Great Work: Cook Inlet Tribal Council

0:00:13 Andrew Williams
Welcome to Let's Talk Recovery Equity. A series of conversations about how we can reach and help more people find freedom from addiction. This is a space for us to reflect on the complexities of substance use and mental health issues and to consider new pathways to hope, recovery, and healing. I'm your host, Andrew Williams. Director of Diversity, Equity, and Inclusion for the Hazelden Betty Ford Foundation. And today, I'm excited to be able to introduce you to our guest, Daisey Vanslyke. The Recovery Services Clinical Manager for the Cook Inlet Tribal Council in Alaska. Hello, Daisy! Thank you so much for joining us today.

0:00:52 Daisey Vanslyke
Hi, Andrew! I'm honored to be here.

0:00:56 Andrew Williams
All right. Well I'm really looking forward to our conversation today. And I often begin our conversations by giving our listeners and viewers a chance to get to know you just as a person before we move into some of your professional work. And deepening our understanding of the issues impacting the communities that you work with. [Daisy nods] You know, one of the favorite sort of exercises or intercultural exercises I've done with students in the past and community members is an exercise from Beverly Tatum, an African-American Psychologist. And her exercise is called 'I Am From.' And it kind of gives us an opportunity to create a four-stanza poem. It starts with the phrase 'I Am From.' And the first stanza of the poem of 'I Am From' asks participant to respond to that prompt by describing the sights, the sounds, and the smells of the community they grew up in or in this case, if you'd like to talk about the community in which you work, that would be fine as well. So please, tell us a little bit about where you're from and where you do your work.

0:01:54 Daisey Vanslyke
I am from Shawnee, Oklahoma. I'm a member of Cherokee Nation. It's funny because I can still remember it like yesterday the thing about Oklahoma is it's very much just prairie land. The dustbowls and all of those pieces. That's one of the reasons I've been up here. I was a military spouse. That led me up to Alaska. And I fell in love with Alaska, I've been here for thirteen years now. A lot of it is the same in regards to cultural values. But here I'm surrounded by mountains. So, I came from flat to mountains. So, I'm a country girl at heart and always will be. [chuckles] I just like to stay in desolate areas. Is my preference. [smiles]

0:02:39 Andrew Williams
Well thank you, Daisy, for giving us a little bit of a window, you know, into the cultural communities, kind of the geography that was part of your lived experiences. I wanna move into talking some about your role as a Clinical Manager for the Cook Inlet Tribal Council. Please share with our listeners and viewers, you know, what inspired you to pursue this role and what's your source of strength in doing this work.

0:03:06 Daisey Vanslyke
So I am a person in long-term recovery. So, it's one of those pieces about your recovery you get to a certain point and quite honestly, every single day I wake up and live my Twelfth Step. I'm using the knowledge, the experiences that I've had in my life to help others. I've been in the Behavioral Health field for about 20 years. I've worked with individuals in a lot of different populations. I decided a few years ago to come work for the Tribal Council. They were actually wanting more tribal leadership. And because I represent Cherokee Nation, I was able to fill that. It's been very interesting 'cause the Alaskan Native culture is—some of it is different and some of it is the same. So, it was me being able to use my voice on a larger platform and really make a lot of the services that we offer here for Recovery Services more culturally appropriate. I as a person that went through a lot of these pieces. Western medicine wasn't always the solid answer. There's a lot of different components that come in when you come from a Native culture. And it's very important for us to be able to build a recovery for somebody for them to be long-standing. We have to take all of those elements into account. So I wanted us to go really from a band-aided treatment to a lifelong preservation treatment.

0:04:32 Andrew Williams
Okay well thank you Daisy for giving us a sense of your pathway to your current role and I think also what you offered us is a really nice preface to the rest of our conversation. In which you remind us that although there are some maybe common cultural continuities across Native cultures that we begin to kind of look at addressing in effective ways the particular needs of Native communities. We really need to have a much more culturally specific and culturally attentive approach. [Daisy nods] I want to ask you some just about the scope and magnitude, you know, of substance use disorder, you know, within the region you currently work in. You know, here in Minnesota, we're seeing huge and growing disparities. Especially in terms of opioid overdose deaths. In our communities here, African-Americans like myself are five times more likely to die from overdose deaths than whites. And that rate is seven times higher for members of our Native American tribal nations. [Daisy nods] Do we see similar patterns in Alaska where you work?

