Tai M. Paquin, LMSW, LADAC

In tribal and urban clinics, providers continue to show that coordinated medical, behavioral health, peer support, and cultural healing approaches strengthen engagement, reduce stigma, and support long-term recovery. Thus, Medication-Assisted Treatment (MAT) stands out as one of the most effective methods for treating opioid use disorder, but its success increases significantly when services are delivered in an integrated care setting.

This article looks at how integrated care helps to strengthen MAT in Native American communities by sharing cultural insights and examples of tribal effort, to support more effective and culturally grounded approaches to recovery.

How Integrated Care Strengthens MAT Success

Opioid Use Disorder (OUD) is a complex, chronic health issue that requires coordinated, whole-person care. MAT, also called Medications for Opioid Use Disorder (MOUD), is one of the most effective treatments available, and many Native American communities have begun to adopt MAT.

Research and real-world experience show that MAT has its strongest outcomes when delivered within an Integrated Care (IC) model, which for BH2I grantees, team-based care is already a primary expectation. Even for clinics not currently providing MAT onsite, integrated approaches strengthen referral pathways, reduce barriers, and create a safe and culturally supportive environment for clients seeking help. In short, IC boosts MAT success because OUD treatment is most effective when medical, behavioral, and cultural healing systems work together.

Effective IC also involves coordination between various sectors, including social services, primary care, mental health, and substance use treatment. These collaborations lead to improved health outcomes for individuals with OUD, who often face co-occurring mental health issues. Integrated services allow for treatment(s) to be simultaneous, which supports consistent and long-term recovery.

Additionally, IC promotes better communication among healthcare providers, which allows for coordinated care plans to be developed. This approach reduces fragmented care (silos), leading to fewer missed appointments and ideally better adherence to medication regimens and treatment plans.

IC improves MAT retention through warm handoffs, shared care planning, collaborative follow-up, reduced stigma, team huddles, and culturally grounded engagement. Even clinics with limited resources can implement integrated strategies through telehealth, shared agreements, SBIRT, and involving peers, Community Health Representatives (CHRs), or other community departments as early as possible.

Native American communities with successful IC models embrace a holistic approach that also includes family involvement, cultural support, and attention to social determinants of health. Programs that factor in these values offer a more inclusive treatment experience that improves engagement, trust, and retention in MAT services.

Tribal nations across the country continue to model this coordinated and culturally grounded response to opioid use disorder.

A noteworthy example is the Cherokee Nation Health Services which has integrated prevention, treatment, and recovery by combining MAT with a community-wide social norms campaign. Their focus was on educating residents about the safe storage and disposal of prescription opioids. This community-driven approach raised awareness, reduced stigma, and encouraged families to become involved in prevention and treatment efforts sooner.

Similarly, the Mashpee Wampanoag Tribe demonstrates the positive impact of community-led initiatives. Their annual powwow has been dedicated to opioid awareness and serves as a platform for learning and discussion. This event brings together speakers from various organizations, including treatment facilities, law enforcement, and federal health agencies, promoting healing and challenging societal stigma.

These examples illustrate how tribal collaboration can creatively develop unified responses across health, cultural, and community systems. When Native American nations design their own solutions that are rooted in history, tradition, and sovereignty, then they strengthen pathways into MAT, reduce stigma, and promote whole-person healing for individuals, families, and communities.

Overall, the integration of MAT within an IC model is essential for providing effective and comprehensive treatment for individuals with OUD. By promoting collaboration, communication, and cultural sensitivity, integrated care not only improves treatment outcomes but also fosters a supportive and inclusive environment that empowers individuals on their journey to recovery.

References

Komro, K. A., D’Amico, E. J., Dickerson, D. L., Skinner, J. R., Johnson, C. L., Kominsky, T. K., & Etz, K. (2023). Culturally Responsive Opioid and Other Drug Prevention for American Indian/Alaska Native People: A Comparison of Reservation- and Urban-Based Approaches. Prevention Science, 24, 88–98. https://doi-org.highlands.idm.oclc.org/10.1007/s11121-022-01396-y

Lewis, M. E., & Myhra, L. L. (2017). Integrated Care with Indigenous Populations: A Systematic Review of the Literature. American Indian & Alaska Native Mental Health Research: The Journal of the National Center, 24(3), 88–110. https://doi-org.highlands.idm.oclc.org/10.5820/aian.2403.2017.88

Substance Abuse and Mental Health Services Administration (SAMHSA). (2023). Medications for Opioid Use Disorder (TIP 63). https://store.samhsa.gov/product/tip-63-medications-opioid-use-disorder/PEP21-02-01-002

Zeledon, I., Telles, V., Dickerson, D., Johnson, C., Schweigman, K., West, A., & Soto, C. (2022). Exploring Culturally Based Treatment Options for Opioid Use Disorders Among American Indian and Alaska Native Adults in California. Journal of Studies on Alcohol and Drugs, 83(4), 613–620. https://doi.org/10.15288/jsad.2022.83.613