Purpose Northwest Montana's Flathead Indian Reservation has a high number of chronic pain patients on prescription narcotics and a high rate of narcotic abuse. Noteworthy is the history of oppression of Native peoples, loss of culture, and subsequent depressed societal behaviors. Using the input of tribal cultural leaders and care providers, a pamphlet was designed to dually offer traditional pain management and uphold Native culture.
Methods Interviews intended to respectfully gather information on traditional ways of life—to be used as a remedy for the prescription narcotics abuse problem—were conducted with cultural leaders from the three major tribes inhabiting the Flathead Reservation. Mental health staff and a family physician, all tribal members, also contributed. A literature search was conducted using MEDLINE and local resources to ascertain causes of narcotics abuse and interventions on reservations.
Summary All methods, along with clinical and societal observation, point to (1) a history of oppression, identity loss followed by pleasure-seeking behaviors, (2) increased patient comfort with and effectiveness of medical interventions involving traditional wisdom, and (3) traditional spirituality correlating with societal health. A pamphlet directed toward narcotics abusers, the general public was distributed to tribal health clinics, substance abuse counselors, and tribal traditional leaders.
Conclusions Reached Historical scars render many Western interventions sterile in reservation settings. Promoting traditional wisdom empowers the elders who offer wisdom and the patients who receive it.
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