0:05:33 Daisey Vanslyke
Yes. We actually had startling statistics from the last few years with COVID. Unfortunately Alaska is a port state which means even throughout COVID, our ports did not shut down, right? We still needed to have vital resources and a lot of our cartel and things like that took advantage of that situation. So, we increased Fentanyl use 800 percent in a matter of twelve months in the state of Alaska. So, we've had a lot of—a lot more Fentanyl use, a lot of ODs. We have certain regions that have more opioids. It's actually kind of interesting 'cause here in Anchorage and the municipality of Anchorage, alcohol use disorder is still our primary. But if you got to the more desolate regions in the villages, it is more opiate use disorder. Including Fentanyl. We lost somebody even to Fentanyl-laced Medication Assisted Treatment. So, I don't know that I would trust anything. So we're kind of a melting pot, a lot of people don't really understand Alaska in the sense that we have really large military bases. So, we also have a lot of military here. We have a lot of military and then we have a lot of villages, which is a lot of the Alaskan Native culture. So culturally specific yes, I would say Alaskan Natives represent still the largest part, but they also represent the largest part of our population as a whole. Primarily for them I would say it is still alcohol use disorder. It is our younger population unfortunately, I would say 18 to 25, that have really picked up on the heroin use and the Fentanyl use. And I—the frequent one that I hear from people often is that they're actually IV using heroin and meth together to offset each other. Which can be fatal any given moment.

0:07:34 Andrew Williams
Now Daisy, thank you, thank you for that response. Which I really think helps us to really grapple with, you know, the complexities of substance use disorder in that region. And I really like how you push us to think about the many layers that we need to understand. Including geography. And what it means to be a port state. And I appreciate the ways in which you kinda help us to parse out the impact, depending on where one is geographically, closer to the coast or further inland. And the different expressions or texture, right, of substance use disorder. Whether it be alcohol or opioids as well. I think you know kind of underneath our conversation already, you know, has been some hint as to what a culturally specific, culturally attentive approach might look like. And the necessity of that in trying to offer greater hope and healing. And I'm wondering if you could speak with our listeners and viewers and tell us a little bit more about your approach to treatment and recovery. In the communities that you serve.

0:08:35 Daisey Vanslyke
Absolutely. This is my passion. [smiles] This is what I do lots of presentations on. And it's primarily the Native model of wellness. We have four sectors. Mind, body, spirit, and context. And the thing about Native culture sorry I'll use my hands, try not to, but all things have to be in harmony together. Otherwise it's gonna fall apart. So, if you think about Alaska villages here, we have a lot of Native villages. A lot of the support and the resources that the individuals are gonna find are within their village themselves. There's a lot of government resources that don't quite make it there. Or they're dropped by very desolate plane and things like that. When you think about recovery services and all the resources that may be available in any type of municipality, that is not always the case. It's also very similar to places like Oklahoma and Wyoming and Montana. We all have these desolate areas. And so it's very important to engrain it in the person and not actually have them reliant on the environment around them. Otherwise we have to kind of bring them into more populated areas for them to have that consistency. And that's not what we wanna do. We want to be able to help them within their own culture. So, we bring it in.

