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- By Elyse Wild
Maine is struggling to meet the needs of its opioid-addicted citizens, due in part to a shortage of detox beds. The state’s four federally recognized tribes, known collectively as the Wabanaki Nations, are helping close the gap with a new medication-assisted treatment and detox facility designed around Indigenous values, but open to all.
Waiting for a detox bed can be the difference between active addiction and recovery for anyone with opioid substance use disorder. In Maine, which has the eighth-highest overdose rate in the nation, the waiting lists for medically licensed detox beds can be months long.
“We know that when someone is ready to get the toxins out of their (system), they are ready right then — they cannot wait,” tribal health executive Lisa Sockabasin (Passamaquoddy) told Native News Online.
Sockabasin, the co-CEO of Wabanaki Public Health and Wellness, isn’t waiting to address the problem either. Last month, the nonprofit tribal health center she runs opened Cedar Road, a detox center in Bangor that utilizes the cultures, values and teachings of Maine’s four federally recognized tribes, known collectively as the Wabanaki Nations.
Cedar Road is open to tribal members, other Native Americans, and non-Natives suffering from substance use disorder, offering a place for them to safely withdraw from opioids under medical supervision. Sockabasin describes it as a sacred place, with natural elements and art depicting animals that hold cultural significance to the Maliseet, Micmac, Penobscot, and Passamaquoddy tribes of Maine. There is also sacred medicine, like cedar, present in each room.
The center’s name comes from the Wabanaki’s strongest medicine, cedar, and the detox center is a crucial component in a continuum of care to help the tribal community heal from the opioid crisis.
Wabanaki Public Health began offering addiction health services five years ago and has been exploring solutions to fill the gaps in addiction-recovery treatment available to members of the Wabanaki Nations.
“We were really diving into building the systems and services that we didn't have in Wabanaki territories,” Sockabasin said. “We quickly learned that detox services were medication-assisted withdrawal services that were really hard to find.”
Cedar Road has six detox beds, but will soon be licensed for 10.
The beds, Sockabasi said, are crucial to meeting the needs of those in active addiction who are seeking recovery.
"Access to detox services is a public health crisis," Sockabasin said. "Waitlists are not something we want to see. We want to see everyone receiving recovery services when they need them."
Not Enough Beds
Withdrawing from opioids is physically and mentally agonizing, with people experiencing flu-like symptoms for days, such as vomiting, fever, diarrhea, intense body aches, anxiety, depression, insomnia, and exhaustion. Withdrawing under medical supervision, or detoxing, involves the administration of medications to reduce the severity of these symptoms.
According to an October 2023 report by New Center Maine, the state is drastically short of detox beds, with waiting lists that are months long. In June 2023, there were 26 detox beds in the entire state that accepted the state's Medicaid insurance, MaineCare.
The state is projected to add nearly 200 beds in the next year; however, with a shortage of healthcare workers, there may not be enough people to staff them.
Opioid-related overdose deaths have continued to climb across the nation since 1999. Once referred to as the opioid crisis, with more than 700,000 people dying from opioid overdoses since 1999, it has now mutated into an overdose crisis with the proliferation of fentanyl, a highly deadly synthetic opioid 100 times stronger than morphine. Fentanyl is frequently found mixed with non-opioid stimulant drugs such as cocaine and methamphetamine, increasing the risk of overdose for non-opioid drug users.
While Americans of all races and ethnicities have been affected, the proliferation of opioid deaths has disproportionately affected Black, Indigenous, and People of Color (BIPOC) communities, especially Indigenous people.
Maine has one of the highest overdose rates in the country, according to the CDC, and many of the Wabanaki Nation's 8,700 members live in areas of the states that are most affected, including the northern and eastern region of the state in Washington County, which bears the highest overdose rate in the state; and Aroostook County, which ranks fifth in the state for overdoses.
Like many tribal communities across Indian Country, the Wabanaki Nation and its citizens have been deeply impacted by the overdose crisis.
"Wabanaki territory is 100% impacted," Sockabasin. "Our communities are small, our families are multi-generational. In a small community, the loss of one person is profound and deep. For Wabanaki people, we need every one of us well (in order for us) to thrive."
A System That Created So Much Harm
While Maine Governor Janet Mills pledged $1.5 million to open a new detox center in Washington County, it's important for the Wabanaki to create their own system of healing, Sockbasin said.
The Wabanaki are the only federally recognized tribes in the nation that are not state recognized, a status that has impeded them from receiving benefits from more than 500 federal Indian laws and resulted in the slowest economic growth in Indian Country. While Wabanaki sovereignty is widely supported in Maine, Mills has blocked attempts to pass laws acknowledging Wabananaki sovereignty.
"We are not going to depend on a system that created so much harm for us," Sockabasi said. "We will work with them if it's a trusting relationship, but we are not going to be dependent on those systems. We know that when we create our own systems, other people want to be healed in our systems, too."
Recovery centers like Cedar Road, designed around culturally centered addiction care, are critical to helping Indigenous communities heal. A review conducted in 2014 of 19 studies throughout the U.S. and Canada found that incorporating Indigenous knowledge, ceremonies, and healing practices reduces or eliminates substance abuse in Native communities by as much as 74%.
The detox center is the latest addition to what Sockabasin describes as a continuum of care designed to meet people where they are on their healing journey.
Wabanaki Public Health and Wellness offers intensive outpatient addiction health care and recovery homes. They will soon add a family and friends connection center, where those in recovery and their loved ones can access services designed to heal relationships and family units that have been affected by addiction.
“Wherever you are in your journey, we have a place to bring them up no matter what,” Sockabasin said. “We are not going to leave you behind.”
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