North Carolina’s Opioid Crisis is Hitting Indigenous People Twice As Hard

Shawna Priest, a member of the Jamestown S'Klallam Tribe in Washington state, sits in the child-care area of the Jamestown Healing Clinic where she works as a medical assistant. Her son and daughter have struggled with opioid addiction. (Image via AP Photo/Ted S. Warren)

By Sarah Ovaska

February 10, 2022

As North Carolina’s opioid epidemic continues, Indigenous communities are seeing the number of overdoses soar. 

Native communities are among those most devastated by North Carolina’s increasingly deadly opioid epidemic

Native Americans are overdosing at more than twice the rate of their white, Black and Latino counterparts in the state, data from the NC Department of Health and Human Services shows.

For example, 75 in 100,000 Indigenous people overdosed in 2020, compared to 33 in every 100,000 white people, 25 in every 100,00 Black people and 10 in every 100,000 Latinx North Carolinians, according to data from the NC Department of Health and Human Services.

Overdose deaths have been growing at alarming rates during the last two years of the pandemic, with preliminary data from the CDC showing that overdoses in the first half of 2021 were among the worst yet in North Carolina and the nation. The disproportionate toll on Native communities has been felt elsewhere in the nation as well. Earlier this month, more than 500 Native tribes, including NC’s Eastern Band of the Cherokee Indians, reached a tentative $590 million settlement with Johnson & Johnson and three drug distributers over the opioid epidemic.

Overdose rates among NC’s Native American (AI/AN) have risen rapidly. Source: NC DHHS Opioid Dashboard

Isolation and uncertainty as the COVID pandemic continues may be further fueling the crisis among North Carolina’s Indigenous residents.

“The problem is getting much worse,” Erica Locklear of the Lumbee tribe’s Medication-Assisted Treatment told NC Health News, in a report published this week.

Locklear explained that COVID-19 may have played a role: “When COVID first started, I don’t know if it was a fear factor or what, but things were getting a bit better. Then, after the first couple of months, the overdose rates just skyrocketed.” 

Barriers to Help 

Substance abuse treatment can be costly and difficult to obtain, especially for those without health insurance. North Carolina is among the 12 states that hasn’t taken federal dollars to expand the state’s Medicaid program to the working poor. Doing so, advocates say, could give those suffering from addiction access to life-saving treatments.  

Opioid addiction – which can include abuse of prescription painkillers as well as illicit drugs like heroin and fentanyl – has hit the nation’s rural areas particularly hard. And that may be part of the reason why North Carolinas’ Native population is suffering so much, given that the eight state-recognized tribes are all located in less populated areas of the state.

North Carolina has the largest Native population east of the Mississippi, with eight tribes recognized by the state: the Coharie, the Eastern Band of Cherokee Indians, the Haliwa-Saponi, the Lumbee Tribe of North Carolina, the Meherrin, the Sappony, the Occaneechi Band of the Saponi Nation, and the Waccamaw Siouan. The Eastern Band of Cherokee Indians in North Carolina’s Smoky Mountains is the only tribe with federal recognition.

The Lumbee, centered in the southeastern part of the state in Robeson County, is the largest tribe, and has been locked in a decades-long fight to gain federal recognition. Federal recognition would send more resources to tribal members.


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