Lesley McClurg [00:02:23] It was pretty unique almost from the moment I stepped out, like got onto the block. This is right off 16th and mission in San Francisco. And then when you walk inside, it’s very clean. It’s very friendly. I mean, it feels like a facility and it feels like a detox center, but it doesn’t have that sort of downtrodden, heavy feeling. There’s Native American art on the wall. There’s a room off to the side, which is like kind of like the recreation room. And there was five men sitting around in a circle with huge drummers in front of them with someone teaching them a Lakota song about survival.
Lesley McClurg [00:03:07] And it was a pulsing kind of powerful chant. I would say. One of them kind of piped out, it feels a little like meditation. It’s like my brain can pause. And I felt that. It just has a very different vibe than any addiction treatment center I’ve ever been into.
Cecilia Lei [00:03:31] And you spoke to a few folks who have benefitted from services offered by the Friendship House. Tell me, who did you meet there and what did they share with you?
Lesley McClurg [00:03:40] I talked to a couple of different clients. One in particular was named Emery Tahy.
Emery Tahy [00:03:44] I am a member of the Navajo Nation, and I work here at the Friendship House as a house manager.
Lesley McClurg [00:03:51] He had a really compelling story. He grew up in Arizona in the Four Corners area on the Navajo Nation.
Emery Tahy [00:03:59] I come from a household where alcohol use was normal.
Lesley McClurg [00:04:03] He had a really hard life of alcoholism and, you know, had his first sip of alcohol when he was four years old, living in a one bedroom I think he said house on the Navajo Nation, very poor. I think there was 7 or 8 children. So a lot of people in this very small space, they didn’t have running water, didn’t have electricity.
Emery Tahy [00:04:24] We definitely lived in poverty. And it’s still that way there in the communities. And alcohol and drugs run rampant through those those communities.
Lesley McClurg [00:04:36] He used alcohol and drugs to numb some parts of him that were really pained by his experience in the world. He experienced a lot of racism, a lot of prejudice, trying to, you know, live on the reservation and also integrate into mainstream population in Arizona.
Emery Tahy [00:04:58] Coming from an impoverished community, coming from a tribe that experiences a lot of trauma, I felt like that’s how I was self-medicating.
Lesley McClurg [00:05:08] But simultaneously he did speak also about a really rich cultural upbringing. And those were sort of two parallel tracks that he experienced growing up.
Emery Tahy [00:05:17] We would burn cedar, we would smoke mountain tobacco, and we would have ceremonies done seasonally to kind of keep the family together and keep the family in balance.
Lesley McClurg [00:05:29] But unfortunately, alcoholism got the best of him and he ended up basically destroying his life on the streets in Phoenix and on the brink of suicide before he landed, eventually at the Friendship House.
Cecilia Lei [00:05:46] And what kind of treatment did he received there? Walk me through what a traditional healing practice would look like there.
Lesley McClurg [00:05:54] Yeah. So he said he was in a detox center in Phoenix in a hospital. And his brother told him about the Friendship House, and he said it felt different from that first phone call.
Emery Tahy [00:06:04] What I can remember from that phone call was promising because I heard a really friendly voice on the other end and the flute music in the back. And and from that first experience, you know, I knew I made the right choice.
Lesley McClurg [00:06:21] And so he arrived. There was a drum circle going on. And so he immediately heard music that he had grown up with that he hadn’t heard for years. He met people who spoke to him in Navajo, his native tongue. And so he was incorporated and I think more open than he had ever been and more hopeful than he had ever been is how he speaks to it from the get go.
[00:06:43] And then incorporated into the treatment, there’s the traditional protocols in the sense that you’re meeting with a psychologist and you’re getting counseling, you’re doing detox therapy. You may even have medication assisted therapy, which would all be offered at a traditional treatment center. But what’s different about the Friendship House is that there’s also the opportunity to engage in traditional practices. So smudging, dancing, drumming, sweat lodges, all of these are part of the curriculum, basically.
Cecilia Lei [00:07:18] So it sounds like encountering sort of familiar practices from his culture. Did it perhaps give him, you know, more motivation to really follow through this treatment?
Lesley McClurg [00:07:29] I would say so. What he said and what he talks about very eloquently is that that really connected him back to a sense of meaning and connected him back to his deep traditional roots and gave him the inspiration to to change his life.
Emery Tahy [00:07:46] Connection to culture and connection to community is the cure to a lot of the health disparities that we experience. And I could I could attest to that today.
Lesley McClurg [00:07:57] It’s not just about getting sober. It’s not just about getting, you know, the opportunity to talk about your issues, which, you know, counseling does, but it’s connecting to something that’s meaningful. And I think that’s a really key part of addiction therapy that is not always offered. And this is a way for the Native American population to have that key, to find the resilience, to find the will to to change one’s life.
Cecilia Lei [00:08:30] And as your reporting highlights, Medi-Cal will now cover these kinds of practices. Tell me what’s included and how does this all work?
