Considerations for American Indian/Alaska Native and Tribal Populations
American Indian/Alaska Native (AI/AN) populations and tribal communities are more likely to report
certain types of substance use disorders (SUDs) when compared to other racial and ethnic groups.
Data from the National Survey
on Drug Use and Health shows that AI/AN persons aged 18 and older were more likely to receive SUD
treatment in the past year (5.8%) than any other racial and ethnic population.
There are still a number of
barriers to treatment in tribal communities, including limited resources, stigma,
and fear of arrest.
Tribal communities may not have naloxone available or people who are trained to administer naloxone.
Additionally, there is a lack of education about how to help someone who is overdosing. Documentation
of substance misuse, including opioid use disorder and overdose, may also be underestimated if
neighboring communities provide emergency medical services and do not identify tribal status in
records. This lack of data impacts the ability of tribes to apply for funds to support SUD treatment
programs and track their success in implementing these programs.
Programs addressing SUD in AI/AN populations should take into consideration the effects of historical
trauma on SUD behaviors. Populations experience historical
trauma across generations due
to an event of oppression.
AI/AN populations have experienced historical trauma due to European colonization of the United States beginning in the 1400s that resulted in loss of land, population, and culture. The trauma from
these events has persisted through generations and contributes to mental and behavioral health
conditions, including SUD. Rural SUD treatment programs should provide AI/AN populations with
historical trauma-informed care. The Indian Health Services offers a series
on historical trauma, including the intersection of trauma and SUD.
Rural communities may consider strategies to engage AI/AN individuals and families in need of SUD
prevention or treatment services. One rural SUD treatment program serving tribal populations
contracted with a Native project coordinator who had existing relationships with contacts at partner
tribes. Programs have also invested in social marketing campaigns to ensure that the messages of the
program are tailored to the culture of the community. Programs that address tobacco use should
understand that tobacco has traditional,
medicinal, or sacred connotations in some tribal communities.
The University of Washington also conducted an environmental
scan of tribal opioid overdose prevention responses that provides an overview of community-based
strategies. Other resources to address SUDs include the Northwest
Tribal Substance Abuse Action Plan.
Resources to Learn More
National Survey on Drug Use and Health: American Indians and Alaska Native (AI/ANs)
An overview of the data collected from the 2018 National Survey on Drug Use and Health for American
Indian and Alaska Native populations.
Author(s): McCance-Katz, E.
Organization(s): Substance Abuse and Mental Health Services Administration
Alcohol and Substance Abuse Program (ASAP)
A collection of information and resources addressing substance abuse in American Indian and Alaskan
Native populations. Provides screening tools, trainings, treatment options, and technical
Organization: Indian Health Services
Systematic Review of Interventions Focusing on Indigenous Adolescent Mental Health and Substance
Analyzes mental health and substance use interventions for American Indian and Alaska Native
adolescent populations to identify key factors in reducing mental health disparities.
Authors: Antonio, M., & Chung-Do, J.
Offers culturally based information and teachings for Indigenous populations pursuing recovery from
alcohol and substance abuse, and intergenerational trauma.