0:09:57 Daisey Vanslyke
A really good example--I implemented it about a year ago and it's been going really well. I'm glad that you brought that up about the different cultures, different tribes have different beliefs, things like that. We have a lot of different stereotypes. But one thing that is pretty standard and symbolic is the Native culture that we like to do storytelling, right? We don't necessarily like to just answer this question, you know, A, B, C, D. You're gonna have to take a minute. You're gonna have to take a minute and sit down and really learn the person that you're in front of. So, for relapse prevention plans, a lot of relapse prevention plans just across the states in general, are kind of a black-and-white homework assignment, right? Where you're just answering these questions. Are they ever gonna look at that relapse prevention plan when they're done with their treatment? And a lot of times the statistic that you're gonna hear is no. [shakes head] IF it's in a paper form, it was just an assignment that they did. Just like they just checked a box. And we all know that's just going to band-aid a situation; that's not gonna be long-term. Versus if I do it in a story mode, and like an interview right now with you, Andrew. In this way, asking well what do your sober supports look like? Right? Like, what are your replacement cultures. And giving it the space for them to tell their story. What it kind of does is it allows them to be vulnerable, right? Which is also not a statistical norm for any Native culture, to be honest. For a long time the voices were silenced. So it's really giving them back their platform and their voice. To be able to say, 'This is what this looks like to me.'

0:11:40 Daisey Vanslyke
So then we can then take that information, which may not be like mine and yours, would be very different. Right? So every single person that's gonna sit in front of me, their relapse prevention plan's gonna be very different. Because their community is different. Their family's different. So, really being able to do it. And so what they do now is they deliver their relapse prevention plan to their peers in group in a story mode. They get to tell their story. Not just well A, B, C, D. So, it's just coming to those. I have a lot of non-Native providers that come to me and ask how do I build rapport and respect with somebody that's Native and I'm non-Native. And it's just at the end of the day, you have to sit and listen. Sit and listen and most likely you're gonna get a story. You have to also be prepared for the story that you're going to hear. Because you're gonna hear a lot of hurt. Here in Alaska we're still dealing with a lot of intergenerational trauma. A lot of the elders that we have right now were those of ones that were sent off to boarding schools. And their names were changed and their cultures were stripped from them. So, understanding what recovery means to a person. Like why are—why do you think you're here? What would recovery look like for you? And really going about it in that way.

0:13:06 Daisey Vanslyke
I'll soapbox that innocence to I've worked with a lot of youth in residential as well, and it's very similar. As much as we can talk about indigenous culture, and that is my passion, I've also worked with a lot of gang-related youth. And I know that that impacts a lot of the United States. It's the same thing. I can't have a youth come to me and my first instinct for this child is to be 'I need to remove you from that gang community for you to have a healthy life.' That gang is their family. Right? So, it's about helping them succeed in whatever environment they're in. And not necessarily molding them into whatever environment we think that they should be in.

0:13:47 Andrew Williams
Thank you so much for deepening our understanding of the complexities of recovery. And you know, we often talk and it's great that we've gotten to a point as a field where we're actually talking about culturally attentive care. But what I appreciate about what you've done is you've given us a sense of what that looks like, what it feels like, what it sounds like when we're doing it, right? And this need to kind of move beyond, you know, we can even talk about a singular tribal culture but what you kinda push us to grapple with is we need to think about where that person is situated within the complexity of that culture. And they could vary depending on if they're an elder or they're a young person. Whether or not they're in a gang or just, you know, living a traditional lifestyle. And so, really appreciate that kind of—the complexity you're forcing us, pushing us, to consider. As we work to—as we look to work in solidarity with leaders like you. And I also really appreciate your kind of point around the significance of storytelling. Maybe like you have been impacted by the work of Adrienne Maree Brown and her book Emergent Strategy. [Daisy nods, smiles] She talks about the need to move at the speed of trust. When we're kind of doing community organizing. And I think in some ways what you speak to around the need to be patient, to be able to listen to stories, really kind of you know is similar and analogous to that point that we need to move at the speed of trust. Right? Which also means moving at the speed of deep listening. Right? Listening so we're able to be willing to have our world turned upside down. And I just really appreciate again lastly the significance of storytelling. As part of the healing work that has to be done. And I really think as we think about our work as an organization at the Hazelden Betty Ford Foundation, that I believe that an important part of our work to advance diversity, equity, and inclusion involves storytelling as well. And we're gonna move toward deeper reckoning and repair as we come together. To share our stories with each other. But like you say, we have to be prepared for what we're gonna hear there as well. [Daisy nods, smiles]

0:15:42 Andrew Williams
Now in your answer, you spoke some about sober support. I'm wondering if you could maybe kind of unpack that a little bit more for us and tell us what sort of sober support groups are being offered in your communities.

