About this Work

Funding for all the work below was provided by the California Department of Health Care Services (DHCS) [contract # 17-94722], through the California Opioid State Targeted Response (STR) to the Opioid Crisis Grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) as part of the state’s Tribal MAT Project. To find more information about the Tribal MAT Project, see the state’s website here.

The report contents are solely the responsibility of the authors and do not necessarily reflect the views of DHCS. 

Claradina Soto, PhD, testifies on growing fentanyl crisis in Native American communities

On November 8, 2023, Claradina Soto, PhD, MPH, associate professor of clinical population and public health sciences at the Keck School of Medicine of USC, testified during a hearing, held by the United States Senate Committee on Indian Affairs, on the growing crisis of fentanyl in Native American communities.

Current Research Projects

Data Collection and Analysis Technical Assistance for Tribal MAT Grantees

As part of the Tribal MAT project, DHCS is providing two grant opportunities to support Tribes and Tribal/Urban Indian organizations: the California Native Medications for Addiction Treatment Network for Healing and Recovery (NMAT) grant and the California Tribal and Urban Indian Community-Defined Best Practices (TUICDBP) grant.

Evaluation of Two Tribal MAT Grants

The USC team will also conduct a program evaluation to assess grantee efforts as well as successes and areas for improvement in both the NMAT and TUICDBP grants. Regarding grantee efforts, the USC team seeks to understand strengths, challenges, and key takeaways of grantee approaches to implementing community-defined best practices.

State, Local, and Tribal Collaboration Project

Challenges around collaboration between state/local entities and American Indian/Alaska Native (AIAN) Tribal nations and Tribal/Urban Indian organizations are common nationwide and span many areas of work. Seeking to learn more about and address some of these challenges, the USC Keck School of Medicine will carry out a project to explore and address some of these challenges as they relate to substance use disorder/opioid use disorder in California.

Substance Use Disorder Policy Advocacy Training Program

USC is delivering the Substance Use Disorder (SUD) Policy Advocacy Training Program to address the need for policy advocates focused on SUD issues in California’s American Indian and Alaska Native (AIAN) communities.

Completed Research Projects

Addressing the Opioid Crisis in American Indian & Alaska Native Communities in California: A Statewide Needs Assessment

This report recognizes the need to address the opioid overdose crisis in AIAN communities in California and aims to identify gaps in prevention, treatment, and recovery services (including medication-assisted treatment, or MAT) targeted to these communities.

Tribal Response to the Opioid Epidemic in California: A Community Report

USC was tasked with evaluating the efforts of five Tribal medication-assisted treatment (MAT) programs serving American Indian and Alaska Natives (AIAN) in California. This report outlines the progress of these five programs.

Urban American Indians and Alaska Natives Experiencing Homelessness in California: Strategies for Addressing Housing Insecurities and Substance Use Disorder

As an extension of the broader statewide needs assessment report, this study specifically focused on urban American Indian and Alaska Natives (AIAN) experiencing homelessness to access to substance use treatment.

Mapping the Network of Care: Substance Use Treatment and Recovery Services for American Indians and Alaska Natives in California

This report is an addendum to the Tribal MAT Project Evaluation Report that was submitted to the California Department of Health Care Services (DHCS) in September 2020.

Publications in this Area

  • Shukla, R., Turner, B., Ramos, G.G., D’Isabella, J., & Soto, C. (under review). Barriers and facilitators to substance use disorder treatment: A qualitative study of Indian Health Programs. Journal of Substance Use and Addiction Treatment


  • Soto, C., Miller, K., Moerner, L., Nguyen, V., & Ramos, G.G. (under review). Implementation of Medication for Opioid Use Disorder treatment in American Indian Health Clinics in California: A qualitative evaluation. Journal of Substance Use and Addiction Treatment


  • G. G. Ramos, A. E. West, C. Begay, V. M. Telles, J. D’Isabella, V. Antony & C. Soto (2021): Substance use disorder and homelessness among American Indians and Alaska Natives in California, Journal of Ethnicity in Substance Abuse, DOI: 10.1080/15332640.2021.1952125