STEVE INSKEEP, HOST:
Statistics don't really show the human cost of opioid addiction in this country. What does show that is the effect on one community, one family, one 9-year-old girl who our colleague Brian Mann met in the Cherokee Nation in Oklahoma.
BRIAN MANN, BYLINE: Late afternoon, Mazzy Walker shows me around her family's farm near Tahlequah, Okla., capital of the Cherokee Nation.
MAZZY WALKER: Cows are walking. Turkeys, a dog (laughter). - I don't know what.
MANN: Mazzy is 9. Walking through the grass, she wears a flowing red dress, huge eyeglasses and big boots. She is curious about everything.
This is...
MAZZY: So I heard you live in New York.
MANN: I do. I live in New York.
She tells me she really wants to see New York. And her dad, Gary, speaks up.
GARY WALKER: Tell him why you want to go there, Mazzy.
MAZZY: Because there's an American Girl doll store.
MANN: She loves American Girl dolls. Mazzy and her 6-year-old brother, Ransom, are both Cherokee. So is Gary, their dad. The reason I've come to visit - the kids are adopted. Their biological parents got caught up in pain pills, heroin and fentanyl. Gary and his wife Cassie are part of a network of Cherokee families who've stepped up in response to the opioid crisis.
CASSIE WALKER: All of the children we have adopted or fostered has been because of that.
MANN: Mazzy was a baby when she was adopted. I asked what she thinks about what happened to her first family, her biological mom and dad.
MAZZY: I don't know. I never got to meet them.
MANN: This is part of the opioid-fentanyl crisis that doesn't get talked about much. Fentanyl is now a leading cause of death for Americans under the age of 40. But even when people survive, addiction is breaking up families as far more parents lose custody of their kids. The Cherokee Nation's principal chief, Chuck Hoskin, says the drug crisis here is so intense it threatens efforts to strengthen his people's way of life.
CHUCK HOSKIN: That's such an important mission for the Cherokee Nation, our language and culture. And yet this drug problem is really hampering it.
MANN: Chief Hoskin says so many Cherokee families are being disrupted, a lot of children wind up being fostered or adopted outside the tribal culture.
HOSKIN: Families not only being broken up but children being removed from tribal lands - this is an additional pressure. And so anything we can do to keep families whole means we can keep our children.
MANN: Public health experts say it's not surprising Native American families are so vulnerable. Across the U.S., many tribes, like the Cherokee, faced generational trauma, including genocide and forced relocation. Government boarding schools tore families apart. Economic policies drove tribes into grinding poverty. Joseph Gone is a member of the Aaniiih-Gros Ventre tribal nation and a public health researcher at Harvard University.
JOSEPH GONE: This has wrought incredible devastation on our traditional ways of life at key junctures in history, and one thing we see around the world is when someone's society collapses is a turn to substances of abuse.
MANN: Beginning in the 1990s, drug companies flooded many Native American towns with prescription pain pills. There were pill mills here in Tahlequah - big profits being made as more and more Cherokee got addicted. Much of the public awareness during America's opioid crisis focused on rural white towns. But Gone says Native communities suffered even higher rates of opioid addiction, overdose death and suicide.
GONE: Deaths of despair were actually worse for a longer period of time, and so that probably should have been acknowledged much earlier and for much longer for American Indian people.
MANN: Gary Walker experienced this wave of addiction and despair up close, as he and Cassie took in a total of nine Cherokee kids.
G WALKER: Being in foster care and going to court cases - and sometimes I would sit there for four to five or six hours. And I would not only watch one court case, but I would watch 30 or 40 at the same time. And it really hit me then just how big the problem was.
MANN: All the kids they've taken in, including Mazzy and Ransom, were exposed to drugs in the womb.
G WALKER: Some of them were definitely opioid. They showed up on the tests. One of them was 14 different drugs, and I didn't even know 14 different drugs existed at the time. It's just really heartbreaking.
MANN: That's meant health and developmental challenges for Mazzy and Ransom. For Mazzy, it goes without saying - this is all deeply personal. And while we talk, she listens closely.
MAZZY: Well, I have a question.
MANN: Sure.
MAZZY: How old was I when I, like, learned to, like, talk and stuff?
C WALKER: You were closer to 3.
MANN: Cassie, the kid's adoptive mom, says it's hard explaining to Mazzy and Ransom what's happened here.
C WALKER: We always remind them that God gave them to us very special and that their parents were sick. (Crying) And so we were able to raise them. There is mothers out there that did lose their child, and I was able to become their mother. So it's just a lot of emotions.
MANN: Now, here's something important. As I talk to Cherokee families about this crisis, they say bluntly, yes, fentanyl and other kinds of substance abuse are hitting really hard. But they also say there is hope and a lot of hard work being done to make things better. Joseph Gone, the researcher at Harvard, says Native communities across the U.S. are doing really innovative things to help their people heal.
GONE: Our peoples are still around and are growing and are charting better futures. We need to recognize that people's resilience carries through.
MANN: The Cherokee Nation just launched a $100-million public health effort focused on addiction treatment and recovery. Principal Chief Chuck Hoskin says a big part of that new investment will help young parents get health care for addiction before fentanyl breaks their families apart.
HOSKIN: The Cherokee people want to take care of the Cherokee people. We want to take care of each other. So I think that's valuable when you're talking about an area of medicine that does involve traditional Western medicine but also involves some element of our culture.
MANN: Back on his farm, Gary Walker watches as his kids play out in the field. He says he is hopeful about this new campaign.
G WALKER: I think it will help. I'm proud of our tribe.
MANN: He says with the Cherokee Nation's support, Mazzy and Ransom are doing really well.
G WALKER: They are thriving with treatment and help from the tribe and the state and different places. We went through therapies. And they are currently thriving.
MANN: Mazzy's in the third grade now, actually reading ahead of level, and she tells me one thing at school is making her really happy.
MAZZY: Friends.
MANN: You have good friends?
MAZZY: Yes. And playtime.
MANN: Mazzy has lost a lot in this opioid epidemic. But she has a family again, and she and her brother are healing. People here tell me they believe this kind of hope and resilience are possible for their whole community.
Brian Mann, NPR News, Tahlequah, Okla. Transcript provided by NPR, Copyright NPR.
