Drug Overdose Prevention in Tribal Communities

On average, 250 Americans die every day from a drug overdose. The number of overdose deaths has increased over time, with a sharp rise during the COVID-19 pandemic, including among American Indian and Alaska Native people. (Source: NVSS – Drug Overdose Deaths) The Centers for Disease Control and Prevention’s (CDC) National Center for Injury Prevention and Control (NCIPC) is committed to comprehensive efforts to address the opioid crisis in tribal and urban Indian communities. For additional details about the broader NCIPC injury prevention work in American Indian and Alaska Native communities, click here.

Overdose Deaths Involving Opioids
Among American Indian and Alaskan Natives, U.S. 2010-2020

The rate of drug overdose deaths among American Indians and Alaska Natives is above the national average and recent data show this trend continuing.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2020 on CDC WONDER Online Database, released in 2021. Data are from the Multiple Cause of Death Files, 1999-2020, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Mar 10, 2022 1:32:20 PM

At a Glance
Fiscal Year 21 Total Tribal Funding


NCIPC’s funding strengthens partnerships among tribal public health and local, state, and federal entities. NCIPC-funded tribal partner projects are supported to improve opioid overdose surveillance and data infrastructure, as well as develop and implement culturally appropriate prevention strategies.

Funded Organizations

In partnership with other centers at CDC, NCIPC is providing $13 million in supplemental funds to 11 Tribal Epidemiology Centers and 15 tribes or tribal-serving organizations. These collaborations address issues of data quality, completeness, accuracy, and timeliness. Funding also supports regional strategic planning to address opioid overdose prevention so that strategies appropriate to tribal communities are developed and the strengths inherent to tribal organizations are built upon.

Tribal Epidemiology Centers (TECs)

Supplemental funding supports 11 Tribal Epidemiology Centers (TECs) to (1) provide technical support to tribes and key partners for data collection, use, and sharing; (2) ensure better data related to race; (3) expand data sharing to enhance non-fatal overdose data collection from emergency departments; and (4) improve data abstraction from death certificates to collect timely data on opioid-related overdose deaths.

National Indian Health Board (NIHB)

NIHB works in partnership with NCIPC to move science into action by adapting and implementing a toolkit based on the CDC Guideline for Prescribing Opioids for Chronic Pain. The toolkit will be piloted in several tribally managed health centers. The project will provide technical and capacity building assistance to tribal health administrators and providers to engage in more safe and effective opioid prescribing practices and more effectively identify and respond to signs of opioid misuse and addiction. NIHB will also expand a national harm reduction meeting to include a track focused on opioid overdose prevention.

National Network of Public Health Institutes (NNPHI)

NNPHI offers technical assistance and capacity building for tribes and tribal organizations for opioid overdose prevention, in collaboration with NCIPC. NNPHI works closely with Seven Directions, a member national public health institute dedicated to Indigenous health and wellness, to (1) strengthen public health systems infrastructure; (2) improve data and information systems; and (3) identify evidence-based programs and services. Involved organizations have established a tribal opioid overdose technical expert advisory group to assist with the development and implementation of a technical assistance and training plan.

Funding Impact on Tribal Communities

CDC funds innovative community-based strategies in tribal communities that build upon the strengths of local tribal culture, tradition, and practices.

  • The Northwest Portland Indian Health Board developed the 49 Days of Ceremony, an Indigenous health promotion framework that aims to connect people to Traditional Indigenous Knowledge (TIK) and cultural practices to address stigma towards individuals with a substance use disorder, reframe perceptions of health and wellbeing, and promote healing among Tribal community members.
  • The Alaska Native Tribal Health Consortium is using technology to promote more informed uptake of medication assisted treatment and empower individuals with an opioid use disorder through an interactive learning experience. Individuals enter the augmented reality platform through a pair of HoloLens glasses and select learning topics ranging from the epidemiology of opioid use to brain functionality.