The opioid epidemic has been especially devastating for Native American communities, according to an analysis by The Washington Post. From 2006 to 2014, Native Americans were almost 50% more likely than non-natives to die of an opioid overdose, the newspaper found.

Indian tribes have joined the more than 3,000 cities, counties and states suing opioid manufacturers and distributors. Several of the tribes that have joined the lawsuit are in Oklahoma, where more than 482,000 Native Americans live. The opioid death rate for Native Americans in tribal lands in Oklahoma was more than three times higher than the nationwide rate for non-natives from 2006 to 2014.

During those years, opioid distributors shipped an average of 57 pills per person per year to Oklahoma, compared with 36 pills per person nationally. At least 370 Native Americans in Oklahoma overdosed and died during that period, with a death rate similar to that of West Virginia.