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Here's how the Cherokee Nation is spending opioid settlement money

ARI SHAPIRO, HOST:

There is hope in one community fighting the opioid-fentanyl crisis. The Cherokee Nation has been devastated by addiction and overdose deaths. A lot of children, like 9-year-old Mazzy Walker, lost their parents to drugs.

MAZZY WALKER: I never got to meet them.

SHAPIRO: Now the Cherokee Nation is spending $100 million to help its people move past addiction. It's money the tribe won in settlements from big drug companies and pharmacy chains accused of fueling the opioid crisis. Tribal leaders say the funds will save lives and save families. Here's NPR's Brian Mann.

BRIAN MANN, BYLINE: When Brenda Barnett was pregnant with her son Ryan, she says the Cherokee Reservation around Tahlequah, Okla., was flooded with pain pills. Her Cherokee family had already been scarred by her brother's long addiction to opioids.

BRENDA BARNETT: At that time, I was thinking, I can't go through what my mom went through. I can't do it. I was terrified. That was one of the biggest fears I had in raising a child. And it happened.

MANN: It happened. Her son Ryan was 15 when he hurt his hand in a car door. A doctor prescribed OxyContin. In a way, they're lucky. Ryan survived. But he says that first opioid prescription, that first high, derailed his life.

RYAN BARNETT: I'd never experienced this before. And we're at Sonic getting a cheeseburger on the way home. And I was like, this is great. You know, I will do whatever I got to do to feel this way forever.

MANN: Sitting with his mom at their kitchen table, Ryan says he hates talking about what followed. He feels a lot of shame - 10 years lost to pain pills, heroin and fentanyl.

R BARNETT: You know, I did take a big chunk of my life and threw it in the trash.

MANN: Brenda and Ryan say a lot of Cherokee, their friends and neighbors, didn't survive.

R BARNETT: You know, you lose your best friends in this whole thing. If they're alive, they're in prison for the most part.

MANN: Through the opioid epidemic that began in the late '90s, a lot of the public's awareness and most of the public health response focused on rural white communities. But new studies and prescription drug distribution data released as part of opioid lawsuits show Native American towns like Tahlequah were also swamped with pain pills. Principal Chief Chuck Hoskin heads the Cherokee Nation.

CHUCK HOSKIN: I'm completely convinced that the industry bears responsibility because of the number of pills that were dumped onto the reservation. And that's not an accident. That's because there was profit to be gained.

MANN: Thousands of governments around the U.S., including tribal governments, sued. They took on the biggest corporations in America that made and sold opioid medications. In the end, most of those companies, including Johnson & Johnson and Walmart, agreed to national settlements, cash payouts worth more than $50 billion. Chief Hoskin says his tribe's share of that money, roughly $100 million, is already revolutionizing addiction care for the Cherokee.

HOSKIN: The suffering would have continued. Our inability to directly provide care would have been very limited. And now that's completely changed.

UNIDENTIFIED PERSON: Three, two, one.

(APPLAUSE)

MANN: The next big project is a state-of-the-art inpatient recovery center planned for Tahlequah, capital of the Cherokee Nation. The ceremony unveiling the project is packed with tribal leaders and Cherokee families who've lost loved ones or struggled with addiction. That's where I met Jenifer Pena-Lasiter, a Cherokee addicted to pain pills and heroin for 11 years.

JENIFER PENA-LASITER: The opioid industry harmed millions of people. And millions - I mean, you know, thousands of Cherokees have been devastated by it all.

MANN: Pena-Lasiter lost custody of her children and spent time in prison before rebuilding her life with help from the tribe. She says these new facilities and programs will help more people heal faster.

PENA-LASITER: I believe that the Cherokee Nation is doing right by this money that they got from the settlement.

MANN: There's already a new harm reduction clinic here. The tribal hospital now offers buprenorphine, a medication that helps people with opioid addiction avoid relapses. Roughly 400 Cherokee are getting that treatment. Over the next five years, the tribe plans to roll out $75 million in new treatment facilities, a huge change for a reservation with a population of around 150,000 Cherokee. So this is a hopeful moment but also a perilous one. Pena-Lasiter tells me pain pills and heroin have given way to fentanyl on the reservation.

PENA-LASITER: It's terrible. It's everywhere. There are people dying here all the time. If I go into a gas station at any time, somebody could be, you know, dead in the bathroom.

MANN: Fentanyl is now a leading cause of death for Americans under the age of 40. Research funded by the Centers for Disease Control and Prevention found the biggest spike in fatal overdoses among Native Americans.

SAM BRADSHAW: A sharp increase in the last two years and even sharper in the last year.

MANN: Sam Bradshaw is Cherokee and heads the tribe's addiction prevention program.

BRADSHAW: A lot of the kids are experimenting with drugs that - they don't know what's in them. And so fentanyl is mixed up in pills they're taking.

MANN: Part of this settlement money will go to create more targeted, culturally appropriate messages to warn and guide young Cherokee. After so much death and loss here, there is one more reality that angers a lot of Cherokee. While America's big drug companies agreed to pay billions of dollars, none apologized or admitted wrongdoing. Principal Chief Chuck Hoskin says it's infuriating only a handful of drug company executives were prosecuted.

HOSKIN: You know, justice is a relative term, but the way that I look at it in this moment is that we have an opportunity to save lives going forward. And getting these dollars in now is important. So I feel good about the measure of justice that we have.

MANN: Back in the Barnetts' kitchen, Brenda says she thinks the tribe is doing its best to move quickly.

B BARNETT: They are taking care of our people.

MANN: After decades of suffering, she believes the Cherokee Nation could actually become a model for how small towns respond to the opioid fentanyl crisis.

B BARNETT: You know what? We're poised to do the better - a better job than anything out there to see them coming in and saying, these are our people. They're not throwaway because they have this disease.

MANN: With financial help and health care from the tribe, her son Ryan has been in recovery, drug-free for five years. At age 31, he's back in college. As we sit at the kitchen table, Brenda puts a hand on his arm.

R BARNETT: Be proud.

MANN: When you hear your mom talk like that, how does it make you feel?

R BARNETT: It makes me feel good. It makes - it's good to know that she's proud. She trusts me. It's good to know that now because there was, you know, over a decade where - yeah, right.

MANN: Public health experts say it will be years before there's data showing whether this is working, whether opioid addiction and overdose deaths among the Cherokee are finally coming down. For now, what people have here is hope that this money and their efforts will finally start the healing. Brian Mann, NPR News, Tahlequah, Okla.

(SOUNDBITE OF BADBADNOTGOOD'S "TIMID, INTIMIDATING") Transcript provided by NPR, Copyright NPR.

Brian Mann