0:15:54 Daisey Vanslyke
So we actually have quite a few. That within ours, ours is probably the most culturally diverse. We've added a lot of cultural pieces to our sober supports. Like we have a lot of AA, we have a lot of NA which I highly believe in, too. We have a lot of churches in our region that have religious-based recovery programs. For us specifically, the differences for ours is that we use the Road to Wellbriety which really encompasses the Native model of wellness in regards to recovery. But also it's just the pieces that we have a cultural room. So somebody can come in that's in absolute crisis and they can just sit in our cultural room with our peer support and bead. Or, you know, read or do whatever they need to do in that space. Because we don't also wanna have somebody just come in in crisis mode and automatically try to assess that person that's not really clinically appropriate either. So, the biggest part is peer support. That's the peer support movement. So they kinda go hand in hand. I love that a peer support can hold somebody you know they're holding somebody's hand. Somebody's walking in the room and maybe they don't need an assessment today, maybe they need to go directly to an AA meeting. So having that ability to have somebody walk alongside them while they do it. anybody that's in recovery along with myself, right, one of the most scary parts about recovery is telling your story. And being able to get up and stand up in one of those meetings and truly be vulnerable.

0:17:28 Daisey Vanslyke
So we offer those. We actually offer a lot within our agency--we have daily peer support and sober support meetings within our building. We have coffee in the morning, we have Warrior Down, and then we have the Road to Wellbriety. But we have like I said a lot of the—we have a lot of AA meetings in the region. The biggest part that you're gonna hear—like I can give you the Anchorage-based, but I think a lot of what people want to know is these villages, a lot of the villages that we have, don't have these resources available. So what we will tend to do is if somebody is coming in from a desolate village to complete like court-ordered treatment or what not, we will help them get all the resources. To start an NA meeting. To start an AA meeting within their community. Like, let 'em take it home. And both are really good about giving the resources and all of those pieces, how do we get this out there, how do we build up more supports? 'Cause storytelling has been around for as long as we can remember. It's interesting to me the peer support movement. I hear it a lot that it's a newer movement and it's not. For the Native culture. It's actually not for all cultures but specifically for Native culture because that's what our elders have been doing in forever. Right? We've always been listening to their stories. They've always shared their experiences to help us through ours.

0:18:51 Daisey Vanslyke
It's just our next generation to pick that up and be able to help everybody else that's going through theirs. There's really hard times to be had and we know this after having walked this walk. So, it's more about we have a ton—ton of opportunities. We do a lot of family barbecues. We just did a bowling event last week. We get a lot of outreach. We work a lot with the homeless shelters as well. And I don't—I'm not sure everybody in other states know—Alaska's really, really got a high prevalence of the homeless population. And with as cold as it gets here in the wintertime and things like that, we have to wrap around it as a community. And a lot of that is substance use-driven. So, we're out on the streets. We're out on the streets sitting with people. Trying to get them in that next step to get ready toward wanting change. And wanting to know what healthy is. We're out there exhibiting what healthy can look like. On the other side of the work is complete. And just showing 'em that they're worth it. That you're worth a fight. Just sitting with somebody, a lot of individuals if you go out and you sit with our homeless population, it's just like what's the point? I'm like, 'There's a whole lot of point. You have a whole lot of life left to live. And I wanna help you figure out how to live that in the most successful way possible.'

0:20:14 Andrew Williams
Well thank you, Daisy, for you know helping us more fully understand the great diversity of sober supports your council offers. And particularly for kind of highlighting the role of peer support within that. And the way in which it builds upon really, really ancient sort of social and cultural traditions within our communities as well. You know, within your answer, Daisy, I heard you name some of the obstacles, right, to Native peoples actually accessing many of the sort of supports that are actually there. You mentioned geography earlier in your efforts to get out to more rural areas, being willing to go out into the street and meet with homeless individuals. Could you say a little bit more just as we move toward closure as to what are some of the barriers to indigenous people in Alaska seeking these supports, and how else you're going to kind of bridge those gaps?

