- [Woman] Hello, and welcome to the Opioids
in Indian Country Learning Community Series.
This is part two of our four part series.
My name is Mardela Sunshine Castanzo.
And I am the broad and focused
technical assistance task lead
for the SAMHSA Tribal TTA Center.
On the behalf of the center's contracting officer
representative, Marie Madison,
and alternate contracting officer representative
Yan Dunbar Cooper,
as well as our project co-directors Lori King
and Gloria Gillerly.
I'd like to thank you for joining us today.
In a few moments,
we'll start our presentation in a good way.
But first I'd like to take a moment
to review our process.
Today's webinar is being recorded.
And a replay will be available in the near future.
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all phone lines will be muted
to minimize outside noise.
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Just left click the file.
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Clicking that button will automatically start the download.
Finally, we appreciate you completing
a brief participant survey that you'll receive
after this session.
This helps us better tailor our events
to suit your needs.
Now we would like to open our session in a good way.
Doing this for us today,
we have our Native Connections technical assistant,
grant technical assistant Mr. Dave Braveheart.
- [Dave] Thank you, Mardela.
And, yes, it is an honor
to be asked to do the open here today.
I just wanted to say that
I'm going to use our Sacred Breath
to play the Native salute.
And I just want to share briefly
that I'm inspired by my family,
children, but I'm also inspired
by Neil Degrass Tyson,
who is an astrophysicist, American astronomer,
who had mentioned that all of the air,
the molecules in the air that our ancestors breathe in
is now circling all around us.
And we are breathing that air as well.
So just wanted to say that
we use a Sacred Breath of our ancestors
to render this flute song for all of you.
(playing Native flute song)
(no audio)
- [Man] --our services, so making sure that they feel
a part of the team and aware of all of our processes.
So I'll touch that a little bit later,
how we had to do a little bit of education there
for some of our individuals
to ensure that we're not creating barriers
of care or potentially retraumatizing patients
who are already in addiction.
So, our objective is safe and effective management
of pain symptoms and substance abuse disorders.
So we started off with that focal point in the beginning.
But that has evolved to include
all conditions that anybody seeks services for.
I realize that this is gonna be very difficult
to read, but I included a picture of the memorandum
from 2014.
It was really a milestone memorandum
and point of origin for our program.
So in the second paragraph,
it says from the date of April 1, 2014 forward,
Commander Hall is authorized to administer
and proceed with patient's medical needs
within the facility of House of Wellness.
We started off as that one facility first,
but now it's expanded to our whole health department.
To include Dr. Amy Delong,
who is our medical director, oversight.
For Traveling Road Ho-Chunk members,
Traveling Road Native Americans,
Ho-Chunk Nation employees,
and general public patients.
And this was a key where we decided
to open up this particular service
to non-Native individuals who are not affiliated
with the tribe in any way.
The opioid epidemic is a public health issue.
And we realize that some of our tribal members
who may be using drugs and alcohol
are not necessarily only doing that
with other tribal members.
So in order to be able to best assist
those individuals and support them,
we want to make sure that we're gonna be able
to offer the same services to people
who may be in relationships
or living in the same household
or even in the same social circles.
And the key to that was they had
to have available insurance.
We tried to do the patient,
the self-pay model, and it didn't work out quite well.
So now basically if somebody is on Wisconsin Medicaid,
they can access our medically assisted treatment.
And then so from April 2014 to today,
all of our medical providers
offer the same services.
Even though I may have been the one who piloted it
and work out some of the protocol details,
all of our providers and all of our clinics
are very familiar with and administer
the same services.
So that was a key component.
So just a really broad overview
of the what the program key components are
is it's an outpatient addiction program.
So we realize that a lot of individuals
cannot get the Vivitrol until they have gone
through opioid detox and withdrawals.
Most insurance plans, I don't think any insurance plans
really, will pay for in-patient opioid detox,
unless they have some other comorbid condition
that's causing a medical threat.
So what we've done is develop an outpatient addiction
withdrawal supportive care treatment plan.
So we basically prescribe medications
that help target each of that person's withdrawal symptoms
to help lessen the intensity of them
so they can successfully detox.
And then at the first negative urine drug screen
for any opioids, we administer the long acting Naltrexone
or Vivitrol injection.
