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Student Well-Being Commentary

Fighting the Opioid Epidemic at Its Source

The strain that a crisis of addiction places on schools will continue—unless we break the cycle
By Todd Hembree — January 10, 2018 7 min read
BRIC ARCHIVE

Editor’s Note: This Commentary is part of a special report exploring game-changing trends and innovations that have the potential to shake up the schoolhouse. Read the full report: 10 Big Ideas in Education.

The Cherokee Nation is comprised of approximately 7,000 square miles in northeastern Oklahoma. Today there are more than 355,000 Cherokee Nation citizens.

As the attorney general of the Cherokee Nation, it is my responsibility to hold accountable those who violate the law and harm the Cherokee Nation. In April, we filed a lawsuit against major distributors and pharmacy retailers of opioid drugs that do business in and around the 14 counties in northeastern Oklahoma that make up the Cherokee Nation for their role in flooding our community with opioid drugs and fueling the resulting health and addiction crisis. Their actions are a threat to our citizens, culture, and traditions.

As the epidemic continues to grow and impact our community, our young people are saddled with the long-term effects. Babies who are born addicted to opioids grow into children with lifelong effects that hinder their success in school. This places an added strain on the public schools in our community as the number of students who need additional assistance continues to rise. Unless we curb the epidemic, this cycle will continue, and we will not have the adequate resources to help ensure our children grow into adults that continue the proud traditions of the Cherokee Nation.

Over the past five years, we’ve seen a steady rise in the number of children entering our Cherokee Nation Indian Child Welfare system. We realized that there was a direct correlation between the number of children entering the system and the number of adults—their parents or guardians—addicted to opioids in our community. We then determined that the best way to protect our Cherokee families was to hold the companies who supply the drugs accountable to stop the flow of diverted opioids.

About the Author

Todd Hembree is the Attorney General of the Cherokee Nation. Based in Tahlequah, Okla., he is a Native Cherokee citizen from southern Adair County within the Cherokee nation.

The Cherokee Nation is comprised of approximately 7,000 square miles in northeastern Oklahoma. Today there are more than 355,000 Cherokee Nation citizens.

There were over 350 opioid-related deaths within the Cherokee Nation between 2003 and 2014, according to the federal Centers for Disease Control and Prevention. The CDC acknowledges that these numbers are often underestimated because they do not account for deaths in which opioids were a contributing factor that complicated other diseases. Vastly larger numbers of Cherokee citizens suffer daily from the health and social consequences of opioid abuse and addiction. Nearly every family has faced the epidemic through personal experience or the eyes of a loved one. The Cherokee Nation leadership has witnessed and listened to these stories from the frontlines of the epidemic for years—and the stories continue to multiply at an alarming rate.

Traditions are a crucial aspect of any culture. The passing of customs and beliefs between generations helps to define a people and create communities. In some of our schools, students are taught the Cherokee language and participate in cultural activities like gourd dancing and stickball. Other children learn these traditions at home through older family members. All of this, however, is in danger of being lost in the Cherokee Nation as more resources are being devoted to fighting the opioid epidemic, and the lives of our families—and children, in particular—are thrown into chaos. Indeed, the opioid crisis has resulted in so many Cherokee babies being born addicted that there are not enough Cherokee foster homes to care for them, and as a result, they are separated from their culture from their first moments of life. Even those who are lucky enough to remain in a Cherokee family may struggle with lifelong health complications and learning disabilities.

We realize that to successfully battle the opioid epidemic, we must fight it at its source. Funding rehabilitation programs, government assistance, a Suboxone clinic that offers opioid-addiction treatment, and a high-quality health-care system is necessary but not sufficient. No matter how much the Cherokee Nation invests in these programs, the opioid epidemic will continue to hold us in its grip unless we take dramatic action to stem the oversupply of opioids into our community.

