Substance and Behavioral Addictions among American Indian and Alaska Native Populations

Abstract

Objective: This paper examines substance and behavioral addictions among American Indian and Alaska Natives (AIAN) to identify the structural and psychosocial risk and cultural protective factors that are associated with substance use and behavioral addictions. Methods: Five databases were used to search for peer reviewed articles through December 2021 that examined substance and behavioral addictions among AIANs. Results: The literature search identified 69 articles. Numerous risk factors (i.e., life stressors, severe trauma, family history of alcohol use) and protective factors (i.e., ethnic identity, family support) influence multiple substance (i.e., commercial tobacco, alcohol, opioid, stimulants) and behavioral (e.g., gambling) addictions. Conclusions: There is a dearth of research on behavioral addictions among AIANs. Unique risk factors in AIAN communities such as historical trauma and socioeconomic challenges have interfered with traditional cultural resilience factors and have increased the risk of behavioral addictions. Future research on resilience factors and effective prevention and treatment interventions could help AIANs avoid behavioral addictions.

Examining Foster Care Outcomes for American Indian Children in the Context of the Indian Child Welfare Act

“…It may be the case that parents with substance use problems have relatives or community members who are willing to foster their children while parents are in substance use treatment. This finding may be particularly relevant to American Indians, who face disproportionately higher rates of substance use problems, such as alcohol (Soto et al, 2022).…”

Wiidookaage’Win: A Community-Based Qualitative Approach to Developing a Facebook Group Intervention for Native Women to Support Recovery From Opioid Use

“…[5][6][7][8][9][10][11] Elevated OUD risk among AI/AN adults is due in part to inequities across social determinants of health and generations of historic trauma. 12,13 In Minnesota, drug overdose deaths are 7 times more likely among AI/AN adults than white adults, with opioids as the leading drug. 14 Although gender-specific risk factors for return to use in women have been identified, including perceived and biological stress reactivity, trauma, and perceived social isolation, 15,16 gender-specific interventions for AI/AN women recovering from OUD do not exist.…”

Increases in Disparities in US Drug Overdose Deaths by Race and Ethnicity

“…In addition, these populations have experienced stigma by health care practitioners related to drug use and hold misperceptions around MOUD, sometimes viewing this approach as "replacing one drug with another" instead of treatment. 5,6 Culturally competent care, awareness of biases, and nonjudgmental communication can help address treatment access barriers, such as stigma and mistrust in health care systems. Systems-level interventions that can improve culturally competent care include hiring diverse staff that reflect the community they serve and universal clinician training and education to recognize and address biases.…”

“…However, prior research demonstrates that many racial and ethnic minority populations cannot access MOUD in hospital or community settings at rates comparable to those for White populations. In addition, these populations have experienced stigma by health care practitioners related to drug use and hold misperceptions around MOUD, sometimes viewing this approach as “replacing one drug with another” instead of treatment . Culturally competent care, awareness of biases, and nonjudgmental communication can help address treatment access barriers, such as stigma and mistrust in health care systems.…”