Wednesday, 23 March 2016 14:56

Cherokee implements full-circle

rehabilitation for drug recovery
Written by Holly Kays

Its been a while since the old Mountain Credit Union building
in Cherokee saw foot traffic from people looking to deposit checks or get financial advice, but its doors still swing
open and closed with regularity though for a much different purpose.
When I first got here, I talked to some clients who said they could never go back to Cherokee because they cant live
here, because everybody they know uses and they feel like its not a place thats safe for them to be, said Doug
Trantham, director of behavioral health for the Cherokee Indian Hospital Authority. I would like people to say
Cherokee is the place to be if you want to live a healthy life.
The Recovery Center, which sits behind the Bureau of Indian Affairs office where the credit union used to be, offers a
range of services for people who need help battling an addiction. Peer support specialists people who are
practicing recovery after dealing with behavioral health issues offer counsel. An employment specialist is available
to help people in recovery find work. A full schedule of classes offers emotional support, life skills, cultural
connections and yoga, among other resources.
What we see ourselves doing everyday is helping people get restarted, get back on track, get a new start, Trantham
said.
Since opening on Dec. 1, 2015, the Recovery Center has been nothing if not well used. Dozens of people pass
through its doors every day with 29 people attending 178 classes in the first three months.
Trantham and the rest of his division are excited about its impact, but the center is far from the only change coming to
the way the Eastern Band of Cherokee Indians handles substance abuse issues.

Attacking the issue

In June 2015, Tribal Council approved a 15-point plan to combat substance abuse from prevention to rehabilitation,
allotting $16 million for facilities and $2.2 million annually for operations.
We have the resources to address it is really why its at the forefront now, said Lynn Harlan, public relations officer
for the hospital and a tribal member. Before it was like, we dont want to talk about a problem we cant address.
As casino profits have rolled in and the tribe has become more able to make and fund its own decisions, Harlan
explained, the Cherokee people have addressed their most pressing needs one by one. High diabetes rates and the
landing of a state grant led to a push to build community gyms. An opportunity came up for property to accommodate
a new school system, so that came next. An $18 million grant from the U.S. Department of Justice paved the way for
construction of a new justice center and jail.

Now, with drug abuse prevalent and the effects bolstering crime rates and leading young adults to early graves, the
time has come to combat the issue head-on. Its made frequent appearance in Tribal Council chambers in recent
months, and programs are ramping up to attack it from a health standpoint.
But substance abuse is not a Cherokee-specific problem, Harlan emphasized.
Our problems arent any more significant than other communities, Harlan said. Its just that we, unlike many
governments, are able to address issues that affect us personally.
No good data exists on use and abuse rates on the Qualla Boundary, so its impossible to compare prevalence on
and off tribal land. But Trantham agrees that substance abuse, especially prescription opiates and heroin, are issues
across Western North Carolina and in the nation as a whole.
Opiates have really exploded all across the country, and its really the case here, he said.
Of 14,700 enrolled members, about 11,000 have been patients at the hospital. In 2012, 1,530 of those 11,000
patients received a diagnosis related to substance abuse. Thats roughly 14 percent of hospital patients or 10 percent
of enrolled members.
Rates are high elsewhere in the region. Every year, about 15 people in Haywood County die from prescription drug
overdose, a rate several times higher than deaths from automobile accidents. In Jackson County, 72,000
prescriptions for abuse-prone drugs were written for 22,000 people in 2014.
The goal for Cherokees program, called Analenisgi Behavioral Health, is to attack the causes of those numbers on
the boundary and turn addicts into healthy and productive members of society. Thats a multi-faceted goal with a lot
going on surrounding it.
Literally, we could water board you with information, Trantham said.
Perhaps, but the summary of Analenisgi is in the name itself. Analenisgi means they are beginning in the Cherokee
language. The name was chosen carefully by a group of Cherokee speakers to underscore the programs purpose.
A lot of what were doing here is we are helping people begin again, Trantham said.

