward sobriety, he found motivation and comfort in his cultural roots.
"What pushed me to get clean was believing in our culture, believing that there is a solution to this epidemic, and to saving our people by the culture," said Neadeau, a 26-year-old member of Red Lake Nation. "The cure is the culture."
Neadeau, who is now 13 months sober, got clean through a Native-based treatment center in St. Paul. It was there that he met James Cross, a former drug dealer who founded the group Natives Against Heroin after he was released from jail in 2005.
Through Cross, Neadeau became involved with the group and started reaching out to addicts in his own community. The Red Lake chapter of NAH held a Walk Against Substance Abuse in July - shortly after the band's tribal council declared a state of emergency because of the large number of overdoses on the reservation.
Minnesota's Native American communities-from the Red Lake and Leech Lake reservations in northwest Minnesota, to the Fond du Lac band near Duluth, to the Native community in the Twin Cities-have been hit particularly hard by the opioid epidemic overwhelming the nation.
According to the Minnesota Department of Health, Native American Minnesotans were five times more likely than white Minnesotans to die from a drug overdose-including from opioids, cocaine, methamphetamine and benzodiazepines-in 2015. While American Indians make up just 1.5 percent of Minnesota's total population, they represent 6 percent of the state's drug overdose deaths, the MDH reported.
Advocates and professionals on the ground in Native communities cite a variety of reasons for the disparity, from racism to lack of funding to the overprescription of pain pills.
"The epidemic is still rapid on our reservation due to, you know, less funding for the reservations," Cross said. "As Native people we are classified as second-class people today, not first-class people. We are forgotten."
A worsening problem
According to Leech Lake Police Chief Ken Washington, the consequences of opioid addiction have hit Leech Lake hard in the past six months, with between three and five band members dying of overdoses. Police and ambulance personnel on the reservation have had to administer about 50 doses of Narcan-a drug that can counteract the effects of an overdose-in that same time. Some opioid users require multiple doses to bring them back.
White Earth Nation, north of Detroit Lakes, and like the Leech Lake police, White Earth officers carry Narcan. Carson Gardner, a doctor with the White Earth Nation Tribal Health Department, said the tribe has trained more than 1,000 people to use Narcan.
As an example of how serious the reservation overdose problem is, White Earth police reported on Dec. 18 that in the 48 previous hours the Mahnomen County Sheriff's Department responded to seven overdoses, two fatal. Heroin is the major problem there.
On Dec. 19, the White Earth Overdose Response Team traveled the reservation providing Narcan and training people on how to use it.
Members of Natives Against Heroin have begun traveling to homes on the Fond du Lac Reservation in northeast Minnesota that they say are "known drug houses" to let the occupants know that resources are available to help them turn away from drugs.
Cross, who founded Natives Against Heroin, said the process of obtaining a chemical dependency assessment, being drug tested and meeting with professionals can be time consuming, sometimes triggering withdrawals and preventing people from getting help.
"At that time, they're in withdrawal, full withdrawal without no help ... so they have to go to detox or to the hospital to get comfort meds," Cross said. "But the triggers and cravings are still there, so they go back to what they know best, and that's calling the dope man."
'Recovery is possible'
Leech Lake's Health and Human Services director, Early Robinson, said the tribe has hired more people to perform chemical dependency assessments, and placed assessors in other areas, such as in Leech Lake's child welfare program.
The tribe also is working to incorporate Native American culture into treatment programs, something Neadeau and Cross say is key to helping Minnesota's American Indian communities overcome addiction.
"The treatment design today is still made for a non-native 40-year-old alcoholic from back in the day," Cross said. "What we have to do is upgrade it."
Tribes such as Leech Lake and the Mille Lacs Band of Ojibwe are working to do just that.
In February, the Minnesota Department of Human Services and the Mille Lacs band agreed to preserve a culturally relevant substance abuse treatment program, which will be operated by the tribe.
Red Lake Nation also began work in July to offer medication-assisted treatment on the reservation.
Robinson said that Leech Lake outpatient treatment programs and halfway houses have worked with a medicine man and filled cultural coordinator positions.
The White Earth Cultural Division has also implemented multiple spiritual and cultural support interventions.
Neadeau, who is working to put together a second Walk Against Substance Abuse, hopes Natives affected by opioids can heal through their heritage.
"We're just working one day at a time, trying to bring people into the culture," he said. "Recovery is possible for our indigenous people."