American Indians and Alaska Natives have higher rates of dependence on or abuse of psychotherapeutic drugs, painkillers and tranquilizers than all other races, according to the U.S. Department of Health and Human Services. A recent news story in the Great Falls, Montana Tribune detailing rampant prescription drug addiction on Indian reservations in Montana and Wyoming attributes the crisis to a shortage of health care resulting in over-prescribing, made worse by a shortage of drug rehab facilities.

There were 5,170 Indian patients on the waiting list for elective surgeries last year in Montana and Wyoming. Local officials said Indian Health Service (IHS) doctors are overworked, and a budget crisis within the IHS means patients wait months or even years for surgeries. To tide them over, doctors prescribe painkillers that are feeding the epidemic. A worker at a drug and alcohol treatment center in Montana’s Indian Country said when patients come to the hospital they are offered more pain pills rather than drug rehab.

The fact that there is no charge for prescriptions at IHS clinics helps fuel the sale of contraband pills – for example, a methadone tablet that was obtained free sells for up to $20 on the Blackfeet Reservation. This leads to a widespread prescription drug trade and more addicts than ever. Poverty also plays a role – investigators have found elderly people selling their prescriptions to make ends meet. In remote communities like Heart Butte, a wind-battered village on the Blackfeet Reservation, residents point out “pill houses" where addicts can buy addictive painkillers like OxyContin, Vicodin and morphine patches that were originally prescribed by the IHS. Drug rehab counselors at the Fort Peck Reservation say addicts have been known to deliberately injure themselves to get more prescriptions.

The manager of a drug rehab and alcohol treatment center run by the Blackfeet tribe and partially funded by the IHS said there has been an upswing of prescription opiate addicts. She said her staff could use more training on treating prescription drug addictions, because opiate addicts require more attention, may need up to six months of treatment, and the center has to leave beds empty despite a waiting list. The center takes addicts from as far away as Alaska, California and Washington state because there are so few accredited, in-patient successfuldrug rehab treatment centers for Native Americans.