0:21:09 Daisey Vanslyke
A lot of that is geography. There's a large part of our state that you can't travel by road. You have to go either by boat, by plane, or in the wintertime you have to go by snow machine. So, trying to get individuals—Anchorage is kind of its own, right? We're one of the—us and Fairbanks are the kind of the cities of Alaska. So we're pretty norm--a smaller city in the United States, in the Lower 48. But, the bigger piece is getting it out there. So you have to have a lot of helicoptered-in. A lot of our resources, if somebody ODs out in one of these desolate villages, a huge part of what we're doing is we're really pushing NARCAN. We're pushing NARCAN out to these villages. So that in the event they don't have emergency medical services available, at least we can give 'em a chance. With getting them enough NARCAN, right? To try to save these individuals.

0:22:07 Daisey Vanslyke
It's mostly the biggest—the biggest challenge we have here is geography. And I can tell you we are linked in--actually Betty Ford helped us a lot—link in with Millelith Corporation which does our Northwest region. And it's very desolate up there. And so, we have—we've now linked in with them because they have probably approximately 300 people that they see virtually Telehealth. In these regions. So what we're trying to do is really just push out more technology to these locations. And more towers. So that we can at least deliver Telehealth. And sober supports. And so we've now been linking out with much more of those that live on the Northern tip and things like that. So we're reaching a lot more people. There's still a lot of boots on the ground trying to keep pushing it as far as we can. We'll keep doing it. I'd love to see the lower—there's just places definitely like Oklahoma, Montana, Wyoming, that could also benefit from this. COVID forced Telehealth upon us, right? We had it a little bit but not on the level that we do. But now we know how to rock it, right? So why not push it out to all of those places that don't physically have a clinician onsite? So that's kinda what we're doing.

0:23:19 Andrew Williams
Thank you, Daisy, for discussing that more. Some of the real significant barriers especially geography. And, you know, my background and training is as a Cultural Anthropologist, you know, and at the core of our work is this sort of comparative analysis. And especially someone like myself who's been into Applied Anthropology--how can we use this, the conceptual tools and methodologies to address social issues. I really appreciate the comparative perspective you just brought. That, you know, the rest of our Lower 48, places like Montana and Oklahoma, have important lessons to learn from how you're approaching some of these challenges in Alaska. Unfortunately, our time is all too quickly running out. So I'm gonna ask you one last question. In your role as a professional doing the work that you do but also as someone who's been honest enough to let us know that you're a person in long-term recovery. And this is a question we ask many of our guests. Which is to viewers from Native communities, whether it be in Alaska, Oklahoma, or Montana or Minnesota, who are struggling or navigating addiction or have people within their circle of love who are navigating addiction, what's a message you might have for them today?

0:24:29 Daisey Vanslyke
You are not alone. And it's up to us to keep our culture alive. And we can only do that if we're in a healthy space. So lean on your people to be able to become healthy so that we can continue to keep our culture alive. [smiles, nods]

0:24:44 Andrew Williams
Well again, Daisy, thank you so much for your generosity of spirit and time. And offering us such an informative conversation and window into the healing work that you and others are doing with American Indian Native communities. So again, thank you for your time. [smiles]

0:25:00 Daisey Vanslyke
Thank you very much for having me!

0:25:02 Andrew Williams
And please know we deeply appreciate you and the work that you are doing and we look forward to continuing to work in solidarity with your efforts.

0:25:09 Daisey Vanslyke
Thank you, dear. [smiles]

0:25:11 Andrew Williams
To everyone out there, please let your friends and colleagues know about these important conversations. And come back often and catch more episodes of Let's Talk Recovery Equity. Together, we can build a healthier, happier, more equitable tomorrow. As we work to advance health equity and bring effective, loving care into the reach of all in need. Thank you.