Native Americans and Substance Abuse

Epidemiology

Substance abuse rates for Native Americans tend to be higher for many substances than rates for non-Native People. Inhalant use among Native adolescents (ages 12–17) is more than 3 times that of non-Natives (32% compared to 9%). Twenty percent of Native American adolescents report having used illicit drugs in the past month, 27% report binge drinking, and 26% report smoking. These rates are the highest of any ethnic group. Methamphetamine production and use is becoming a major problem on reservations, as evidenced by a tripling in the number of seizures in Arizona between 1997 and 2000. Illicit drug use also appears to be increasing among Native Americans nationwide. Treatment facility admittance rates for marijuana abuse increased 86% for males and 57% for females between 1994 and 1999. Cocaine treatment admittance rates increased 25% and 12% for males and females respectively. Similar patterns exist for opiates (100% and 38%) and stimulants (100% and 60%). Females are more likely than males to be in treatment for cocaine, opiates, and stimulants; males for marijuana and alcohol.

Alcohol, however, remains the most seriously abused substance by Native Americans, both on and off the reservation. Five of the top 10 causes of deaths among Native Americans are alcohol related (e.g., homicides, suicides, cirrhosis, accidents). Alcoholism rates among Native People are 3 times that of non-Natives. Nearly one half of deaths of Native Americans in Arizona can be attributed to alcohol, and another 8.5% attributed to drugs. Fetal alcohol spectrum disorders (FASD) are another unfortunate and unintended consequence of high rates of alcoholism in the Native communities of the United States. The FASD rates run as high as 2.5 per 1,000 live births in some communities and as high as 5.6 in Alaska, compared with the .2 to 1.0 rates in the general population.

[Page 590]Clearly, high rates of substance use and abuse have many negative consequences for Native Americans and Alaskan/Hawaiian natives. Many explanations have been suggested, including biological factors that make these indigenous populations more susceptible to alcohol addiction. Most theoretical and treatment models, however, point to societal and cultural factors that contribute to high rates of substance abuse and dependence in Native communities.

Causes of Substance Abuse by Native Americans

Native American adolescents are most likely to engage in substance use and abuse. Not surprisingly, most studies evaluating risk factors associated with substance use and abuse in Native American populations focus on adolescent risk factors. There are three general categories of risk factors: individual level (including peer), family, and school. Native American adolescents are more likely to believe there is moderate to no risk associated with smoking one pack of cigarettes per day than members of other racial/ ethnic groups. They are also less likely to believe that their peers disapprove of tobacco or alcohol use than other ethnic groups. Native American youth are also less likely than their non-Native American peers to believe that their parents disapprove of drug use. Poor performance in school has been associated with substance use and abuse among all racial/ethnic groups; Native Americans are more likely than others to report doing poorly in school (averaging a D or lower). There is also a higher perceived rate of peer substance use among the adolescent Native American population than among other groups.

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