Sen. Udall On Health Crisis in Drunk Town, USA

U.S. Sen. Tom Udall, D-N.M., is calling for commitment from “every level of government” to help address the public health crisis facing Gallup, N.M.
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Two dozen Natives have died on the streets of Gallup, New Mexico, in the last two years. Although the cause of death ranges from hypothermia to intoxication, all are being called “alcohol-related exposure deaths.”

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Gallup’s only detox center, Na'nizhoozhi Center Inc., has served a mostly Native population since it opened in 1992, but it is chronically underfunded and faces possible closure before next winter.

U.S. Sen. Tom Udall, D-N.M., is calling for commitment from “every level of government” to help address this public health crisis. A member of the Senate Indian Affairs Committee, Udall twice it the last two months testified about substandard care at Indian Health Service facilities and called on IHS officials to address the struggling Na'nizhoozhi Center.

Here, Udall responds to questions from Indian Country Today Media Network:

You have called the situation in Gallup a public health crisis, suggesting that it’s more than just a small isolated segment of the population. Can you elaborate?

The issues facing NCI are complex, but one thing is clear: Gallup desperately needs a strong detox center. A critical health center like NCI must remain open for the good of the patients it serves and the community, and NCI’s struggles are just one example of the chronic alcohol and drug abuse that plagues our tribal communities. We need to end this cycle.

We must tackle the long-term problems that lead to alcoholism, but we can’t focus on the bigger picture without a strong crisis center. Lives are at stake every day. If funding dries up, people are going to die. That’s what makes this a public health crisis, and it’s one that we can come together to end.

Why is the detox center chronically underfunded?

NCI has historically been supported by a combination of state, local and federal funds, and support from the Navajo Nation. The Navajo Nation managed the facility until last fall, when the tribe terminated its Memorandum of Understanding with the city of Gallup (over alleged mismanagement and concerns about liability). Without funding from the Navajo Nation, the center’s future has been uncertain.

We’ve been able to secure emergency funding to keep NCI open through the winter. Federal funding is part of the solution, but we all need to work together to combat this crisis. This is still in a very precarious situation, but keeping the facility open isn’t the full solution. When a person is an alcoholic, it takes a lot more than an overnight stay in a facility.

Photo by Alysa Landry

Gallup’s only detox center, Na'nizhoozhi Center Inc., serves 24,000 people per year.

Is this a problem for IHS to handle?

NCI is not an Indian Health Service facility, but about 98 percent of its clients are Native. It is the only detox facility serving the rural community adjacent to the Navajo Nation and Zuni Pueblo.

Chronic, severe underfunding prevents IHS from providing quality care for patients in New Mexico and nationwide. Spending per patient lags far behind the national average. In 2014, the average spending per capita on patient health services was just $3,107. That’s compared to $8,097 nationally.

Even with funding for the detox center, Gallup is still looking at a revolving door of minimal behavioral health services. What’s the real solution here?

The detox center saves lives by keeping folks off the street and giving them a safe place to sober up, but I agree we need a more comprehensive solution. There are real, longstanding problems that lead to alcoholism and drug abuse. This is a crisis. Families are being torn apart.

We need to do everything we can to support prevention. Growing the economy in our rural communities is a big part of that, and ensuring everyone who wants treatment can get it so we can end this vicious cycle of abuse. We should build capacity for quality, accessible behavioral health services in the area. Like many other rural areas in our state, there are not enough programs or medical professionals to address the grave need.

But we can’t make progress unless everyone comes together and brings all they can do the table. That means the federal government, but it also means the state investing in behavioral health and our tribes stepping up to the plate. It will take time, but there’s nothing more important for the wellbeing of our families.

Gallup officials are not optimistic that real help is on the way. Are you?

Right now we’re nearing the bottom and the short-term solution is really very simple: get NCI the funding it needs to keep its doors open. Long-term, we need to tackle the bigger issues contributing to alcohol and drug abuse in our rural communities. We can fight this crisis, but I can’t say this enough: only if we all come together and commit to working toward a solution.

Underneath all the bureaucracy of government funding and local efforts is a population of Native Americans that is in deep pain. What would you say to those who are struggling?

I would say that no family should have to go through what you’re struggling with. It is terrible to lose family and people we love to drug abuse or alcoholism. We must come together as a larger community and ensure that help is available to anyone who wants it, and we must address the complex reasons people abuse drugs and alcohol in the first place.

I am fighting for resources for both treatment and to help tribal communities offer treatment. I’m also fighting for resources for programs and support to help young people feel that they don’t have to use drugs and alcohol—to help them see a bright future and find good jobs.

It’s frustrating when something as critical as NCI can barely manage to keep its doors open. If NCI can barely operate, how can we tackle the bigger problems that put our community in this situation to begin with? Know that I am fighting for you. We’re on your team.

What are your personal impressions of Gallup and its problem with substance abuse?

I’ve been in Gallup many times over the years. I have seen the hopelessness. I have seen people lost at night and wandering the streets. This is not a good situation, and these people need a place to go. In a community like Gallup, 25 deaths have a ripple effect. These are 25 mothers and fathers, children who’ve lost their parents. This needs to be a priority at every level of government.