Washington's Lummi tribe was among the first in the nation to make Naloxone kits, along with prevention and education training, standard for law enforcement. The tribe acted in response to an "epidemic of drug overdose and death due to illegal drug use by community members of all backgrounds," according to one FBI press release. In partnership with Lummi public health agencies, Lummi Nation police officers were trained to recognize the signs of opioid overdose and to respond appropriately. Within six weeks of training, officers had reversed three overdoses.

Recently, the Suquamish tribe announced a partnership to equip and train all officers, as well as members of the general public, with Naloxone kits. Access for individuals is critical for rural populations, where emergency response may take too long, presuming the drug users were willing to call emergency services for help in the first place.

When these tribal communities saw an increase in prescription drug abuse and then heroin use, the tribal governments, health departments, law enforcement and community members collaborated on a response. The tribal councils passed "Good Samaritan" laws to ensure that someone trying to help would not be liable for the outcome. Tribes worked with local pharmacies to keep supplies of the kits available, and to distribute kits and training to individuals.

While tribes in PL 83-280 states like California, Minnesota and Wisconsin may benefit from state or county responders being equipped with Naloxone, this simple and effective tool is not experiencing widespread use in tribal communities, despite Indian Country suffering a higher overdose rate than the general population. In areas of the country without protection for first responders to administer Naloxone, tribes may be wary of negotiating state laws regarding the administration of Naloxone, especially where cross-jurisdictional agreements are in place.