Washington tribal leaders are looking at an overseas model to combat the rise in opioid use among teens.
It’s called the Icelandic Prevention Model, and it’s helped slash alcohol use among Icelandic 15- and 16-year-olds from 77% to 35% in 20 years.
“There’s no other model in the world that has that kind of turnaround in the community,” said Nick Lewis, councilmember of the Lummi Nation and chairman of the Northwest Portland Area Indian Health Board.
Washington has dubbed its effort the “Washington Tribal Prevention System” and the Health Care Authority, along with five tribes, will partner with Planet Youth, a non-profit bringing the Icelandic Prevention Model to other places.
The model involves re-thinking how to discourage drug use by placing responsibility on the community, rather than the individual. Instead of asking kids to “just say no,” the Icelandic Prevention Model calls on the adults in a child’s life to create an environment without drugs and alcohol, said Margrét Lilja Guðmundsdóttir, chief knowledge officer at Planet Youth.
“The child should never be responsible for the situation in the community,” Guðmundsdóttir said.
The Washington Tribal Prevention System officially kicked off its ten-year pilot program with the ceremonial signing of contracts on Feb. 14. The five tribal governments participating are Jamestown S’Klallam Tribe, Lummi Nation, Tulalip Tribes, Swinomish Indian Tribal Community and Colville Tribes.
In Washington, American Indian and Alaska Native residents have the highest rate of death from opioid overdoses, far outpacing other races and ethnicities, according to state Department of Health data.
“Our stories might be different,” Lewis said. “But if they can turn things around, we can too.”
The first two years, the Health Care Authority officials said, are just administrative planning, which will cost $2 million to $3 million a year. Gov. Jay Inslee has called for $1 million for the project in his supplemental budget proposal this year, and the rest of the money would come from federal grants.
Whether lawmakers will provide the $1 million Inslee requested or some other amount for the program will become clearer in the days ahead as the Legislature irons out budget legislation.
When the program moves out of the planning phase – scheduled to happen in its third year – costs are expected to go up dramatically. But Aren Sparck, tribal affairs administrator for the Health Care Authority, said he’s optimistic about finding funding from both private and public entities because of how much interest there is in the model.
Sparck also said the program could be adopted by other tribes and communities. “I think this is going to be a test for the entire state,” he said.
What exactly is the Icelandic model?
In Iceland, youth, parents, schools, the government and other community members work in tandem to create an environment that discourages drug use.
For example, the country has free after-school activities funded by the government. Kids are bussed directly to those activities. Youth councils help shape what activities happen, so teens are actually interested. It’s about making drug-use prevention a lifestyle, said Loni Greninger, tribal vice chair at Jamestown.
Last year, Health Care Authority officials and several tribal delegations visited Iceland to see the model for themselves. Sparck said he was skeptical at first — but when he saw the model in person, “jaws were on the floor.” The way Iceland has managed to make its model just a part of daily life, Sparck said, is exactly what he wants to see in Washington.
“I was talking to some of the youth and asking them, ‘What’s it like to be in the world’s most successful prevention model? And they asked us, ‘What’s the Icelandic Prevention Model?’” Sparck said.
Sparck said one of the things he learned about was a large dance party that young people in Iceland helped plan. Students invited one of the well-known DJs in Europe and policed each other, ensuring there were no drugs and alcohol at the event.
“What we saw was empowering the youth to make their decisions together. So they own this, and they’re a part of it and invested in it,” Sparck said.
Putting trust in youth to help create an alcohol and drug-free environment is also a big part of the model, officials said.
“A child wants a healthy environment,” Lewis said. “A child wants to grow up and be healthy. You never hear a child say ‘I want to grow up and be a drug addict.’”
The tribal model
The Icelandic Prevention Model relies on cultural practices within Iceland. Planet Youth works with its partners to translate the model into their own cultures, Guðmundsdóttir said.
While this is the first time Planet Youth has worked with tribal governments, Guðmundsdóttir and tribal leaders said Iceland and Washington’s tribes share a lot of values in common — namely the belief that it takes a community to raise a child.
“You’re literally wrapping your arms around these kids in everything prevention and wellness,” Greninger said about Iceland’s model.
“That’s what we tribes aspire to do,” she said. “But when you are working with separate entities, we all have our own visions and missions and agendas, we’re all busy every single day. It’s hard to line up all of that.”
Planet Youth — and efforts to implement Iceland’s model in other places — are relatively new, and it took Iceland decades to get where it is now. But there’s already research suggesting Iceland’s model is transferable.
“It’s not a quick fix,” Guðmundsdóttir said. “It’s a never-ending story. You will always have new kids, new parents, new kinds of substances.”
“It’s not a one-year project. It’s a long-term way of thinking,” she added.
When Lummi Nation policymakers presented the Iceland Prevention Model to Lewis, he said he recognized it as just another name for what his tribe is already doing, but without the resources they need to implement it at the level Iceland has.
According to Lewis, it’s often difficult to get funding for tribal drug treatment practices because they aren’t always considered evidence-based — and it’s almost impossible to gather enough proof that a tribal practice works because tribal populations are so small.
The Icelandic Prevention Model, to Lewis, proves that what tribes have already been trying to do works when it’s fully resourced. He hopes using Iceland’s model will help raise the funding needed and remove the silos between different efforts in Washington.
“If we’re going to break this cycle, we need to go back to creating healthy environments and get back to the values that bring people together,” Lewis said.
