Editor's note: This story is part of Southwest Michigan Second Wave's On the Ground Calhoun County series.

The legacy of alcohol and drug use as a coping mechanism among generations of Native Americans is one that Mariesha Keith does not want to see passed on.

Keith, Tribal Liaison and Indian Preference Coordinator for the Nottawaseppi Huron Band of the Potawatomi, is making it her mission to ensure that future generations of tribal members have healthier ways to cope with the legacy of trauma. 

In June 2019, she organized a Sobriety Walk at the NHBP’s annual Pow Wow. The walk has not happened since then because of COVID, but efforts to highlight the toll alcoholism and substance use take on tribal members are continuing.

“Our Pow Wow and all Pow Wows celebrate sobriety,” Keith says. “I had gone to a Sobriety Walk in Grand Rapids with another tribe and I said we need to bring that to our tribe. We need something to help our people. It helps show unity and that whether you’re the alcoholic, the child of an alcoholic, or the survivor of alcoholic parents, we all know that alcohol plays a huge role in the history of killing us off.”

The walk she organized began and ended on the grounds of the Pow Wow and kicked off the event. The group of more than 10 walked around the Pine Creek Reservation and came back to the site of the Pow Wow where they shared stories about their own personal journeys to become sober. Those who spoke included a tribal elder and Keith’s niece. 

The rates of substance abuse among Native Americans are generally much higher than those of the general U.S. population, according to the American Addiction Centers website.

“Data indicate that Native Americans have the highest rates of alcohol, marijuana, cocaine, inhalant, and hallucinogen use disorders compared to other ethnic groups,” says an article on the AAC website.
 
Members of the AA group at the Pine Creek Reservation use smudging, a Native American a ritual for cleansing.The American Indian and Alaska Native population, alone and in combination, increased from 5.2 million in 2010 to 9.7 million in 2020, a 86.5 percent increase, according to U.S. census data quoted on the website Indian Country Today. This means the American Indian and Alaska Native people represent 2.9 percent of the U.S. population.
 
Although they only make up a portion of 2.9 percent of the total U.S. population, Native Americans experience substance abuse and addiction at much higher rates than other ethnic groups, says an article in the American Journal of Public Health. The median alcohol-attributed death rate for Native Americans (60.6 per 100,000) was twice as high as the rate for any other racial or ethnic group, according to the World Health Organization.

From 2006 to 2010, alcohol-attributed deaths accounted for 11.7 percent of all Native American deaths, more than twice the rates of the general U.S. population. By comparison, about 5.9% of global deaths are attributable to alcohol consumption, a WHO report says.
 
“Now we know even more about the importance of getting sober and changing the course of our history,” Keith says. “Walking sober together through our reservation to pay homage to our descendants who didn’t make it is showing a new way of living to younger generations.”
 
The majority of those descendants were reluctant to discuss issues such as the abuse they suffered when they were put into government or church-run boarding schools, separated from their families. How they were treated at the boarding schools colored the way they viewed themselves as adults and perpetuated intergenerational trauma, says Cameryn Ryan, the NHBP’s Community Health Education Outreach Manager.
 
Ryan, an NHBP tribal member, says this trauma is being addressed by going back to its source, the disruption caused by forced colonization.
 
Coins used by AA members to celebrate milestones in their sobriety.“We’re coming to terms with it and are now able to have more focused efforts because of the resources available,” she says. “Our tribe received federal recognition in 1995 and from that we were able to receive grants and other funding opportunities to put revenues back into our health department and police department. It creates a safety net.”
 
When the Tribe’s FireKeepers Casino officially opened in 2009, it signaled the biggest boost in funding to programs like those managed by Ryan. The NHBP’s Tribal Council also implemented health care coverage for all tribal members about five years ago. 
 
“That’s when things opened up,” says Nichol Bremer, Behavioral Health Manager for the NHBP. “The health plan covers inpatient stays, transitional housing, and outpatient services for all NHBP tribal members.”
 
Funds from the casino also helped cover the cost of building a community center and health center on Pine Creek Reservation in Fulton, home to more than 100 tribal members, and an expansion of the Tribe’s Behavioral Health Services department.
 
