Bella, who just turned 14 in September, is struggling with fentanyl addiction. From May to September, Bella overdosed three times, needing reversal with Narcan each time. Although she knows the stakes are high (death) for her to keep using fentanyl, she says “the pull is so hard that I can’t stop myself.” Fentanyl abuse has exploded on the Hoopa Valley Indian Reservation (population 3,393), located in far Northern California. K’ima:w Medical Center (tribal clinic in Hoopa) has flooded the Valley with Narcan. Hoopa Tribal Police say they now attend three to four opioid overdoses a day, and the tribal ambulance service says it is seeing a 53% increase in overdose calls.

A story written by Judith Surber—grandmother to Bella and mother to a number of adult children who are all struggling with fentanyl addiction—follows her life on the Hoopa Valley reservation as manager of the Medical Assisted Treatment Program at K’ima:w. Justin Maxon—a family friend of the Surbers who grew up on the Hoopa Valley reservation, who is also in recovery (18 years) from an opioid-related substance abuse disorder—documents the story with photography and video.

The story was published by The New York Times' Opinion section as an interactive multimedia piece, intertwined with data about fentanyl and the larger systematic failure of treatment available for Native youth across the United States, especially those living on rural reservations where there are limited services for adults and almost none for youth. The work captures everyday life surrounding substance abuse to illustrate a shared humanity, rather than portraying a singular and sensationalized version of complex, politicized issues, issues that have become commonplace in small towns and large cities alike across America.

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