
The stories began to emerge, first by the dozens and then by the hundreds. There were concerns for potentially thousands of missing Indigenous people coercively recruited in Arizona, New Mexico, and other parts of Indian Country and displaced from their communities. The scheme involved targeting Native Americans who were unhoused, low income, or experiencing substance use disorders with the end criminal goal of billing the government for behavioral health programs that did not provide the promised treatments. Loved ones who went missing were offered food, money, shelter — and sometimes substances - before transported in vans far from home. There have been reports of death, severe mistreatment, and hazardous living conditions.
The state of Arizona suspended (PDF) more than 300 providers from Medicaid payments for participation in the fraudulent schemes. Tribal governments mobilized resources, including the Navajo Nation’s Operation Rainbow Bridge to respond to the needs of its displaced relatives. The U.S. Department of Health and Human Services issued an advisory (PDF) to tribal leaders and a consumer alert . The Federal Bureau of Investigation established a portal to gather information from potential victims.
The targeting and scale of missing Indigenous relatives is deeply concerning and rooted in historical injustices, marginalization, and socio-economic disparities. The connection between exploitation and the displacement of Indigenous communities underscores the importance of addressing the root causes of vulnerability. This involves enhancing collaboration between Indigenous leaders, law enforcement, and policy makers to develop effective strategies for prevention, intervention, and support for victims and their families as described in the findings (PDF) of the Not Invisible Act Commission.
While missing loved ones were exploited for profit through fraudulent use of Medicaid funds, it has been much less clear whether there have been direct links to other modes of commercial exploitation, including forced labor and sex trafficking. Nevertheless, understanding the coexistence of vulnerabilities of human trafficking and substance use can help raise awareness and strengthen prevention efforts.
Human traffickers may exploit individuals struggling with substance use disorders. Compromised judgment, impaired decision-making, and desperation for financial support generated by substance use disorder make it easier for traffickers to exert control. Traffickers may directly use drugs or alcohol as a tool to manipulate, increase compliance, and deepen dependency to make it harder for victims to leave the exploitative situation. Survivors of human trafficking may turn to substance use as a coping mechanism to numb the emotional and physical pain endured during exploitation.
Identifying and assisting individuals in this dual crisis requires comprehensive interventions involving collaborative efforts between healthcare professionals, social service organizations, and law enforcement. Individuals experiencing substance use disorders can be screened (PDF) for human trafficking just as survivors of human trafficking are assessed for substance use issues. Behavioral health providers can take training to provide specialized support for those battling addiction within the context of human trafficking, including culturally responsive healing practices and peer-led support groups. Raising awareness about the vulnerabilities associated with substance misuse and substance use disorders and the tactics used by traffickers can decrease stigma, enhance community understanding, and provide context-specific support from first responders.
We must keep searching for our missing relatives, upholding the principle that each person’s life matters. Every person, regardless of their circumstances, deserves to be acknowledged and have their well-being and whereabouts known. Timely searches can prevent exploitation, ensure justice, and promote safety. Searches, even under difficult conditions, can contribute to the healing process for families of missing individuals to process emotional distress, gain answers after uncertainty, and find a way to move forward.
Families left in the wake of a missing loved one face profound grief and anxiety, where the uncertainty about the fate of their relative is compounded by the cruelty of exploitation for financial gain. Our collective commitment to actively search for and reconnect with missing loved ones can foster inclusivity and build trust. We are sending the message that every individual, regardless of their circumstances, is an integral part of the community. Our commitment can shift social norms to encourage others who may be struggling to come forward, seek support, and reconnect.
The Administration for Native Americans (ANA) and the Office on Trafficking in Persons (OTIP) have been coordinating with tribal leaders, Indigenous-led organizations, and state and federal partners. Commissioner Kunesh recently visited the Drumbeat program in Phoenix, which has been supporting families of missing relatives and coordinating with federal victim assistance specialists to support survivors. ANA also released a podcast series on Missing and Murdered Indigenous People (MMIP), published a paper on culturally based prevention strategies, funded a study on addressing colonization and historical trauma, and named a new senior policy advisor on MMIP.
OTIP has connected Arizona state officials and clinicians to online trainings on human trafficking and other resources to strengthen screening and trauma-informed responses to human trafficking including for organizations supporting Indigenous communities. OTIP partnered with ANA and StoryCorps to surface oral histories of survivors of human trafficking and allied service organizations, supported Indigenous survivors to implement culturally responsive anti-trafficking programming, and funded grants to provide victim services to Indigenous communities alongside program evaluations.
National Human Trafficking Hotline
Phone: 1-888-373-7888
Text: 233733
Phone: 1-800-662-HELP (4357)