Trauma and Substance Use among Indigenous Peoples of the United States and Canada: A Scoping Review

Abstract

Substance use has been identified by Indigenous populations as contributing to health disparities facing their communities. Rates of trauma exposure and post-traumatic stress disorder are higher in Indigenous, compared to non-Indigenous, populations and have been linked to substance use. Historical trauma is thought to be one mechanism underlying substance use and related disorders. The purpose of the present study is to summarize the current state of the literature focusing on the association between trauma (historical and lived) and substance use among Indigenous populations in the United States and Canada. Databases were systematically searched using the preferred reporting items for systematic reviews and meta-analyses statement. The search strategy initially yielded 4,026 articles. After exclusion of ineligible articles, 63 articles remained for synthesis. Results of the present review provide evidence for a positive link between substance use and both historical trauma (i.e., 86.4% of studies) and lived trauma (i.e., 84.7% of studies). Indigenous participants reported that historical trauma and pain related to loss of cultural identity contributed to substance use in their communities. Indigenous participants also consistently described an association between lived trauma and substance use. Despite heterogeneity among Indigenous communities, findings suggest a significant association between trauma and substance use across many different tribes and settings (e.g., reservation/reserve, rural/urban). Indigenous participants identified healing from trauma and reconnecting with culture as necessary components for reducing substance use and maintaining sobriety. With this, the development and implementation of interventions should partner with Indigenous communities in a manner that promotes and enhances cultural values for healing.

Ground-up approach to understanding the impacts of historical trauma in one reserve-dwelling first nations community.

“…These observations are consistent with empirical findings, with one recent scoping review finding that 86.4% of studies found evidence for a positive link between alcohol and other drug use and historical trauma (Spillane et al, 2022). For instance, the findings of Whitbeck et al (2004) showed that higher levels of historical loss predicted an increased likelihood of alcohol use disorder among American Indians.…”

The association between emotional abuse in childhood and healthcare utilization in adulthood among sami and non-sami: the SAMINOR 2 questionnaire survey

“…We did not examine the prevalence among Sami and non-Sami specifically. However, Table 2 indicates that more Sami than non-Sami participants report emotional abuse in childhood, which corresponds to other research on indigenous populations [ 16 – 19 ]. There might be several possible explanations for this trend, but harsh assimilation policies, colonization and discrimination appear to be the main hypotheses [ 21 , 50 ].…”

“…Research on childhood abuse in indigenous populations is based on limited data. However, some research has indicated that childhood violence is more common among indigenous than non-indigenous populations [16][17][18][19]. This has been linked to the cultural experience the indigenous populations have had to endure, such as harsh assimilation policies, colonization, and discrimination [16,20,21].…”

Development and Feasibility Pilot Study of Indigenous Recovery Planning: A Community-Engaged Approach to Addressing Substance Use in a Native Community

“…However, many core components of IRP, if adapted, may be transferable to other communities. Although each tribe has a unique history and culture, there are commonalities among many AI/AN cultural groups, including the history of colonization that gave rise to historical trauma and disproportionately high rates of SUD (Nutton & Fast, 2015;Pride et al, 2021;Spillane et al, 2022), inadequate funding of the Indian Health Service ( Joseph et al, 2019;Whitesell et al, 2012), and a preference for culturally grounded interventions (Walters et al, 2020;Wendt et al, 2022). Many Native cultures share common values regarding the importance of family, language, spirituality, and cultural identity (Dickerson et al, 2020;Walters et al, 2020) and may find elements of IRP to be well-suited to their communities.…”