An investigation of substance use An investigation of substance use patterns and associated issues in patterns and associated issues in

urban treatment-seeking urban treatment-seeking Northern Plains American IndiansNorthern Plains American Indians

Native Research NetworkNative Research Network

2011 Annual Conference2011 Annual Conference

Frankie Kropp & Michelle MooreFrankie Kropp & Michelle Moore

This work was supported by NIDA grant: U10-DA013732 to the University of Cincinnati 11

Study DescriptionStudy Description

• Information was collected from 3 samples of American Indians seeking treatment at an urban, non-tribal substance use treatment program in the Northern Plains.

• ~1/2 referred through criminal justice system

143 - standard intake questionnaire (de-identified) 77 - ASI-NAV 9 - focus group (client)

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Study ParticipantsStudy ParticipantsASI-NAV

(N=77)CCADP Intakes

(N=143)Ct. Focus Groups (N=9)

Males 62% 65% 44%

Females 38% 35% 56%

Average Age 38 30 -

% Grad HS/GED 68% 67% -

Currently living on-reservation 12% - 0%

“-” indicates not asked

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Substance Use PatternsSubstance Use Patterns(ranked by % clients reporting use, all samples)(ranked by % clients reporting use, all samples)

1st - Alcohol– Average age onset = 15 yo (ASI)– Average age onset use to intox = 17 yo (ASI) – Females use to intox younger than males (15 yo – ASI)

2nd - Marijuana– Average age onset = 15 yo* (ASI)

3rd - Stimulants (Cocaine and/or Meth)– Focus group females reported greater meth use than focus group

males

4th - Opioids– Greater proportion of Rx opioids than heroin

• Females begin using >1 substance/day earlier than males (14 yo vs 18 yo – ASI)

• Over half of the clients identified themselves as cigarette smokers (58% - ASI)

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PsychosocialPsychosocial

• Relationships– Majority indicated friends/family supportive of recovery

(92% intake, 62% ASI)

• Employment/Economic– One-third employed full time (30% intake, 36% ASI)

– Majority unemployed (56% intake, 69% ASI)

– $617 income past 30 days (those with income only - ASI)

• Abuse Victimization– Physical (25% intake, 57% ASI)– Sexual (14% intake, 26% ASI)– Females report abuse more than males (79% vs 44% physical,

48% vs 13% sexual - ASI)

• Mental Health (ASI)

– Depression 80%– Anxiety 70%– Past Suicide Attempt 32%

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Culture/SpiritualityCulture/Spirituality• Cultural Engagement

– 30% raised on reservation (intake)

– 68% rated cultural identification “important” (intake)

• More likely to see as important if born in one environment but raised in another

• Approximately 1/3 did not consider cultural identification important

– 56% indicated cultural elements helpful in recovery (ASI)

– 69% indicated regular participation in cultural activities (ASI)

– Focus group males typically more engaged in culture than focus group females

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Treatment ConsiderationsTreatment Considerations(Focus Groups)(Focus Groups)

• Recognize value of both native-focused and non-native treatment

• Importance of prayer in recovery

• Social support critical– Females more interested in same-gender

relationships– Males more interested in relationships with other

Natives

• Accessibility to traditional activities would enhance treatment

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ConclusionsConclusions• Alcohol is most frequent presenting problem for

Treatment-Seeking Urban American Indians in the Northern Plains

• These clients face numerous economic and health disparities

• The importance of elements of Native culture may differ for some American Indians seeking treatment for substance abuse problems in urban settings.

• Urban treatment providers must consider health and economic disparities as well as cultural identification when developing individual treatment and referral plans.

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THANK YOU!THANK YOU!

Please feel free to contact us:

Frankie Kropp

kropp@carc.uc.edu

Michelle Moore

NIDARA@co.pennington.sd.us

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Clinical Trials Network ∙ Dissemination LibraryClinical Trials Network ∙ Dissemination Library

National Drug Abuse Treatment

A copy of this presentation will be available

electronically after the meeting from the:

http://ctndisseminationlibrary.org

CTN Dissemination Library

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