So, a little clinical pearl that we learned early on
is that we have to make sure that we're testing
for Buprenorphine, which is Suboxone and methadone.
Those are synthetic opioids that won't typically show up
on a routine drug screen.
So there have been instances where they didn't self-report
that they had been using these medications
off the street.
They came up with a negative urine drug screen
for opioids, and then we participated withdrawal.
So now these two Buprenorphine and methadone
are part of our standard urine drug screen panel.
We provide psychoeducation to assist understanding
of dependence as a biopsychosocial chronic brain disorder.
So both in the behavioral health clinic
and the medical clinic, we're doing a lot of education
for individuals to understand
why they may be feeling some physical effects
or some of the their behaviors
and to help with their retraining
of their cognitive approaches to life stressors.
So we work in a very highly integrated healthcare model.
So once a month,
we have two hours set aside
where all of the medical providers,
all of the behavioral health clinicians,
the clinic nurses, the public health nurses,
the pharmacists, the nutritionists
all meet and we all present
on our more complicated patients.
And then each individual, each one of us
provides our perspectives of our touchpoints
with that patient.
And then we come up with a unified coordinated care plan
around that individual,
and then follow up with them at each visit.
So I think that's one of the most important elements
of any program for substance use disorders,
or even chronic care management.
So, realizing that we all have a unique component
in treating the individual,
the patients are fully supported
from this multidisciplinar team
that collaborates and engages
with each other in communication.
So part of our protocol,
the individual must engage with a clinic.
- [Man] I just would like to make a pitch
on behalf of MAT that we know it's evidence based,
we know it's best practices.
And Indian health service, SAMHSA,
including our practitioners here at Nimkee Clinic,
we are behind medical-assisted treatment.
Let's go ahead and get those clients the help they need.
And one of the ways that we go ahead
and to communicate with our culture,
we embrace those Seven Grandfather Teachings.
Honesty, truth, wisdom, bravery,
love, respect, humility.
And the best way that those Seven Grandfather Teachings
were imparted to me was after a sweat lodge teaching,
I was on the banks of Lake Superior,
and my elder, Mucatay Yanaquit, reached down,
grabbed a handful of sand
on Lake Superior and he went through
and as that sand was going through his hands,
he said, "This is all we are."
All we are are grains of sand on Mother Earth,
and we're only here for a short period of time.
And he started talking about that grandfather humility.
The grandfather that makes all of
those other grandfathers work.
And as long as we can embrace this teaching
of humility, we're spiritual beings
having a human experience.
We're no greater than,
we're no less than,
we're all a child of the Creator.
And we're here for a purpose.
And through those Seven Grandfather Teachings,
we can go ahead and to embrace that red road of recovery.
And one of the ways that we can do that,
we can let people know it's a good day
to be indigenous.
We can be who we are and what we are, as Native Americans.
We kind of look at cultural approaches
to medically-assisted treatment.
Western medicine, being strengthened
by these cultural approaches.
And I would use the Poagan, the Sacred Pipe,
the Sacred Fire, Eagle Feathers,
and some of our spiritual gifts
that we were given by the Creator.
And certainly a part of that with the Saginaw Chippewa Tribe
is embracing those four sacred medicines.
And one of the things that we look at
is what comes from the heart touches the heart.
And when I think of medically-assisted treatment,
the medical part is the physicians
and the medicine people.
The assistance part comes from people
like 12-step recovery sponsors,
traditional elders, and the treatment part
comes from therapy and lodge.
And just like our Ho-Chunk brother mentioned,
the the medicine, like Vivitrol,
is only as good as the treatment
that follows the medicine.
One of the traditional teachings
that we look at from the Sacred Fire
is we can be a storyteller
and remembering that everyone does have a story.
When we sit at those lodge teachings,
when we sit in those conference rooms,
maybe we can agree to disagree without being disagreeable.
And one of the teachings that I receive
from my grandmother Nokomis.
It's nice to be important,
but it is more important to be nice.
And you will be known from how you treat people,
especially your clients that are trying
to embrace recovery.
But the warmth of a Sacred Fire,
as any fire keeper and pipe carrier knows,
it has to start with a spark.
And that's where it has to come from within,
to be able to go ahead and to embrace your clients
and to know that if you can just get
the fire of a spark going in their recovery,
they can go ahead and to build that sacred fire
within themselves.
