Training community members to deliver an intervention for substance use disorder: Overcoming implementation barriers in American Indian communities.

Introduction: Although American Indian and Alaska Native (AI/AN) people have high rates of abstinence from alcohol and other drugs, there also is evidence of greater rates of substance use disorders (SUDs) in Native communities. Health disparities associated with substance use are compounded by inadequate access to evidence-based treatments (EBTs). Lack of mental health providers is one notable barrier to EBT implementation in rural AI reservation communities.

Development and Feasibility Pilot Study of Indigenous Recovery Planning: A Community-Engaged Approach to Addressing Substance Use in a Native Community.

Although Native (American Indian and Alaska Native [AI/AN]) populations have high rates of abstinence from alcohol, health problems associated with substance use remain a pressing concern in many AI/AN communities. As part of a longstanding community-based participatory research (CBPR) project involving five years of relationship building and three preliminary studies, our team of academic and community co-researchers developed a culturally grounded intervention to facilitate recovery from substance use disorders among tribal members from a rural AI reservation. Our (IRP) intervention consists of six weekly sessions and aims to provide inroads to existing resources in the community, affirm and enhance Native identity, address culturally relevant risk factors, and build upon strengths.

Association of racism and substance use treatment with belief in the myth of an American Indian/Alaska Native biological vulnerability to alcohol problems.

Objectives: Belief in an American Indian/Alaska Native (AIAN) specific biological vulnerability (BV) to alcohol problems is associated with worse alcohol outcomes among AIANs. Despite a notable lack of evidence that biogenetic factors play a greater role in the development of alcohol problems among AIANs than other groups, many people still believe this myth. Consistent with theory and evidence that greater experiences with discrimination leads to the internalization of stereotypes and oppression, we hypothesized that greater perceived racial discrimination (racism) would be associated with greater BV belief, but that having a stronger ethnic identity would weaken this association.

Belief in the myth of an American Indian/Alaska Native biological vulnerability to alcohol problems among reservation-dwelling participants with a substance use problem.

Background: Belief in the myth of an American Indian/Alaska Native (AIAN)-specific biological vulnerability (BV) to alcohol problems is associated with worse alcohol outcomes among AIAN college students who drink, despite also being associated with greater attempts to reduce drinking. This study examined the association of belief in a BV with alcohol use among reservation-dwelling AI adults with a substance use problem.

Methods: Participants (n = 141) who drank alcohol in the past 90 days were selected from a larger AI sample who self-identified as having a substance use problem.

Determinants of Relapse and Opportunities for Growth: Perspectives on Substance Use among American Indian Community Members.

Resulting from generations of historical oppression and systemic racism, American Indian and Alaska Native (AI/AN) communities experience serious health disparities associated with substance use disorders (SUDs). As part of a longstanding community-based participatory research intervention development project, our partnership of academic and community co-researchers conducted seven focus groups ( = 35) to understand community stakeholders' perspectives on substance use, relapse, and recovery on a rural AI reservation. Participants included cultural leaders ( = 10), SUD treatment providers ( = 5), people with SUD ( = 10), and affected family members ( = 10).

Historical trauma and substance use among American Indian people with current substance use problems.

Objective: In the United States, American Indian and Alaska Native (AI/AN) people suffer health inequities associated with alcohol and other drug use and also experience historical trauma symptoms resulting from colonization. Research suggests that historical trauma may be associated with substance use among AI/ANs.

Method: As part of a Community-Based Participatory Research project with tribal partners from a rural AI reservation, our team collected cross-sectional survey data from 198 tribal members who self-identified as having substance use problems.

Belief in the American Indian/Alaska Native biological vulnerability myth and drinking to cope: Does stereotype threat play a role?

The effects of stereotype threat and internalized alcohol stereotypes on negative affect and negative affect-related drinking have not been examined in American Indians/Alaska Natives (AI/ANs), despite their frequently being subjected to alcohol stereotypes. The current study examined the association of belief in the myth of an AI/AN specific biological vulnerability (BV) with alcohol consequences through its effect on depression and drinking to cope with negative affect. In this cross-sectional study, a moderated mediation model examined the association of belief in a BV with alcohol consequences via sequential mediators of depression and drinking to cope.

A Systematic Review of Trauma Interventions in Native Communities.

American Indian/Alaska Native and First Nations communities suffer from health disparities associated with multiple forms of trauma exposure. Culturally appropriate interventions are needed to heal current and historical trauma wounds. Although there are evidence-based trauma interventions for other populations, few have been implemented or evaluated with Native communities.

Partnering with Native Communities to Develop a Culturally Grounded Intervention for Substance Use Disorder.

Studies have documented serious disparities in drug and alcohol-related morbidity and mortality among American Indians and Alaska Natives (AI/ANs) compared to other ethnic groups in the U.S. despite high rates of abstinence in these groups.

Understanding the link between racial trauma and substance use among American Indians.

Historians and scholars from various disciplines have documented the pervasive influence of racism on American society and culture, including effects on the health and well-being of American Indian (AI) people. Among the many health problems affected by racial discrimination and oppression, both historical and current, are substance use disorders. Epidemiological studies have documented greater drug and alcohol-related morbidity and mortality among AI/AN Alaska Natives compared to other ethnic groups, and culturally appropriate, effective interventions are sorely needed.