In our quest to understand the epidemic and how best to fight it, we looked at the supply chain from top to bottom, and our best course of action was quickly apparent. The opioid distributors and pharmacies are required by law to take affirmative steps to ensure that dangerous opioid drugs are only provided to individuals with a legitimate medical need for them.

The companies named in our lawsuit knowingly failed to fulfill their duties, and they must be held accountable for the damage they have caused. They must be forced to change their behavior to end this scourge. We would hope that they will decide to meet their legal and moral obligations voluntarily, but, if not, our lawsuit will force them to do so.

This lawsuit is symbolic of the centuries-long struggle we have faced throughout history. For too long, we have been targeted by groups seeking to exploit us. At the end of the day, success in this lawsuit will mean curbing the flow of diverted opioids to ensure that our Cherokee families can stay together and pass our customs and traditions down through future generations. However, if these companies remain unchecked, the drugs will continue to be diverted into our community. And the crisis of addiction will continue.

NOTE: Since this essay was published, a federal judge, siding with the pharmaceutical companies and distributors, issued a preliminary injunction to prevent this case from being heard in tribal court. In his Jan. 9 ruling, U.S. District Judge Terence Kern states that the tribal court “clearly lacks jurisdiction.” In response, AG Hembree filed a new lawsuit in Oklahoma state Court on Jan. 19, and issued the following statement: “The defendants prevented this case from being heard in the Cherokee Nation Tribal Court, but no matter where this case is heard the facts will clearly demonstrate the damage these defendants have inflicted on the Cherokee Nation and its people.”

Background: Schools and the Opioid Crisis

By Evie Blad

Opioid abuse is a problem that has crossed racial, economic, and cultural boundaries.

It’s also a problem that increasingly affects the work of schools, particularly in areas that have been hardest hit by the public-health crisis, including Appalachia, the rural South, and tribal communities like the Cherokee Nation.

In 2015, more than 33,000 people lost their lives to opioid abuse, according to the most recent data available from the U.S. Centers for Disease Control and Prevention. In a nationally representative 2016 survey, 18 percent of 12th graders said they had used a prescription drug without medical supervision.

Across the country, school districts have reworked their drug-prevention curriculum to address prescription painkillers and illicit drugs like heroin and fentanyl. And high schools are increasingly stocking overdose drugs, such as Narcan, and training staff members to use them.

The epidemic has sparked social and emotional needs in children—related to issues like broken family relationships—that educators must address to help students succeed in the classroom. This comes at a time when schools are increasingly working to engage parents and communities and to address the nonacademic concerns that can hinder learning—such concerns as poverty and adverse childhood experiences that can actually alter a child’s brain development. All those issues cross currents in the opioid crisis.

When adults abuse or overdose on opioids, they stir up a wake of issues for their children, district leaders recently told Education Week. Children whose parents can no longer care for them are now in state care or being raised by aunts, grandparents, even great-grandparents, according to school officials.

There’s work to address the issue on a national level. A White House task force has recommended enhanced prevention programs, screening, and counseling in schools, and last fall, President Donald Trump declared opioid abuse a public-health emergency. But some say those actions aren’t enough and that increased federal funding will be necessary to address the issue.

Meanwhile, some state governments have taken a more aggressive approach, challenging drugmakers and distributors in court.

The Cherokee Nation filed its own lawsuit in the district court of the Cherokee Nation in April, becoming the first tribal group to take legal action on the issue. Drug distributors and pharmacies failed to fulfill their role as a “check” on the flow of prescription drugs, ensuring that they were not being misused, says the complaint.

Defendants in the case have contested the Cherokee Nation’s claims and challenged the court’s jurisdiction over the issue.

Related Video

The United States is facing an opioid crisis. Deaths have nearly quadrupled in the last 15 years — the latest figures show 91 Americans dying from opioid overdoses every day. In this report for the PBS NewsHour, Education Week Correspondent Lisa Stark traveled to rural Jackson County, W.Va, to see how one school district is responding:

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