An investigation of substance use patterns and associated issues in urban treatment-seeking Northern Plains American Indians Native Research Network 2011 Annual Conference Frankie Kropp & Michelle Moore This work was supported by NIDA grant: U10-DA to the University of Cincinnati 1

Study 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  standard intake questionnaire (de-identified)  77 - ASI-NAV  9 - focus group (client) 2

Study Participants ASI-NAV (N=77) CCADP Intakes (N=143) Ct. Focus Groups (N=9) Males62%65%44% Females38%35%56% Average Age3830- % Grad HS/GED68%67%- Currently living on-reservation12%-0% “-” indicates not asked 3

Substance Use Patterns (ranked by % clients reporting use, all samples) 1 st - 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) 2 nd - Marijuana –Average age onset = 15 yo* (ASI) 3 rd - Stimulants (Cocaine and/or Meth) –Focus group females reported greater meth use than focus group males 4 th - 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) 4

Psychosocial 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% 5

Culture/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 6

Treatment Considerations (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 7

Conclusions 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. 8

THANK YOU! Please feel free to contact us: Frankie Kropp Michelle Moore 9

Clinical Trials Network ∙ Dissemination Library Clinical Trials Network ∙ Dissemination Library National Drug Abuse Treatment A copy of this presentation will be available electronically after the meeting from the: CTN Dissemination Library 10