Lesley McClurg [00:08:38] Yeah. It’s a two year pilot program that could be extended. There will be two different kinds of practitioners that will be able to receive reimbursement from medical either traditional healers, folks who teach dancing, smudging, sweat lodges, who are part of the Native American community in some way. Or you can receive psychological support from leaders within the Native American communities who maybe a client may see that person as more trustworthy. And so those two types of of practitioners qualify for for reimbursement.
Cecilia Lei [00:09:19] Why is this happening now and what is motivating the state to finally cover health care in this way?
Lesley McClurg [00:09:26] The Native American population, unfortunately, has some of the highest addiction and overdose rates in the country. So this is a population that has been hit really hard by alcoholism and substance use disorders. And so I think especially with the fentanyl crisis just escalating, that this is a moment that the state is willing to try anything. And there is not a ton of research, but the research that does exist shows that using traditional healing practices is a powerful way to help the Native American community.
Damian Chase-Begay [00:09:57] What California is now covering under Medi-Cal is exactly what our native communities have been asking to be covered for years.
Lesley McClurg [00:10:08] I talked to a man named Damien Chase Begay. He used to work in Oakland at one of the Indian health centers and now is a researcher at the University of Montana.
Damian Chase-Begay [00:10:17] This kind of support, had it been in place, could have helped stop some intergenerational trauma and substance use years ago. I’m so thrilled that it’s in place now, but it’s long overdue.
Lesley McClurg [00:10:31] One thing that’s important to remember is that a lot of Native Americans are no longer living on reservations where they may qualify for Indian health services or may have more access to traditional healers. A lot of Native Americans are living in cities. And so I think this moment is important to think about. How do you ensure that this population, who may be living in Oakland and has a local clinic as their primary health provider, you know, that that clinic may be able to use this funding to offer traditional healing to this population.
Damian Chase-Begay [00:11:00] So we want to see our MDS are NPS or is working side by side with our traditional practitioners because our community is using both.
Cecilia Lei [00:11:12] You mentioned earlier that there is limited research and evidence to show how traditional practices can be more effective than a clinical approach for some communities. But speaking about this moment, do you think this could potentially spur more research and study about these kinds of practices in health care?
Lesley McClurg [00:11:30] I think absolutely there is a lot of hope that this will lead to increased funding. That is something that Damien Chase Begay has really been excited about, but also frustrated.
Damian Chase-Begay [00:11:42] Indigenous communities have had generations of practice based evidence on the effectiveness of these approaches, and Western research is finally catching up.
Lesley McClurg [00:11:52] Thus far, although the qualitative evidence is quite solid, there hasn’t been a lot of quantitative evidence and that really is a result of a lack of funding.
Cecilia Lei [00:12:02] Lesley, we all know that drug addiction is such a prevalent and visible problem in San Francisco. Do you think other communities could benefit from this medical expansion?
Lesley McClurg [00:12:12] I think it absolutely could. I think there’s a lot of promise that connecting people and focusing on a more holistic approach to treatment could really turn things for folks. The Friendship House is a really solid example of this. We have an incredible center here in San Francisco that has a long history of doing really good work. Hopefully more centers like this or even one offs at, you know, various clinics where practitioners may work will happen as a result of this Medi-Cal funding.
Cecilia Lei [00:12:47] What do you think that sort of reveals about the gaps that these kinds of practices could fill in current drug treatment strategies?
Lesley McClurg [00:12:59] I think it reveals that we can’t just take a clinical approach to this disease. People are often taking drugs and alcohol or abusing drugs and alcohol because they’re deeply conflicted and struggling with life. And if we don’t address that part of their humanity and potentially these, you know, traditional healing practices are away, like who doesn’t love to sing and dance? Who doesn’t feel better after sitting in a sweat lodge and singing with people? That’s a that’s an incredibly cleansing and enlivening experience and adding that to our medical repertoire. You know, it makes intuitive sense and hopefully the science will continue to back that up.
Cecilia Lei [00:13:46] You mentioned Emery Tahy at the start of our conversation. I wonder how is he doing today after receiving treatment from the Friendship House?
Lesley McClurg [00:13:54] Oh my god, his story is such a success when he has turned his life around completely.
Emery Tahy [00:14:00] I’ve been sober for three years, so very, very, very healthy today.
Lesley McClurg [00:14:05] He volunteers at the Friendship House. He works full time for the Indian Health Center.
Emery Tahy [00:14:10] I feel, you know, healthy in my mind, my heart, my body, emotionally, I feel connected.
Lesley McClurg [00:14:18] He’s almost finished a master’s. He plans on going on to get his Ph.D. and he’s run the San Francisco Marathon. My gosh. And he works out almost every day. So the guy is doing really well. He’s doing way better than I’m doing. I mean, he really is an exemplary example of someone who’s turned his life around.
