Native American Hospitals Contribute to Opioid Misuse

Last Updated: May 31, 2023

Editorial Policy | Research Policy

According to a report by the U.S. Department of Health and Human Services’ Office of Inspector General, U.S. government hospitals are putting Native American patients at risk of developing opioid dependence because they failed to follow their own protocols for prescribing and dispensing opioids. The federal audit sheds light on the potential for hospitals to be contributing to opioid abuse.

This news comes at a time when there is concern about the opioid epidemic along with rising rates of Native American drug abuse and related overdoses.

Native American Opioid Addiction

Native American opioid addiction rates have gone up significantly since 1999, according to the Centers for Disease Control and Prevention. Additionally, a survey that looked at drug use among Native Americans living on or near reservations comparing a national sample of American youth found high rates of alcohol, marijuana, cigarette and illicit drug use among Native American youth.

Native American drug use history and current research continues to show trends of Native American youth misusing substances at higher rates than average. There has been a big push for culturally-sensitive intervention strategies.

Native American Drug Abuse Statistics

As far as specific Native American Drug Abuse statistics and in particular, opioid overdose rates and related deaths, these numbers have been rising since 1999. According to the CDC, from 2013 to 2015, drug and opioid-involved overdose death rates were 2.7 times higher for Native Americans than the rates for Caucasian people in Washington state.

Native Americans and Alaskan natives had the second-highest opioid overdose rates of all racial and ethnic groups in the United States in 2017.

Hospitals Disorganization Promotes Unnecessary Risks

Following the CDC’s reporting on the higher-than-average overdose rates for Native Americans and Alaskan natives, recommendations were made to the Indian Health Services. These recommendations were focused on helping better track patient health records and pain management. Other recommendations revolved around ensuring proper security and storage of opioids and updating information technology systems. The agency agreed to implement the changes.

However, the information coming out of the federal audit shows serious issues. The audit looked at 5 of the 25 hospitals directly operated by the Indian Health Service. Auditors looked at how many opioids were dispensed by each hospital and the percentage increase over three years as they decided which ones to review.

Auditors found that more than 100 patient records they looked at didn’t include evidence of confirmed consent. The informed consent form is intended to show patients the risks and benefits of opioids. Dozens didn’t have evidence that providers appropriately educated patients on the use of opioids.

Auditors also found issues related to mixing drugs. For example, some patients were prescribed opioids and benzodiazepines. The drug mixing effects of these two combined can significantly increase the likelihood of an overdose.

Dangers of Overprescribing

CDC guidelines call for opioid prescribing of no more than the equivalent of 90 morphine milligrams a day. The audit found that every hospital they looked at either met or exceeded that amount at different times. At one hospital, the daily dosage was more than four times higher. Overprescribing opioids increases the risk of a patient misusing them, developing an addiction, and experiencing an overdose.

Improvements to Procedures Recommended

Auditors have made what they describe as reasonable requests to the Indian Health Service to make the necessary changes at each of their Native American health center locations. According to auditors, the goal is not only reasonable requests but also cost-effective changes. The Native American hospitals aren’t the only organizations facing similar opioid prescribing scrutiny in the United States.

For people who are currently struggling with opioid misuse or dependence, help and treatment resources are available. Contact The Recovery Village Ridgefield today to find out more.


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    Associated Press. “Hospitals are putting Native American patients at risk for opioid abuse, audit says.” USA Today, July 22, 2019. Accessed September 4, 2019.

    Joshi, S; et al. “Opioid-Involved, and Heroin-Involved Overdose Deaths Among American Indians and Alaska Natives.” 2015. Accessed October 7, 2019.

    National Institute on Drug Abuse. “Higher rate of substance use among Native American Youth on Reservations.” May 31, 2018. Accessed September 4, 2019.