And part of that Eagle Feather Teaching
that we look at within our tribe,
the eagle is a very majestic creature.
But just like people,
they can have that eagle-eye vision.
And an eagle, a great hunter they can see
for distances and be able to see their pray,
but just like an eagle,
sometimes we have an inability to focus
on those things that are right up close to us.
And that's why sometimes we need our elders,
we need our therapists,
we need adult supervision in our lives
and those teachers to come in
to help us see the big picture,
to help us to focus on those things
that are right in front of us.
And with that, I'd like to go ahead
and to turn it over to my colleague,
Aubree Gross, who is our Healing to Wellness case manager.
(speaks Native language).
- [Aubree] Okay, thank you.
I'm Aubree Gross.
And as Joe had stated,
I am the case manager for the Healing to Wellness Court.
My part of the presentation will be discussing effective
community engagement through using
an integrated healthcare model of case management.
Integrated care is a systematic coordination
of general and behavioral healthcare.
And by combining mental health,
substance abuse, and essential healthcare services,
the best outcomes are achieved
and have proven to be the most effective approach
to caring for people with multiple healthcare needs.
Our Healing to Wellness program is comprised
of dedicated teams from several tribal
and local departments.
And through multidisciplinary efforts,
services are offered that are specifically coordinated,
managed, and comprehensive.
And they include substance abuse treatment,
judicial oversight, random drug screens,
and any other services identified throughout the program
based on individual's needs.
We are able to utilize our Nimkee Medical Clinic.
Our clients are required to have updated medical,
dental, and optical services.
And all of those are available at the clinic.
They also offer a maternal
infant health nurse, nutritionist.
The clinic is able to offer Vivitrol assessments
and administration.
We encourage physical health
so clients are able to use the Nimkee Fitness Center.
The Nimkee Pharmacy is also located within the clinic.
And they are able to fill a client prescription.
The pharmacists offer education to our team
as well as the clients within our court session.
The pharmacy also contacts
our case manager, coordinator, to let us know
if clients are filling any prescriptions
that may be a question.
Nimkee offers access to IHS funding.
There's also referrals to outside services,
such as an addictionologist,
liver specialist, neurologist,
and any other services that may be available
to clients outside of the clinic.
We also work closely
with our behavioral health department
for all mental health services for clients.
The team over there does assessments
which may include recommendation
for individual and group sessions,
individual intensive outpatient services as well.
They offer substance use outreach services.
They house the Residential Treatment Center
and Supportive Living Center,
which is based on the 12-steps.
It incorporates the cultural and traditional teachings
as part of the healing process.
Clients can also be referred
to other treatment centers outside
of the community, within the state
or out of the state.
They offer drop-in groups,
talking circles, sweat lodges,
acupuncture, and traditional healers.
We also utilize other mental health providers
in the community to best meet
all of our client needs.
Also part of our multidisciplinary efforts,
other departments within the tribe
are utilized that are not health professionals
to assist in improving client's quality
of life and overall well-being.
We work closely with the Anishnaabeg Child
and Family Services Department.
We have several clients who are involved
with both our program and theirs.
And the team members from ACFS
are active in weekly team meetings.
We work closely together to best serve
the needs of the clients with families
and try to not overlap services
and not overwhelm the client.
The ACFS Department provides bus passes
to program participants,
including those are not active ACFS participants
for opportunities.
ACFS offers a prevention department,
which allows clients to participate
in parenting classes and have additional resources available
based on the client's needs.
Working with ACFS offers extra supervision
and engagement and extra eyes may often catch red flags
and bring them to the team meetings
to help ensure that we are covering all gaps.
In the last six months,
we have had two families reunited and closed,
and we have another one that will be occurring probably
in the next 90 days.
We also work with our Human Resources Department.
Participants are required to work towards education
or employment in the third
and fourth phase of the program.
We have the Anishinaabe workforce developer
part of our team.
And he assists participants
in seeking opportunities
throughout the Saginaw Chippewa Indian Tribe.
And in helping clients obtain employment,
it helps establish self-worth and positivity
for the client.
Part of the education component.
They have to be working on one of the two,
whether it's education or employment.
So we work with the Saginaw Chippewa Tribal College
as well as the Mount Pleasant Public Schools
Adult Education program
to help clients with the GED prep and testing
and other higher education services.
