Native tribes of North Dakota are trying to work with the state to find a way to bridge the treatment gap for residents. Last week, treatment providers representing four of North Dakota’s five tribes met with leaders from the state's Department of Human Services to discuss how they could improve communication between the state and its tribes, as well as what treatment and prevention funding programs are available to them.

"I would like to know and understand how the state can help us, as private providers, help our people," Bruce Gillette, director of Mandan, Hidatsa and Arikara Nation's Circle of Life, a drug treatment center in New Town, told the Bismarck Tribune. "We're in an epidemic with our adolescents. From seventh grade on up, it's a big problem."

In 2014, a team of NIDA-funded prevention researchers at Colorado State University analyzed data from the American Drug and Alcohol Survey given to Native students at 33 schools on or near reservations in 11 U.S. states. They found that Native youth are beginning alcohol and drug use earlier than their non-native peers.

The tribes say that opioids and methamphetamine are their biggest concerns. North Dakota is not the only state where tribes say that drug addiction is a problem. According to the Tribal Epidemiology Centers of the Indian Health Service, dependence on methamphetamine more than tripled for tribal members in Montana and Wyoming between 2011 and 2015.

"People are saying they're seeing it as young as third grade, because, 'Oh that's ok, I see that at home—my aunt does this, my mom does this, my dad does this, my grandpa does this.' So, they can't see the error in it. Or they don't see it as a risk," Miranda Kirk, co-founder of Aaniiih Nakoda Anti-Drug Movement—a native-led peer recovery project in Fort Belknap, Montana—told NPR earlier this year.

Tribal leaders gave Kirk and her sister, Charmayne Healy, $150,000 to fund a substance use prevention and treatment program last year after they convinced the Fort Belknap Tribal Council to declare a state of emergency to call attention to the methamphetamine problem last year. 

In North Dakota, Pam Sagness, director of the Department of Human Services' behavioral health division, said the department holds quarterly prevention meetings with the tribes, but they did not include substance use disorder treatment or mental health until last year. She also mentioned a substance use disorder treatment voucher that is available for the tribes.

However, she says, "I think that there's always room for improvement with collaboration.”