Friendship House drum circle in San Francisco, California. Friendship House is an Indigenous-led restorative treatment program that provides culturally responsive care.
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Emery Tahi of San Francisco knows firsthand the struggle of addiction and recovery. For him, that journey is intertwined with his experience as a Native American.
In her 20s, Tahi landed on the streets of Phoenix, battling severe depression and alcoholic seizures. Tahi said she was on the brink of suicide about four years ago when her brothers intervened and filed for court-ordered treatment.
While undergoing detoxification treatment in a psychiatric ward, Tahi learned: friendship housean Indigenous-led recovery treatment program in San Francisco. As soon as he was released from the Arizona hospital, he headed to California.
“I knew right away that I was in the right place,” said Tahi, 43. “Traditional practitioners said prayers for me. They taught me some songs. They put me in a sweat lodge, and I followed those rituals. And from that day on, I was able to reconnect with my spiritual and cultural upbringing.”
For the first time, Medicaid in California, Arizona, New Mexico, and Oregon will cover traditional health practices such as music therapy, sweat lodges, and dance to aid physical and mental health. It became. .
The Centers for Medicare and Medicaid Services announced the move this week. This is a two-year pilot program applicable to Indian Health Service facilities, tribal facilities, and organizations in urban India.
Two new categories of interventions will be subject to regulation in California. Medi-Cal Expansion. People suffering from substance use disorders can seek therapy from traditional healers who perform rituals, as well as elected officials and spiritual leaders who provide psychological support, trauma counseling, and recovery guidance. You can also work with trusted people within your tribal community. California is home to the nation’s largest Native American tribes, and Gov. Gavin Newsom said in a press release announcing the expansion that the state is committed to “healing the historical wounds inflicted on tribes, including the health disparities faced by Native communities.” I am working hard to do so.”
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Seeking Healing from Addiction
Tahee’s struggle with alcoholism began at an early age. He says he took his first sip of beer at the age of 4, surrounded by his parents, uncles, aunts and grandparents who were big drinkers of the Navajo Nation.
“I’m a full-blooded American Indian,” Tahee said, recounting the challenges he faced as a young man. “As a child, I was exposed to a lot of prejudice, racial discrimination, and racial discrimination. I had no pride in who I was. I felt ashamed of that. I feel like I used drugs and alcohol as a way to cope. Alcohol gave me sociability and gave me courage.”
As a teenager, Tahi began drinking and dabbling with marijuana, cocaine, and meth. Through it all, he said, his family instilled a meaningful connection to his culture.
“My maternal grandparents always encouraged me to learn and connect with the traditional Navajo way of life,” Tahi said. “There was a deep connection between family, land, and ritual activities related to the changing of the seasons.”
Tahi’s story is not unique. Some Native American communities have been affected by: highest rate Addiction and overdose deaths are on the rise in this country, and medical experts have long argued that Western medicine alone cannot adequately treat substance use disorders among Native Americans.
In 2022, Native American organizations gathered at Friendship House for a ceremony to pray for the success of The Village SF, San Francisco’s Indigenous healthcare and community hub.
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This crisis is compounded by centuries of historical trauma.
Roselyn Tso, head of the federal Indian Health Service (IHS), supports Medicaid coverage of traditional medicine. “These practices have kept people healthy for generations and continue to serve as an important link between culture, science, and health in many communities,” she said in a release from CMS. “There is,” he said.
Historically, some Native Americans have had access to traditional medical practices through IHS spending, tribal resources, various testing programs, and grants. This is the first time that Medicaid covers these services.
Bridging traditional and modern medicine
Clinical approaches such as detox, pharmacotherapy, and behavioral therapy are essential to treating substance use disorders but often fail to address the cultural and spiritual needs of Native patients.
“Traditional practices are holistic in nature,” said Damian Chase Begay, an American Indian health expert at the University of Montana. “They treat the person physically, mentally, spiritually and emotionally. They benefit the whole being, not just the physical symptoms.”
the study Although most of the current research is qualitative rather than quantitative, it shows that integrating cultural practices into addiction treatment can lead to higher engagement and more positive recovery outcomes.
Health care workers dedicated to Indigenous communities have long struggled with the limits of insurance coverage. Medi-Cal, the state’s Medicaid program for low-income residents, covers the cost of prescriptions and talk therapy, but traditional treatments are often excluded and many Native Americans Patients continue to lack access to treatment that is consistent with their cultural values.
“What California currently covers under Medi-Cal is exactly what our indigenous communities have been asking for to be covered for years,” Chase Begay said. “Had this type of support been in place, intergenerational trauma and drug use could have been stopped years ago. I’m very excited that it’s being introduced now. But it was a long time coming.”
The new Medi-Cal policy is scheduled to go into effect next year, and Indian health care providers in eligible counties will be able to request reimbursement for these services starting in January 2025. Unless extended, the policy will expire at the end of 2026.
“It’s extremely important to respect traditional healing methods,” said Kiana Maye, a certified therapist in San Diego and a member of the Lone Pine Paiute Shoshone Tribe. “Traditional healing is deeply rooted in our culture. Without it, we lose a part of ourselves.”
As for Tahi, she hasn’t touched a drop of alcohol since she started therapy at Friendship House. He currently works full-time as an evaluator at the Native American Health Center in San Francisco. He will soon receive a master’s degree in American Indian Studies. And a few months ago, he completed the San Francisco Marathon.