The majority of clients have a ninth
to tenth grade education level.
And throughout the program and clients
moving through the program,
we have seen increased education levels overall
among program participants.
Part of the program is participants
are required to complete 200 hours of community service.
And part of our program,
we do include attending cultural
and community events towards community service hours.
Examples would be seasonal fees,
educational workshops,
and cultural teachings.
But allowing these to count as community service hours
allows for clients to rebuild the relationships
with the community and strengthen themselves.
And by doing this,
we're building stronger, healthier,
and more positive community.
And right now, this is a little bit
of our current Healing to Wellness data.
I think some of the most important things to look at
would be the age of first use.
A lot of our clients are 10 to 13.
And the majority of the highest level
of education would be not having a GED
or a high school diploma.
And it's very possible that two of these things
may be connected.
But I think that is all that I have
for my portion.
And I am going to turn it back over to Judge Shannon.
- [Judge Shannon] Thank you, Aubree.
As usual, you did a wonderful job there.
And I'm very fortunate to have
a really good working group here.
I have to fill in for Cathy Matthews.
Cathy, she's in court right now.
So we have a number of cases
that have to be finished up sentencing.
And she's in there representing the probation department.
Just a few things I want to go through.
And then we'll take a break, I believe,
and answer questions either for us
or Commander Hall.
But let me just go through a few of these.
I think many of you have worked in a court
and know that probation is a form of sentencing.
And we look at certainly community service,
fines, costs, work, behavior, health.
But at the same time, when we talk about probation,
the Healing to Wellness program,
the probationers there are people who have volunteered,
have been convicted of either a control substance
tribal crime and are now in the probation area.
These are some recent jail data,
looking at the percentage of tribal members
who are in jail.
We've been over the last three or four years
trying to cut this down.
It was higher than this.
I don't have that data.
But unfortunately there are times
that we have to rely upon a jail.
Sometimes, however, just to keep people safe.
As I mentioned earlier,
one thing that we do is we do have a Vivitrol program
in the jail work with Community Mental Health
and also the Nimkee Health Center.
And so, at least our people are given the opportunity
to access medical-assisted treatment inside the jail.
Because what the sheriff and I said seen
is people were being released from jail
and then using at the same level
they were using when they went in.
And many times it was fatal.
So what I learned the hard way, it kills.
And so, it was so good to hear
from Commander Hall and also the training
that we received through SAMHSA and others
about the need and the use of medical-assisted treatment.
And now Carol is sick today.
Carol is our magistrate.
And she just put a few slides together
regarding the magistrate.
Magistrate in our court does all the arraignments.
And so, she's the first contact.
And so, she sees the behaviors
of the people inside the court.
I do have to share with you,
Carol in the last year and a half
has lost two children to prescription drug overdoses.
And so, it has impacted our lives,
all of us here at Tribal Court.
And so, it's unfortunate she can't be here today.
I don't know if I've ever met a more,
a person who's more just really involved
in doing away with the death
and the hurt that has resulted.
But some of the things that Carol has identified
if some of our people are struggling,
can't sit still, shaking, fidgeting, scratching,
I like this, wiggling, docile,
limp, sad, shoulders are down.
But she evaluates them at that time
at the initial arraignment time.
And these are some of the things that she has identified
as important.
Listen to the defendants.
Go off the record if necessary.
And certainly offer them assistance
and show that the Court cares.
We're not there to beat people down.
And also we have to certainly collaborate.
The Court, as I mentioned,
we get the issues in the court.
All we're doing is looking for remedies.
How are we gonna work with each
one of our clients?
And then, as Carol points out here,
HOPE equals Hold On, Pain Ends.
I don't know if I've met another person
who has experienced as much pain as Carol has.
And so, she is a wonderful addition.
Certainly in the judicial role,
we have to interact with the defendant.
And community with staff.
Be active and participate in the Healing
to Wellness Court hearings,
and monitor the requirements.
Every Monday morning, we have Healing to Wellness.
And this past Monday was just kind of a rough Monday
for me because I had some administrative duties to do.
But when I got in with our clients,
it really made my day.
Looking at our participants
as equals, as humans here on his Earth
trying to figure things out,
has been an eye-opener for me.
It's very healthy.
Never lose your sense of humor.
Isn't that true?