Implementing the plan

The tribe has the beginning and the end of that cycle mostly in place. The Recovery Center is there to help people
who need outpatient help and encouragement to stay sober. And people in need of intensive detox can go to the
hospital for care as the drugs leave their system. But the resources to bridge those two extremes are still in progress.
This summer, the tribe hopes to have a halfway house for men in recovery up and running in Whittier, just off the U.S.
74 exit for Cherokee. Theyve purchased the property and secured a Conditional Use Permit from Jackson County.
Now theyre just waiting on contractors to return bids to renovate the 1960s brick structure. The 4,400-square-foot
home would house eight men as they work on life skills and reach the stability theyll need to safely reintegrate to the
community.
While living there, Trantham said, the men will stay busy with work or volunteering or treatment, but theyll be safe
while doing so.
A lot of our folks do not have a place to live here in Cherokee that is safe for them safe from the standpoint of
being free of triggers, Trantham said.
Plans are in the works for a similar facility for women, designed to accommodate their children as well. But that
project will take a little longer. The folks at Analenisgi have their eyes on the property that used to house the
Cherokee Childrens Home, behind the Ginger Lynn Welch Complex. The location is perfect, within walking distance
of the library, a coffee shop, two daycares, a recreation center and multiple playgrounds. Thats basically ideal for
mothers who may or may not have access to a car.

Its close to a lot of things, but when youre there it feels very residential, said Kristi Case, recovery services
manager for Analenisgi.
The construction, however, is problematic. The existing buildings are old and probably not worth the cost of
renovation. Currently Analenisgi is investigating the cost of building a new facility. Its hard to say exactly when that
project might be finished.
The flagship of the Analanisgi program, however, will be the Snowbird Recovery Center, a facility that now exists only
on paper. Accounting for $13.5 million of the $16 million Tribal Council promised for facilities, the center would
accommodate both men and women in need of intensive rehabilitation.
The Snowbird Recovery Center would offer everything from medical services to family engagement to connection to
Cherokee culture, a one-of-its kind facility using the same environmentally themed design principles as the new
hospital.
Theres not anything like this facility, Trantham said. There wont be anything like it in North Carolina, certainly not
west of Asheville.
Located in economically struggling Graham County, another boon of the new treatment center will be the jobs it will
provide to the area, Harlan said. A staff of 10 to 15 will be required to run it.
Everything on the news about Graham County is jobs leaving, so the Snowbird center is a huge opportunity, she
said.
The center is expected to open sometime in 2017, with the timeline largely depending on permitting. The land itself is
trust land owned by the Eastern Band, but access will require building a road through land managed by the U.S.
Forest Service.

Connecting mind and body

Though the planned continuum of care progresses from hospital detox to the rehabilitation center to the halfway
house to continued contact with the Recovery Center, not every person will follow that same path. Not everyone will
need to. And not everyone who is touched by the ramped-up behavioral health efforts will actually be seeking out
help.
For example, the Analenisgi program includes a fulltime therapist who works in the jail, treating a population thats
often overlooked but includes high proportions of people with behavioral and mental health issues. The program
addresses prevention, too, working in Cherokee Central Schools. And the integrated care model at the new hospital
is also being put to work to combat the stigma that can come with seeking help for mental and behavioral health.
The new hospital is organized into integrated care teams, teams of medical professionals representing a diversity of
specialties. The idea is that they collaborate and share responsibility for each patient in an effort to address the whole
person. The teams include a psychologist.
No one knows whether youre getting your blood pressure medicine or having a mental health checkup, explained
Harlan.
It very much normalizes behavioral health, Trantham said.
The connection will get even stronger down the road when the hospital completes its plan to renovate space for the
behavioral health program in the old hospital building, now empty.
Thats basically saying there isnt some great separation between the mind and the body, Trantham said.
Everything is connected.
Thats a mantra that Harlan is happy to repeat.

This is a project that is a step in taking care of our community, and there will be another issue that comes up that we
address next, Harlan said. This will help us have more healthy individuals to work toward what the tribe believes is
important, and thats keeping us strong as a culture and keeping us strong as a nation.

Get connected
Cherokee people looking for help with substance abuse issues can find it at the Analenisgi Recovery Center, which is
always open to walk-ins. The center provides an extensive range of services, including therapy, employment services
and a full schedule of classes to assist with recovery.
The center is located on 375 Sequoyah Trail behind the Bureau of Indian Affairs office and open weekdays from 7:45
a.m. to 4:30 p.m. 828.497.9163 ext. 7550.