Throughout Indian Country, drugs affect communities in unfathomable ways. Both the Wyoming Division of Criminal Investigation and the Bureau of Indian Affairs have generally noted that drug abuse often leads to other crimes, including theft, burglary, assaults and even homicide. For far too long, the Wind River Reservation had one of the highest rates of violent crimes in Indian Country. In 2009, the Wind River Reservation was selected for the Bureau of Indian Affairs law enforcement pilot program to reduce violent crime. It was called the High Priority Performance Goals Program. According to the Bureau of Indian Affairs, from 2009 to 2013, the Wind River Indian Reservation had a 60 percent reduction, a 60 percent reduction in violent crime. It's a remarkable accomplishment and perhaps a template that other tribal communities could model.

Addressing the harmful effects of dangerous drugs in native communities : field hearing before the Committee on Indian Affairs, United States Senate, One Hundred Fourteenth Congress, first session, March 31, 2015.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.