We try to laugh here
because sometimes we don't deal with the best things.
But anyway, thank you very much.
I think, BC, that kind of leaves some time
for answering questions.
I'm sure Commander's gonna have a lot of questions.
So with that, I'll turn it back to you, Jeff, and BC.
- [Man] Thank you, Judge, Joe, and Aubree.
Thank you for the presentation.
I think that you really articulated clearly
both the risk for individuals
with opiate use disorder in terms of being in jail
and the importance of MAT in terms
of preventing death and overdose.
As well as really talking about the role,
how the judicial system or law enforcement
are critical partners in terms
of forging a path to recovery.
And how the traditional culture of healing,
it's certainly a critical component
of that recovery and how you sort of incorporate in
with your medication-assisted treatment.
Before we (mumbles),
I just wanna say from HSA standpoint,
we are very supportive in terms of our grants
and in terms of the use of medication-assisted treatment.
I think it's, Joe made a good thing,
how we talk about it and how we reference it
is really important in our community.
I know there's been a couple questions out there
in terms of enabling, substituting one drug for another.
And sometimes that might prohibit our ability
to move medications as a treatment forward
in our tribes and communities.
But the department is firmly behind it.
We kind of talk about that a little bit more.
I know there's some questions coming in.
So, Ted, did you want to take the first question
that popped up?
- [Ted] Sure, I can, thank you.
So the question that came into the audience is,
can you describe any obstacles that were faced,
if any, from other segments of your tribal community?
I.e., law enforcement, courts, et cetera,
regarding the implementation and success
of medically-assisted treatment services?
I bring this up because I have encountered professionals
from other communities who see MAT
as another way of enabling clients
who are addicted to opioids.
Just looking at some different strategies
to overcome the perception of MAT
as an effective treatment option.
So, certainly, right in the beginning,
we have encountered it.
We actually encountered it even internally
where we had certain providers
that were not supportive because they said things
like I don't want those patients in our patient room
or in our waiting rooms with our other patients.
So a lot of education had to happen,
even internally with our medical staff,
and then rolling out from there.
So what I alluded to before
was our patient registration staff
who were our front line face to our point
of access in our clinics,
is they sometimes had some negative perceptions
and even created some barriers
with making appointments because of what I like
to call big behaviors.
I don't like to say bad behaviors.
Bad and good are arbitrary labels.
And, yes, there are some behaviors
that people struggling with addiction will exhibit
because of their discomfort or where they are
just in their addiction or mental capacity.
But the big behaviors of just being aggressive,
assertive, a lot of what the magistrate
had on her slides of assessing,
what does the person look like in front of you?
So when I did a mini education to the patient registration
staff of what a person is going through
when they're going through withdrawals,
and that's somebody's brother, sister,
mother, father.
I just saw a natural compassion ensue.
And they went from going to blocking appointments
because they were frustrated at the person in front of them
to going out of their way and going above and beyond,
making appointments for those individuals
and making sure that they got connected
when they were ready to get some help.
So, yes, certainly from internal
all the way up to the community,
how we addressed was slowly education,
and just like the judge said, number one,
from compassion, approaching this from compassion,
realizing we have an individual who is suffering
from not only addiction but probably
some underlying mental health and trauma
that we may not know about.
And to treat everybody a little bit kindly
like they were our grandmother.
So that was our approach.
And it seemed to have worked.
So we really didn't have to do much more than that.
- [Man] Thank you, Ted.
To the folks from Saginaw Chippewa,
in terms of implementing your program,
have you encountered some resistance
related to the promotion of medication-assisted treatment?
- [Man] Yeah, it's continual.
It's all an educational process.
My fear along the way is we just don't want
to lose anybody.
We brought in MAT training three years ago,
working with University of Michigan School
of Public Health.
And health educators were provided CEUs.
And we got a real good turnout.
And also, it's on the Public Health Training Center
at the University of Michigan,
if anyone wants to access that training
and get CEUs for health educators.
And also bringing in a speaker from U of M on brain health.
And so, I think you'll remember seeing the one slide
of Sisyphus, the Greek who was pushing
the rock up the hill, and every morning,
the rock would be down at the bottom of the hill.
And as I told Joseph and Aubree and others,
I said we just have to find a way
to get around those rocks.
And get up the hill.
So it's a struggle.
