Addiction Treatment & Recovery for Native Americans

Individualized addiction treatment that addresses their unique cultures, traditions, and needs can help members of Native American communities fight addiction to alcohol and drugs, and the various problems related to addiction. Native American addiction treatment acknowledges the historic and present problems indigenous populations have faced and incorporates different approaches to help people heal.

Last Edited: 04/10/2021

Author: Pamela Zuber Pamela Zuber

Clinically Reviewed:

04/11/2021

Medical Reviewer:

Dr. Neil Shah

Dr. Neil Shah

About Native Populations

Native American populations have a history longer than the United States. They’re a diverse group with cultures, traditions, and beliefs that are unique and different. Understanding this is critical for successful addiction treatment and recovery.

Individuals from these populations use many names to describe themselves, such as Native Americans, American Indians, and Indigenous Americans. Such names are general terms for all indigenous people in the country. The U.S. Census Bureau refers to the community as American Indians and Alaska Natives (sometimes known as AIAN or AI/AN).

Terminology is different for individuals and smaller groups. “The consensus … is that whenever possible, Native people prefer to be called by their specific tribal name,” says the National Museum of the American Indian. To be even more specific, some indigenous people also refer to themselves by their clans and regional languages within these larger tribes.

Native Americans is a term used to describe people of many tribes within the United States. Similarly, Native Americans sometimes use the term Indian Country to encompass the many places the many tribal members live.

Scholars hold different theories about the origins of Native Americans. After studying DNA samples from Native Americans as well as people from Siberia and China, some genetic researchers deduced that about 250 people immigrated from Siberia to the Americas some 15,000 years ago. Others place the arrival at over 13,000 to 16,000 years ago. Their descendants live throughout North, South, and Central America.

Using the category American Indian and Alaska Native alone or in combination with one or more other races, the U.S. Census Bureau has tried to determine the number of Native American people living in the United States. In 2019, it was estimated that there were 5,665,200 people in this category.

With more than five and half million members, Native Americans are a large and diverse group of people. While the U.S. federal government recognizes 573 AI/AN tribes, U.S. states recognize more than 100, according to the U.S. Office of Minority Health. The office noted that some Native Americans live on reservations or trust lands (22%), but most don’t, with 60% living in metropolitan areas.

High addiction rates have accompanied these large numbers. “Compared to other racial/ethnic groups in the U.S., American Indians/Alaska Natives (AI/ANs) have the highest rates of alcohol, marijuana, cocaine, and hallucinogen use disorders and the second highest methamphetamine abuse rates after Native Hawaiians,” stated researchers in the Journal of Addictive Diseases in 2011.

The Indian Health Service (IHS) is a U.S. federal program created to address the health of American Indians and Alaska Natives (AI/AN), which is the program’s term for indigenous peoples. It also calls AI/AN people a race of people.

According to the IHS, compared to the 2008 death rates of other races, the 2007-2009 death rates of American Indians and Alaska Natives were higher in several categories:

  • Deaths related to alcohol: 520% higher
  • Cirrhosis and chronic liver disease: 368% higher
  • Vehicle crashes: 207% greater
  • Accidental injuries: 141% greater
  • Homicide: 86% greater
  • Suicide: 60% greater
  • Firearm-related injuries: 16% greater

Alcohol and drugs often play a role in such deaths. The substances can cause liver disease that leads to cirrhosis (scarring), heart disease, lung disease, and other complications.

They can also contribute to violence and accidents. Alcohol or drug abuse contributed to 50% of the deaths of people fifteen to twenty-four years old, reported the American Academy of Child & Adolescent Psychology.

By treating substance abuse and addiction, people could prevent several of these problems.

Learn About Inpatient Drug Rehab

There are many different inpatient drug rehab options out there, but not all of them work for everyone. When seeking a residential treatment program, it is important to know what to look for to ensure the best recovery experience possible.

Benefits of Programs Designed for Native Americans

Treating addiction is essential to improve health outcomes amongst Native Americans. It can address current addictions and the problems they cause. It can also prevent the long-term complications of addiction.

“Alcohol use disorder (AUD) is viewed as a primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and appearance,” says the Indian Health Service (IHS).

Since it calls alcohol use disorder a primary chronic disease, the IHS acknowledges that addictions aren’t cured but managed. Ongoing support can help people from turning to alcohol and drugs again, especially when life becomes difficult. Relapse is a part of the journey that must be taken in stride and dealt with as it comes.

In fact, Native Americans have had to face considerable challenges. The National Congress of American Indians says that compared to other groups of U.S. residents, Native Americans have

  • A lower life expectancy by 5.5 years
  • A higher numbers of heart disease-related deaths
  • A higher suicide rate
  • A lower median household income
  • Lower numbers of homeowners
  • Fewer members who receive post secondary education

Throughout their history, Native Americans have also had to face racism and social injustice, challenges they continue to face today. When discussing these challenges for other populations, people sometimes don’t know or fail to acknowledge that Native Americans also experience them as well.

Programs designed for Native Americans can address these issues. The Indian Health Service provides federal funds to Native American tribes and federal programs. It also offers alcohol and substance abuse programs managed by tribes.

With such initiatives, tribes help their fellow community members receive assistance to treat substance abuse disorders and addiction. They manage and operate these programs, playing an integral role in helping other members of their community.

