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Up and down the remote waters of the Klamath River, in the far reaches of Northern California, dual afflictions have flung dozens of Indian tribal settlements into crisis. The Klamath is sick, and so are many members of the Yurok, Hoopa and Karuk Indian tribes that live alongside one another on its banks.

An epidemic of heroin addiction has gripped the region in recent years, at the same time that ecological strain has led to a sharp decline of salmon in the river’s waters, threatening the tribes’ subsistence and commercial fishing.

Together, the crises represent a devastating affront to the traditional way of life on the Klamath.

“The river is the lifeblood of our community. It’s no coincidence to me that this opioid problem and the river crisis are happening at the same time,” said Amy Cordalis, the Yurok tribe’s general counsel. “When that resource is gone, it leads to a sense of despair.”

Last year the tribe had to cancel commercial and subsistence fishing altogether because there were virtually no fish to catch. Four out-of-date dams upstream have led to residual ecological strain downstream, and now the solution tribal members hope for — their removal — awaits approval by an obscure federal government agency. The tribes, environmentalists and others hope the dams can be removed to address the ecological and cultural crises at once.