And even today, I ran into some opposition
from law enforcement standpoint.
I haven't really seen that here as much.
And like I said, my background was law enforcement
for 22 years.
And I could talk law enforcement.
But this is public health.
And so, even on the Opioid and Prescription Drug Commission,
there are representatives from law enforcement.
And they get it.
And I do, I worry about our first responders out there
who are bringing people back to life.
And many of them probably don't like it.
I don't know who would.
But I would just say this.
It is that feeling is everywhere.
It's in the healthcare industry.
It's in the law enforcement area.
It's in the court systems.
And then also the other health providers too,
that feeling that we're just exchanging one addiction
for another, and it's hard to overcome.
And so, it's ongoing education and preparation of people.
Like I said earlier, we're in the business
of keeping people alive.
And I'd rather see on a Monday morning
than read about them in the obituary.
- [Man] Thank you, Judge.
And, Joe, I know you talked about the importance of story.
And I think that something our next series of webinars,
we're actually gonna talk about the importance
of a recovery story.
And I think in terms of promoting,
Aubree talked about two people
who are reunified with their families.
I mean, I think there's these examples that we have
that really are great that they need to be shared
and elevated in our communities
so others can see the effectiveness
and some of the productive outcomes
in terms of functioning family reunification
and just overall benefit to our communities.
- [Man] Well, when you look at things
like Family Against Narcotics Chapter.
One of the strongest components of that
is to be able to put a face
on the situation.
And for those that have lost people due to addiction,
they have a story to tell.
And it doesn't have to be that way for a lot
of our communities.
To go ahead and to give them a platform
where it's a safe environment,
where the medicine is there and the healers are there,
where they can open and share some of the pain
and grief, but also being able
to get that release.
And as long as we can let the clients know
that they're not in this alone
and we can love them through it,
I think that's the importance
of the Nokomis Teachings,
being able to embrace those Seven Grandfathers.
And let our culture speak for itself.
And when we put our culture first,
it does speak volumes,
regardless of what tribe you're from.
- [Man] Thank you, Joe.
So I'm just kind of looking at the chat box,
and I know there's been quite a few questions
and discussion about a tribal action plan.
I believe that in the file for download,
you can find information about a Tribal action plan.
I believe there's probably a recording
from the first webinar that we did
that talked about the tribal action plan
from (mumbles).
And how they utilized a doughnut
to help advance that tribal action plan.
And I think the benefits to the tribe through that.
And I know that BC could probably identify
in terms of folks who are interested
in perhaps some potential technical assistance,
what we can do in terms of assisting tribes
with that from at least a SAMHSA perspective.
So I'm gonna put that in the chat box or something.
- [Woman] Yeah, I think folks have noticed Sarah Pearson
has been responding to a few comments here
and has taken a few e-mails.
She is one of our tech experts, if you will.
She's worked on it for quite a bit.
Our last session, we had our other colleague,
Supriano Ricario, on as well as
who did a little more in-depth discussion
about TAP and starting to develop it.
So I hate to put her on the spot,
but, Sarah, if you're connected via phone,
would you like to say a little bit about TAP development
and maybe help guide people to some of our materials
that we have?
And I'm not quite sure Sarah's on the line.
So let me just say that at the output. (laughs)
Okay, she may not actually be on the phone line.
Okay, she is not.
What I would like to know,
and I don't know if others are interested as well,
but, Joe, you know, I noticed in your presentation
about MAT, you say that you integrate
cultural aspects to it.
And I didn't know if you could elaborate
on that a little more.
Of course everyone's gonna have different cultural tools
that they use, but what are you using
in your community that helps you to do that?
- [Joe] Well, let's use the example of genetic coding.
In western medicine, you have 64 genetic codes
as it relates to healing.
You bring in ceremony, you bring in ritual,
you bring in the healing medicine,
you can have a multiplier effect
of those genetic codes.
And overall, you're trying to promote
the good healing.
And that's why we bring in the drum,
we bring in the shaker,
we bring in the smudge medicine.
And you can actually get better outcomes
when you're bringing this sort of thing
into the emergency room,
when you're bringing it over to the OR.
When you have the medicine there available
before the client gets a chance
to go ahead and to meet with the doctors
at the Nimkee Clinic.
And I get an opportunity to go ahead
and to work with a lot of healthcare professionals
just going ahead and showing that concept.
