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Those who struggle with drug and alcohol abuse also have a higher incidence of mental health issues and severe medical problems. For Native Americans that are challenged with opioid use, these problems skyrocket. These individuals may have a chronic medical condition, suicidal thoughts, and increased rates of IV drug use. Treating these problems is a challenge, but through specialized therapy and addressing the unique problems that Native Americans face, rehabilitation can be possible.
For a population that lives in reservation communities, legally separate entities exempt from a state or national oversight, getting treatment can be challenging. These challenges are threefold, financial barriers to providing clinical services, the infrastructure of treatment settings with regard to the living accommodations on reservations and the low instance of people leaving home to seek treatment outside the reservation, and the treatment system overall, which is based on Western medical practices that many native populations view with suspicion.
While about 1 in 8 of those who need rehab treatment actually receive it, a figure close to the national average, the treatment barriers for Native Americans and Alaskan Natives (AN/AI) are further complicated by geographical remoteness and the extreme poverty of many communities. For these reasons, rehab treatment is both more necessary and more difficult to obtain. Funding can be challenging.
Low rates of high school completion and graduation from college contribute to the poverty that many Native Americans experience. This, along with low job prospects, leads to economic hardship that carries down through generations. From a societal, environmental standpoint, there are more risk factors in many Native American populations that lead to increased use of drugs or drinking.
In addition to external factors, there are studies that demonstrate a substantial genetic factor in the rates of addiction among Native Americans. Certain “genetic protective factors” like metabolizing enzymes aren’t present in many Native American tribes, which means that alcohol and drug use impacts them more physically than other individuals.
The rate of binge drinking and alcohol abuse for Native Americans and Alaskan Natives is 72%, a number significantly higher than the country as a whole. Methamphetamine use is also higher in this ethnic group than any other in the U.S. Treating alcoholism and dependence on meth are among the most difficult, and with the highest rates of relapse, ensuring that patients who struggle with these addictions have access to quality rehab treatment, including strong relapse prevention components, is critical. According to the Pew Research Center, Native Americans are three times more likely to die of an overdose than any other population group.
Essentially, many Native American tribes have a higher than average number of factors that contribute to substance abuse. This, coupled with the lack of resources for treatment on many reservations, make substance abuse and addiction a serious health issue for many Native Americans, and this issue can deeply impact their communities.
There are several challenges to providing addiction treatment in Native American communities, including cultural insensitivity in many programs. Due to a history of oppression and mistreatment, many AI/AN communities view Western medicine and treatment with suspicion and question the treatment processes, preferring to rely on traditional indigenous medical practices. However, traditional substance abuse programs are few and far between, thus limiting options for those seeking treatment.
There is a lack of treatment centers on many reservations, especially for those in more rural areas, and previous attempts to bring treatment to those in need have failed to take into account the specific cultural needs of the AI/AN communities. Fortunately, the Indian Health Service (IHS) has partnered with clinics and clinicians to develop new treatment approaches that take into account the different backgrounds of each tribe.
Lack of transportation to treatment programs and therapy sessions, a shortage of quality substance abuse treatment providers, lack of health insurance to cover the costs of treatment, and even a lack of awareness about the nature of addiction and warning signs that an individual or loved one may have a problem are also important barriers to treatment.
Recovery options vary according to the area that a person lives in and their healthcare coverage. Wealthier tribes have several excellent substance abuse treatment centers, while other reservations have few options for treatment. Some of the treatment options for Native American and Alaskan Native populations include:
Due to the limited number of addiction treatment resources in many AI/AN communities, finding a program that incorporates important aspects of Native culture with substance abuse treatment may be difficult. When looking for a rehab center, read online reviews and don’t be afraid to ask questions about how the treatment program tailors addiction treatment in a way that honors and accommodates certain cultural values and beliefs.
Hospitals in many larger cities may have health care workers that have had training in cultural competency, as these workers tend to interact with people from many diverse backgrounds. However, many Native Americans live in rural areas, so finding a respectful treatment program is more difficult. Talking to friends or family members to find recommendations for treatment and reading online reviews may be a good place to start. Other reservations have community services that can include helping those in need to find culturally respectful programs.
Don’t be afraid to ask specific questions during the process. Addiction treatment isn’t a one-size-fits-all program, and what works for one person may not work for another. Part of the treatment is introspection and examining yourself, so learning more about what types of approaches work best for you may help you have lasting sobriety. Women, for example, may have certain traumas in their past that make single-gender treatment more effective and give them a secure place to open up and share what others who have similar experiences.
Increased rates of heart and lung disease for those who suffer from addiction are among the consequences of drug abuse. Charges in criminal court, such as DUI and DWI charges, are also a result of this behavior.
Successful rehab is based on the individual feeling secure and safe to be vulnerable to explore the underlying reasons behind substance abuse. An environment that includes elements of tribal culture and respect for their way of life may help addicts open up about struggles with past trauma or mental health challenges.
The rates of drug and alcohol use among AI/AN teens and adolescents are much higher than the country as a whole. There’s a special program called We Are Native, which is operated by the Northwest Area Indian Health Board. It’s a holistic approach to healing addiction for AI/AN youth that incorporates cultural practices.