Smith told lawmakers that part of the problem is a lack of access to preventive and treatment programs.

Barnard said the passage of the HELP Act, which expanded Medicaid in Montana, has increased access to treatment, but the state still struggles to connect people with the care they need. Many Montanans don’t seek out treatment because of stigma associated with it she said.

Kirk knows that struggles of accessing treatment first-hand.

“After-care is nonexistent on the reservation,” Kirk said, adding that without sober living programs, people who finish treatment are moving right back into the situations they were in when they started using drugs.

Kirk runs a peer-mentor program that has been successful; of 20 who have come in for treatment, two have not relapsed after a year, two more have not after six months, another two have lowered their relapse rate and six more are still in the program.

One of the problems Kirk, as well as other providers across the state, face is a challenge to find ways to pay for services. Peer treatment is not billable under Medicaid, but Senate Bill 62, which passed the Senate and is on its way to the House floor would change that, Kirk said.

“Right now we’re running off seed money from the tribe,” Kirk said.

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