Negative life events and incident alcohol use disorders among ethnic minorities.

The association of negative life events (NLEs) with incident alcohol use disorders (AUDs) was examined among Blacks, Hispanics, and Whites in the second wave of the National Comorbidity Survey (NCS) among 3,679 participants without AUDs at the first wave. The number of past-year NLEs at NCS-2 was higher for Black than White participants, but the rates of incident AUDs did not differ by racial/ethnic group (14.2% among all participants).

Association of belief in the "firewater myth" with strategies to avoid alcohol consequences among American Indian and Alaska Native college students who drink.

Belief in an American Indian/Alaska Native (AI/AN) specific biological vulnerability (BV) to alcohol problems (aka the "firewater myth") is associated with worse alcohol outcomes among AI/AN college students who drink, despite also being associated with greater attempts to reduce drinking. The current study examined how belief in a BV may have affected how 157 AI/AN college students who drink (a) attempted to moderate their alcohol use and avoid alcohol-related problems using abstinence-based and harm reduction strategies, and (b) attitudes toward these strategies as a means of addressing alcohol problems. Contrary to our hypotheses, belief in a BV was not found to be associated with use of harm reduction strategies or with how effective students believed these strategies to be.

Alcohol Consumption, History of Sexual Assault in Adolescence, and Revictimization in a Sample of University Students in the Western United States.

This study evaluated alcohol consumption as a moderator of the association between adolescent sexual assault and risk of sexual assault in college. It was hypothesized that sexual assault in adolescence would be associated with higher risk of college victimization and that this association would be moderated by alcohol consumption. Predominantly female and European-American university students ( = 201) completed self-report measures of alcohol consumption and sexual assault victimization in adolescence and since enrolling in college at a medium-sized university in the Western United States.

A preliminary needs assessment of American Indians who inject drugs in northeastern Montana.

Background: Injection drug use has not been well documented in American Indians living in the USA. American Indian and Alaskan Natives (AI/ANs) show higher rates of substance use compared to the general population, and have historically been subject to a number of risk factors that are known to increase the likelihood of substance use. AI/ANs also experience increased risk for infectious diseases that are transmitted via injection drug use and/or sexual activity.

Association of the firewater myth with drinking behavior among American Indian and Alaska Native college students.

The firewater myth (FM) is the notion that American Indians and Alaska Natives (AI/ANs) are more susceptible to the effects of alcohol and vulnerable to alcohol problems due to biological or genetic differences. Believing that one is vulnerable to problems with alcohol may have negative effects on expectancies and drinking behavior among AI/ANs who drink; however, the association of belief in the FM with alcohol outcomes has not previously been examined. In this study we examined the factor structure of a revised version of the Firewater Myth Scale (FMS; LaMarr, 2003) and the association of belief in the FM with alcohol use, consequences, attitudes, and expectancies with 159 AI/AN college students who drink.

Sobriety and alcohol use among rural Alaska Native elders.

Background: Although notable health disparities related to alcohol use persist among Alaska Native people living in rural communities, there is a paucity of research examining drinking behaviour in particular segments of this population, including elders. One explanation for this is the distrust of behavioural health research in general and alcohol research in particular following the legacy of the Barrow Alcohol Study, still regarded as a notable example of ethics violations in cross-cultural research.

Objective: The present study reports findings from one of the first research studies asking directly about alcohol abuse among rural Alaska Natives (AN) since the study in Barrow took place in 1979.

Ethnic identity, drinking motives, and alcohol consequences among Alaska Native and non-Native college students.

This research involves the examination of drinking motives, alcohol consequences, and ethnic identity in a sample of Native and non-Native college student drinkers in Alaska. Although more Alaska Native students are abstinent from alcohol compared to any other ethnic group, Native students who do drink experience greater alcohol consequences and dependence symptoms. Therefore, we attempted to examine the influence of ethnic identity on alcohol consequences in a diverse sample of Native and non-Native students in Alaska.

Energy drink use, problem drinking and drinking motives in a diverse sample of Alaskan college students.

Background: Recent research has identified the use of caffeinated energy drinks as a common, potentially risky behavior among college students that is linked to alcohol misuse and consequences. Research also suggests that energy drink consumption is related to other risky behaviors such as tobacco use, marijuana use and risky sexual activity.

Objective: This research sought to examine the associations between frequency of energy drink consumption and problematic alcohol use, alcohol-related consequences, symptoms of alcohol dependence and drinking motives in an ethnically diverse sample of college students in Alaska.

Attitudes toward harm reduction and abstinence-only approaches to alcohol misuse among Alaskan college students.

Background: Harm reduction is a public health approach that aims to guide hazardous drinkers to change unsafe drinking and minimize alcohol-related consequences without requiring abstinence. In contrast, abstinence-based interventions are designed for people with more severe alcohol problems and they aim to eliminate consequences via complete abstinence from alcohol. Current best practices for treating college student alcohol misuse involve harm reduction strategies, but no research has been conducted examining students' perceptions of these strategies.