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J Law Med Ethics. 2018 Jun;46(2):422-436. doi: 10.1177/1073110518782950.

The Opioid Epidemic in Indian Country.

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Gregory Buzzard, J.D., is a citizen of the Cherokee Nation. He is a recent graduate of Yale Law School and holds a A.B. from Dartmouth College in Native American Studies. Robin Tipps is a member of the Quapaw Tribe of Oklahoma. He is currently pursuing a joint J.D./M.D. through Yale Law School and Duke University School of Medicine. He received his B.A. from the University of Oklahoma. John McDougall, M.D., M.H.S., is a rheumatologist and current Yale National Clinician Scholar working to improve access and reduce health disparities in both rural and American Indian/Alaska Native populations.


The national opioid epidemic is severely impacting Indian Country. In this article, we draw upon data from the Centers for Disease Control and Prevention to describe the contours of this crisis among Native Americans. While these data are subject to significant limitations, we show that Native American opioid overdose mortality rates have grown substantially over the last seventeen years. We further find that this increase appears to at least parallel increases seen among non-Hispanic whites, who are often thought to be uniquely affected by this crisis. We then profile tribal medical and legal responses to the opioid epidemic, ranging from tribally-operated medication-assisted therapy to drug diversion courts rooted in traditional tribal cultures.


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