Twice a week, Coleman Cox drives more than an hour into controversy. He's headed to Vinita, Oklahoma, in the northern part of the Cherokee reservation, in a van stocked with clean syringes.
The program is based around harm reduction, a method focused on preventing drug overdoses and the spread of infectious diseases rather than urging abstinence.
In Oklahoma, opioids, often laced with fentanyl, are especially devastating among the Cherokee Nation.
"Across the board, this 7,000-square-mile reservation, no one's immune," said Chuck Hoskin, the tribe's principal chief. "No one sets out to really get addicted to anything, but so many people were using this medicine because it was prescribed to them."
In 2022, more than 100,000 Americans died of an overdose, according to the CDC. Native Americans are twice as likely to have a fatal overdose than non-Native Americans.
Cox and Chris Rich set up their van in an alley to hand out points, or sterile syringes, to people who struggle with addiction. Harm reduction programs are often controversial for this reason.
They've been tried in dozens of communities. In several states, needle exchange programs were disbanded after critics complained they encouraged homelessness.
"It's easy to be unsuccessful, because it tends to be just blanket approaches," said Cassy Abbott-Eng, who has researched harm reduction programs at the University of Tulsa.
When asked if this type of approach is born of desperation, Abbott-Eng said, "I would agree with that."
Vinita resident Donald Cody, 61, has struggled with addiction since he was 17.
"So tired of doing the same old thing and expecting something different to happen," Cody said.
As for the harm reduction program, Cody says, "People are gonna do what they're gonna do, and that way they have the safest way they can."
Cox, now in recovery himself, agrees.
"I am enabling them. I'm enabling them to live tomorrow. All my enabling leads to them eventually making the decision to change their relationships with their drugs, and then we can begin to talk about treatment and recovery," Cox said.
As a tribe, the Cherokee fought opioids by suing multiple drugmakers and pharmacy chains. They've won more than $100 million. Some of that money funds the harm reduction program.
Its mission calls to mind the Cherokee word "gadugi" which means "working together as a community, as a tribe," Coleman said.
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