Living in a family where substance abuse and addiction were prevalent, Caroline Cruz said she could have easily succumbed to the drug culture at the Warm Springs Indian Reservation. Instead, she left the reservation and developed a passion for drug and alcohol prevention in Native American tribes.

“I knew that if I stayed within that environment, I became that environment,” Cruz said.

Cruz, general manager of Health and Human Services on the reservation and a former sheriff’s deputy in California, spoke about her development of prevention methods at the 2018 Oregon Conference on Opioids, Pain and Addiction Treatment, hosted by Lines for Life, a substance abuse and prevention organization.

The conference took place at the Eugene Hilton from May 17 to 19. This is the first year the conference has been held. Dozens of speakers covered a variety of approaches regarding prevention and healing. Health representatives, medical field workers and community members attended. 

Cruz described the curriculum she developed, “Tribal Best Practices,” as a guide for educating Native Americans on mental health, substance abuse and prevention of abuse.

In a 2005 paper, she described the challenge of meeting state-imposed evidence-based-science requirements while working within a tribal culture, which often distrusts outside agencies.

“Oregon Tribes and tribal communities … are voicing objections to this movement to impose a linear approach to funding requirements that are greatly at odds with the circular worldview held by most Native American people,” the paper said, and proposed allowing tribes to develop their own research and evaluation practices.

Cruz has been working with tribal prevention since 1987, when she was recruited to start working on drug and alcohol prevention in tribes. In 1998, she became the first person in Oregon to be certified as a prevention specialist. 

“What we do is create a common way of how we do prevention,” she said. “If all of us are doing prevention in a similar way, we are going to be able to move forward in terms of reducing risk factors.”

Cruz wrote a report on tribal best practices in 2005 so the methods she was using would be recognized through the state and would receive federal funding. The template was built with the purpose of adapting to other cultures, she added.

Tribes are trying to use culture to change opioid, drug and alcohol use, she said. In their research, they are trying to examine environmental shifts and how they can change patterns in behaviors of those who fall into the same addictive patterns.

“What we are trying to do is break that generation,” Cruz said. “We can hopefully start teaching people how to get out of it.” 

Doug Barrett, alcohol and drug prevention coordinator of the Confederated Tribes of Coos/Lower Umpqua/Siuslaw, has worked with different methods of prevention over the years. He talked about a curriculum he developed called “The Healing of the Canoe,” which teaches tribe members how to get in touch with their culture as a means of prevention. 

Barrett touched on the curriculum during the session and went into detail about the canoe journey taken each year. The goal of the journey is to bring Northwest tribes together and to connect kids of all ages with their culture, free of alcohol and drugs. On a canoe journey, groups called “canoe families” travel in ocean-going canoes to a chosen destination, stopping to visit other native nations along the way.

“Our main motto is, culture is prevention,” Barrett said. He believes by involving kids in their cultural practices, the culture of drug abuse can change. 

The issues and solutions discussed at the conference will be addressed in June at the Oregon Tribal Summit on Opioids in Warm Springs, Oregon. This summit will address drug abuse in tribes and the best ways of prevention.

“We don’t believe we should just focus on one drug,” Cruz said. “We are talking more specifically on what we are doing for treatment and prevention so we can share with other tribes what is best for us.” She wants the conference to educate families in tribes and provide them with hope for a better future.