And it's putting your faith first.
It's putting the traditions first.
And that's one of the ways that we can assist
the medicine through our traditional teachings.
- [Woman] Great, thank you.
I know someone has mentioned SAN.
And Jeff has put a link in the chat box.
But I want to say it out loud
because folks won't see that link.
It's www.familiesagainstnarcotics.org.
So that's got some information you'll be able
to use as well.
And Judge Shannon was saying that FAN
listens to the community.
So maybe, Judge, would you like to tell us
a little bit more about that program?
- [Judge Shannon] Yeah, and that's really important.
Families Against Narcotics, another colleague of ours,
Linda Davis, Judge Davis was out in Macomb County,
and they initiated this a few years ago.
And it's just caught on like fire throughout the state.
There's a program in Sault Sainte Marie.
And I live in Sault Sainte Marie.
And practiced most of my career up there.
And so, if you don't know Michigan,
it's in the upper peninsula.
But in any event,
the tribe here were the leaders
to establish a FAN organization here.
And it's grassroots.
And for those people who are interested
in dealing with this opioid and prescription abuse crisis
that we're facing,
one of the beautiful things.
It was a few weeks ago I went to Sault Sainte Marie
and hosted a panel.
And then also there was a showing
of Chasing the Dragon,
which is a movie.
And it's very moving.
And we did the same thing back here in Mt. Pleasant.
But what that did was allow the community to speak.
Our panel was made up of law enforcement providers.
And so many times, like today I think probably
most of us are providers at some level.
Either we're in the courtroom or behavioral health
specialists and medical.
And we're getting all the training.
But this really is directed toward the community.
To listen to the community as to what
the needs are.
So FAN is extremely important.
I know if you access that website,
the folks there, they'll work with you.
They just will work for the wonderful people,
wonderful grassroots people.
And quite frankly, I'm very proud
that it started in Michigan or thereabouts.
But it's taken off in Michigan.
Because there was a hole as far as healthcare,
as far as law enforcement?
Now they do something called,
what is it, Hope, Not Handcuffs.
And they initiated something like that
where people who can surrender themselves
and the FAN volunteers will work
to get them into treatment.
And so, there's this intervention
and prevention and treatment model
that they've adopted.
So I would urge you, if you're interested,
take a look at that.
- [Woman] Great, thank you.
And we've got a comment from Cassie
about reaching out and encouraging more participation
to webinars and trainings like this.
Jeff, I believe in addition to what we're doing,
there's other information out there, correct?
- [Jeff] Yeah, I know that's certainly something
that I know we work closely with
all of our federal partners, IHS,
and try to provide the information,
whether it's a webinar like this,
or sometimes we could do more things
in person and other technical assistance
to help build the capacity.
I think that there's a theme,
obviously we know that there's challenges.
We know that there's certainly some,
this is very impactful across the lifespan.
But I think we're also,
what we're hearing about is that there is hope,
and there is ways and there is solutions
that many tribal communities are bringing forward.
And the way we can help do more of those solutions
that would fit appropriately for that tribe,
we can see some productive results,
and we can continue to forge recovery.
So whatever way we can help support that,
I think you would find some willing partners.
- [Woman] Well, keeping that in mind,
we do have part three of this series
coming up in May.
Right now that is scheduled for May 16th.
And we'll be talking a little more about
the movement from treatment to recovery.
And really specifically how tribes are integrating
cultural practices and traditions into recovery.
So it'll be the same timeframe, 2:30 Eastern
to four o'clock Eastern Time.
And keep an eye out for that.
We do send out e-mails letting folks know.
Additionally, we're looking at a part four
that would be a town hall.
So when we send out, or if you register for that,
you'll have an opportunity to ask questions.
We're going to invite all of the folks
that end up being part of the three sessions back
just to answer your questions.
So that is tentatively scheduled for June 20th.
Again, it would be at the same time.
I want to mention that website one more time.
Www.familiesagainstnarcotics.com.
And unless anyone has a final comment.
We want to thank everyone for joining us.
Jeff, did you ever anything?
- [Jeff] I do, just thank you to our participants
and our presenters.
And look forward to seeing folks in the third webinar.
- [Woman] Great, thank you, everyone.
- [Jeff] And have a great afternoon.
- [Woman] Yes, have--
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