Trends in Non-Medical Prescription Opioid Use among Urban and Rural American Indian and Alaska Native Youth Residing in New Mexico: 2013-2017

Increasing rates of opioid-related deaths over the last twenty years have created a national public health crisis. However, minimal research investigates opioid use among American Indian and Alaska Native (AI/AN) youth. This study examined non-medical prescription opioid prevalence rates and resiliency of urban and rural AI/AN and non-AI/AN students. The sample included eighth, tenth, and twelfth grade students who participated in the New Mexico Youth Risk and Resilience Survey in 2013, 2015, and 2017 (n = 42,098). Logistic regression models showed no significant differences in non-medical prescription opioid use among rural and urban students in 2013, 2015, and 2017. No significant differences in use between AI/AN and non-AI/AN students occurred in 2013, 2015, or 2017. Family and community support were protective of misuse consistent across time points, and included caring adults, community involvement, and clear rules at school. These findings may help to inform the development of strengths-based prevention activities for AI/AN youth.

The Validity of the Short Inventory of Problems and Drinking Intensity among Urban American Indian Adults

BACKGROUND

American Indian (AI) adults have both high prevalence rates of alcohol abstinence and alcohol use disorders compared to non-Hispanic White adults. We investigated the applicability and validity of the Short Inventory of Problems (SIP) among AI urban adults and the moderating effect of biological sex.

METHODS

AI adults from three Alcoholics Anonymous samples (n = 124) provided baseline, 3-, 6- and 9-month data. Measures included Form 90 and the SIP, which includes 5 domains of alcohol-related negative consequences including interpersonal, intrapersonal, physical, impulse control and social. Drinking frequency and intensity were assessed by percent days abstinent (PDA) and drinks per drinking day (DPDD).

RESULTS

Cronbach alphas of the SIP were similar between urban AI adults and the mainstream treatment-seeking population reported in the SIP manual. DPDD was a significant and positive predictor of all five SIP scales collected 9-months later. Higher PDA was significantly and negatively associated with later consequences, and all 5 SIP scales. Moderation tests indicated that the association between consequences and drinking intensity was stronger for AI females with fewer drinking days resulting in significantly fewer consequences for AI males relative to AI females.

CONCLUSIONS

Findings highlight the acceptability of SIP as a measure to assess drinking related consequences among AI urban adults, with clinical implications related to alcohol use and sex. Further research is warranted to examine differential drinking related outcomes among AI men and women in addition to adaptations of the SIP that more fully capture the range of negative drinking consequences.

Aligning three substance use disorder interventions among a tribe in the Southwest United States: Pilot feasibility for cultural re-centering, dissemination, and implementation

In this article we describe cultural re-centering, dissemination, and implementation activities in partnership between an American Indian reservation community and a university in the Southwest United States. We offer examples of cultural adaptation and implementation of evidence-based treatments (e.g., Motivational Interviewing, Community Reinforcement Approach and the Community Reinforcement and Family Training) using the Interactive Systems Framework. Facilitators and barriers are described within each study including recruitment strategies, training, and sustainability of counselors in the community. Through this Tribal-university partnership, we offer insight on the cultural adaptation and implementation process that will be translatable and clinically meaningful to other rural and reservation communities.

Native Americans resolve alcohol use disorder: "Whatever it takes or all that it takes"

OBJECTIVES

There is a growing awareness of the prevalence of abstinence and rates of remission from alcohol problems among Native Americans (NAs). Past NA remission research has included epidemiological studies, treatment outcomes, and qualitative inquiry. In this study, we sought to qualitatively examine how NAs resolved moderate to severe alcohol use disorder (AUD) and maintained long-term sobriety.

METHOD

Recruitment via newspaper advertisements, flyers, and word-of-mouth yielded 55 NA participants (56% male). Face-to-face semistructured interviews lasted about 1 hr. We transcribed the audio recordings and analyzed data with NVivo software using an iterative process of thematic analysis and consensus building.

RESULTS

Two major coding categories were used: motivating factors and actions used to resolve AUD. Each of these categories consisted of subcodes (8 and 13, respectively).

CONCLUSIONS

NAs resolved AUD via multiple methods and efforts. What worked for one individual did not necessarily work the first time or for another individual. Although some motivators or actions were unique to NAs, others were similar to findings in the general population. Because multiple and varied motivations and actions may be required to resolve AUD, individuals with AUD and their loved ones should persevere in their efforts to make positive changes. Future research should examine other NA tribal regions and NA remission from drug use disorder. (PsycINFO Database Record (c) 2019 APA, all rights reserved).