American Journal of Drug and Alcohol Abuse 2012;38(5):498-504
Rieckmann, Traci R. | McCarty, Dennis | Kovas, Anne E. | Spicer, Paul | Bray, Joe | Gilbert, Steve | Mercer, Jacqueline
This is the Results Article for CTN-0033-Ot-1 and CTN-0033-Ot-5. American Indians and Alaska Natives (AI/ANs) experience significant disparities in health status and access to care. Furthermore, only limited data are available on substance use, mental health disorders, and treatment needs for this population. Addressing such disparities and developing culturally relevant, effective interventions for AI/AN communities require participatory research. The Western States Node of the National Drug Abuse Treatment Clinical Trials Network (CTN) partnered with two American Indian substance abuse treatment programs as part of protocol CTN-0033-Ot-5: an urban health center and a reservation-based program to assess client characteristics, drug use patterns, and treatment needs. Data collected by staff members at the respective programs from urban (n=74) and reservation (n=121) clients were compared. Additional sub-analysis examined patients reporting regular opioid use and mood disorders. Findings indicate that urban clients were more likely to report employment problems, polysubstance abuse, and a history of abuse. Reservation-based clients reported having more severe medical problems and a greater prevalence of psychiatric problems. Clients who were regular opioid users were more likely to report having a chronic medical condition, suicidal thoughts, suicide attempts, polysubstance abuse, and IV drug use. Clients who reported a history of depression had twice as many lifetime hospitalizations and more than five times as many days with medical problems.
Conclusions: Findings from this project provide information about the patterns of substance abuse and the importance of comprehensive assessments of trauma and comorbid conditions. Results point to the need for integrative coordinated care and auxiliary services for AI/AN clients seeking treatment for substance use disorders. In addition to more details about the epidemiology of alcohol and drug use disorders among AI/ANs, there is also the need for more information about the treatment system this population has access to.
Keywords: Alaska Natives | Alcohol | Community health services | Co-occurring disorders | Cultural humility | Heroin | Methamphetamine | Minority groups | Native Americans / American Indians | Prescription-type opiates | Trauma | American Journal of Drug and Alcohol Abuse (journal) | CTN platform/ancillary study results | CTN platform/ancillary study
Document No: 903 ; PMID: 22931085 ; PMCID: PMC3622709
Submitted by: CTN Dissemination Librarians (8/31/2012)