Although Behavioral Health Services have been available to tribal members in some form for many years, Bremer says there has been substantial growth since she joined the team in 2016. She has seen the team expand from one manager and two therapists to a team of nine.
 
“We treat a lot of opiate use disorder, but a lot of federal resources were thrown at that,” Bremer says. “We may see almost as much alcohol use disorder where there’s not federal money or grants available. We’ve advocated with other tribes to equalize that. Most people who seek treatment struggle with one or more things. It’s not as simple as someone has mental health issues or struggles with alcohol, so it’s a pretty complicated situation.”
 
Mariesha Keith leads a small group of a AA members at the Pine Creek Reservation.The NHBP doesn’t have an in-patient treatment center, but does offer outpatient services and is in the process of developing a peer support program. Bremer says the expansion of these health and wellness services goes back to the tribe’s commitment to the “Seven Generations,” a core philosophical value of many American Indian and Alaska Native communities.
 
“This value is grounded in the belief that the responsibility and well-being of future generations rests on every generation that comes before them,” according to information on the United American Indian Involvement Inc. website. “If we act and make decisions that have the best interest of the Seventh Generation, our future descendants, then we will engage in behaviors that ensure healthy future generations of American Indians and Alaska Natives.”
 
“Everything the Tribe does is aimed towards the Seven Generations principles,” Bremer says. “We continue to grow to meet the need.”
 
Part of addressing the need is meeting tribal members where they are in their efforts to become sober and maintain recovery. Bremer says this means understanding why they choose alcohol or drugs or both as a way to cope with negative experiences and in many cases historical trauma that was passed down by older generations of their family. 

She uses the term “substance use disorder” rather than substance abuse because “We want to see the whole person as a person,” she says. “People with substance use disorder are our moms and dads and sons and daughters. The diagnosis is not who they are that’s a part of who they are.”
 
Struggling to get sober
 
Keith, 38, began trying to get sober when she was 25. When her father died in May 1999, her journey to becoming a full-blown alcoholic began, she says.
 
“That was when it really heightened. I didn’t really care about anything and that’s when my drinking really started. I was 16 at the time,” she says.
 
Coins used by AA members to celebrate milestones in their sobriety.The poverty, financial hardships, and the historical traumas experienced by her parents, which were passed along to her and her siblings, played a “huge part” in her condition, Keith says.
 
“Everybody was doing it,” Keith says of drinking. “They’d get drunk, share their feelings, and they might get angry and fight, and then they’d recover and start over the next day.”
 
This was the pattern she followed.
 
“When I was drinking I didn’t realize that what I thought was normal wasn’t,” Keith says.“I was drinking at the park while my kids were playing or drinking because I had a hard day at work. There were times when I would leave the park totally wasted with my son in the car and not think twice about it. Alcohol was my go-to and I thought that was normal.”
 
At the age of 25, she began the first of numerous attempts to quit drinking.
 
“I struggled. I tried to quit on my own several times. I would quit then go back to drinking,” Keith says. “I’d stop for several weeks and then have a glass of wine. But my tolerance was so high that one glass wouldn’t be enough and I would drink two or three bottles of wine and wake up with a hangover.”
 
During this time, there were no programs available through the NHBP and she didn’t know about Alcoholics Anonymous. Her journey to recovery was partly motivated by watching an aunt, a recovering alcoholic, deal with health issues.
 
“After my Aunt Cheryl quit drinking she had so many health issues. They gave her five months to live. She gave her life over to the Lord and lived 15 years after that,” Keith says.
 
Up to this point, Keith had dodged a lot of bullets in her own struggles with alcohol. Her luck ran out when she received two DUI’s (Drinking Under the Influence citations) in the same year. She was sentenced to 6.5 months of probation for her first DUI. The second DUI found her in Sobriety Court with a lawyer and legal costs of about $20,000. She graduated successfully from a court-ordered sobriety program in 2014 and says she “hasn’t looked back once.”
 
