“Medicine without Walls” an innovative MOUD model developed by the Sisseton-Wahpeton Oyate (Tribe)
Through TOR grants and partial Indian Self-Determination contracting of IHS primary care services, the Sisseton-Wahpeton Oyate started up Asniyapi Field Health Clinic (AFHC) in 2023. Our aim is to provide consistent, evidence-based, and compassionate medication for treatment of opioid use disorder (MOUD) treatment and wrap-around care connection services for our relatives. Besides primary care and recovery support services, TOR at Asniyapi Clinic provides harm reduction (Narcan® kit) training and supplies. The model is “Medicine without Walls” with emphasis on the health status priorities identified in the SWO Tribal Action Plan (where substance use disorders rank #2). Through our work, we have served 128 MAT patients so far. We strive to meet patients where they are at so they will have better access to care when there is a window of opportunity to assist them. This includes going to community settings, such as the jail, workplaces, diabetes center, districts, and homes. In TOR IV we are striving to better integrate mainstream medicine and MOUD/MAT treatment alongside American Society of Addiction Medicine (12-step) psychosocial treatment, indigenous best practices, and help with the underlying/causal factors referred to as social drivers of health.
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