One of the members of the AA group at the Pine Creek Reservation.But, eight years later, she continues to deal with the consequences of that last DUI. She drives on a restricted license with a blow machine in her car and is still dealing with court fees and legal bills.
 
Her sobriety enabled her to see that she needed to do something to make sure that tribal members had the resources and support she didn’t have to get sober or free of substance disorder issues. In 2015 she started an AA group that meets every Thursday at the Pine Creek Reservation. She and her sister, also a recovering alcoholic, have also visited different AA groups along with their mother, brother, and an aunt, all of whom share their journey to recovery.
 
“I’ve taken my kids to these AA meetings,” Keith says. “The hardest part is to share my story so openly so that people get it. I don’t hold anything back. I don’t regret anything. It did major damage to my family.”
 
Encouragement and Reluctance
 
Keith’s decision to get sober and her determination to make that happen is not the norm among tribal members, many of whom are reluctant to seek help because of the stigma surrounding asking for treatment, Ryan says.
 
“Sometimes it takes them accessing care to get to the root of the problem,” Ryan says. “They’re a victim of their environment and the historical impact of colonization. Even though we’re a Native American tribe, we’re very much influenced by the communities around us. I do feel like there’s an overarching stigma of not wanting to access services because of how it would look. 

“We see the impact of substance use and intergenerational trauma in anything we do. There’s a higher risk of other health impacts. If someone is not seeking out help, they’re at a higher risk for anxiety, depression, and suicide.”

Bremer says, “Typically they come to us on their own. It’s more effective when people come to the realization on their own that they need support or because their parents or loved ones want them to get help. Infrequently, we have folks that are court-mandated and we service these folks too.”

Dave Beatty, a Behavioral Case Manager with the NHBP, works with Bremer and her team to make sure tribal members get the services and resources they need. His position was created four years ago to assist more than 1,500 tribal members throughout the United States.

Beatty has been working in this field for 22 years and has had his own personal experiences with rehab. He helps tribal members access substance abuse services, but the bulk of what he does is to place them in residential substance abuse treatment programs.
 
“I deal with a ton of heroin or meth and alcohol is almost always mixed in there,” Beatty says. “People use alcohol but the primary thing now is opioids.”
 
He takes his victories where he can get them and says that if someone drinks and smokes weed, but doesn’t do heroin anymore he feels like that’s a win.
 
In 2021 he sent 42 people to treatment centers, double the number that he sent in 2020. He says he has had some cases where a person has been sent off multiple times only to back out at the last minute. This is what happened with a woman who was headed to a residential treatment facility in California. He put her on a plane five times and she turned around in Chicago and headed home three out of the five times and once never made it to the airport.
 
“She finally made it there last year,” Beatty says. “If you never knew what recovery was about, it’s not your fault. I sent one woman last year and she really resisted because she thought she was going to a mental health institution and she loved it once she was there.”
 
If it takes 50 tries to get someone the help they need, that’s what Beatty will do, he says.
 
“The point is if you keep trying you’re not dead and you’re not doing a life sentence because you’ve got a life,” he says. “It takes a long time to just see there’s a blue sky. People in addiction don’t know what season it is and there is repeated trauma from their lifestyle. There’s guilt and shame, everybody’s aware they’re going against a value system, but addiction is stronger than that.”
 
Beatty says there’s still a significant stigma surrounding substance abuse and people try to hide or minimize it. Statistically, he says, “Native Americans have a higher rate of alcoholism and substance abuse disorder stuff than others. That rate is 10 to 15 percent higher than African American or Latinx.

“It’s like coming out,” he says of making the decision to seek treatment. “After generations of shame, addiction, and trauma, a lot has changed, but a lot hasn’t.”
 
Seeking treatment for substance use disorders, particularly through inpatient care, is scary, Bremer says, but she is seeing a lot of successes among tribal members who now have access to quality, residential programs.
 
“There’s always a stigma. I would like to say that we see a little bit of improvement in the NHBP community,” she says.  “What we have found in the past year is one family will seek treatment and find success and other family members will see that and come in. We’re hoping that this is helping to dispel preconceived notions.”