Other programs and treatment facilities help Native Americans address the physical and mental ramifications of addiction and abuse. Early treatment for alcohol-related problems can prevent certain conditions or prevent them from worsening. The problems include:

  • Liver disease
  • Heart disease
  • Changes in the brain or brain damage
  • Weight gain and obesity
  • Skin problems
  • Problems with work or school
  • Financial problems
  • Relationship problems

Early treatment can have a significant positive impact on a person’s life. It could even save it.

Treatment Considerations

Not all assistance is the same. While Native Americans have the same treatment options as other populations, certain considerations might make some choices more inviting and effective.

Understanding is key. When studying why Native Americans often have worse health outcomes compared to other groups, researchers found that they might not have the health literacy they need to understand disease and acknowledged that doctors might not have the cultural competency required to assist them.

Native Americans who seek treatment might well be minorities in the facilities they visit. They may be nervous about discussing their condition with others, especially if they’ve encountered racism and prejudice in the past.

If they’re more comfortable speaking in a specific language, they might find it difficult to communicate in English and understand the details of their care. If they live on a reservation, they might be anxious about traveling somewhere else for health care.

“Minorities, including Native American, Hispanic, Asian, Latinos, and African American populations, are less likely to have a regular source of care,” noted the American Journal of Managed Care (AJMC). The journal notes that these differences could be due to

  • Poor communication from health care providers.
  • Cultural differences in patients’ beliefs about seeking treatment and the importance of medical care.
  • Differences in insurance coverage and finances.

Professionals who work with Native Americans should understand the beliefs, customs, and health care approaches of the tribe members in their areas. If they don’t, they could ask the people they’re treating.

For example, some rural Native Americans think that dreams are tools for predicting the future, but they might be reluctant to talk about them because they think that medical providers will judge them. But if practitioners know this belief, they can reassure their clients and encourage them to have such discussions. The dreams could ultimately help practitioners assess the state of their clients’ mental health.

Furthermore, some Native Americans say that members of white communities move more quickly and don’t take enough time to talk with others. Native Americans might be more comfortable with taking more time to form thoughts and with silence. Understanding how different cultures behave can improve the quality of care.

Treatment providers who are also in minority groups might provide such care. Researchers have found that therapists who belonged to minority groups were more

  • Likely to incorporate the clients’ cultures in their practices.
  • Sensitive to their clients’ cultures.
  • Personally involved in minority communities.

Care that is culturally sensitive also recognizes that some Native American tribes sometimes incorporate drugs such as peyote and ayahuasca as part of their spiritual beliefs. Professionals who recognize and respect these practices and other aspects of their clients’ backgrounds may develop better relationships and achieve more successful treatment outcomes.

Cultural competence is an important factor in addiction treatment and other aspects of health care. Without it, people may not understand each other or be comfortable with each other, which could prevent people from receiving the treatment they need.

Types of Treatment Offered for Native American Communities

To achieve the best outcomes, Native Americans need addiction treatment assistance that is both comprehensive and culturally competent. Health care providers who are culturally competent value diversity, are committed to learning more about cultures, and incorporate their values in their work.

They might require clients to undergo detoxification procedures (detox), which eliminate alcohol or drugs from their bodies. This procedure usually takes place under medical supervision, because the side effects of withdrawing from the substances could be painful or dangerous. Doctors might prescribe drugs to ease these symptoms and reduce cravings.

A prominent part of addiction treatment is therapy. Culturally competent therapists use different therapeutic approaches to help Native American clients explore why they developed addictions to alcohol or drugs and develop ways to avoid using them again.

Since addiction affects people differently, it’s important to tailor addiction assistance programs to fit individual clients. If they’re interested in exploring their culture, Native Americans may want to incorporate traditional Native American healing practices into their programs. These practices might include

  • Prayers
  • Talking circles
  • Sweat ceremonies
  • Smudges
  • Sessions with spiritual healers

Such practices might be considered holistic approaches because they address the entire person: body, mind, and soul. An increasing number of addiction treatment centers and programs are using holistic approaches to treat addiction, a condition that affects the body, mind, and soul.

When people leave rehab centers or complete addiction treatment programs, their healing isn’t finished. They’ll need aftercare and other measures to provide continued support.

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NAIGSO-AA

Many people find that joining support groups is a useful way to stay sober. Here, too, finding culturally sensitive assistance can make all the difference.

They might want to contact the Native American Indian General Service Office of Alcoholics Anonymous (NAIGSO-AA). This group assists Native American members of Alcoholics Anonymous (AA) by

  • Serving as a contact point regarding AA activities related to Native Americans.
  • Creating and maintaining a directory of Native American individuals and groups who are affiliated with AA.
  • Participating in Indian AA council gatherings.
  • Representing Native American traditions and cultures on the group and organizational level.
  • Urging AA to incorporate aspects of Native American culture.
  • Using Native American gathering customs to provide service.
  • Encouraging self-determination and sovereignty for Native Americans.

Spiritual beliefs “embodied in Indian culture and tradition” can help people achieve and maintain sobriety, according to the NAIGSO-AA. Incorporating such beliefs indicates that Native American culture can enhance addiction treatment instead of impeding it.

Finding a Rehab Program for Native American Communities

Colleges and universities are dedicated to uncovering and sharing information. They are good sources for information about addiction and treatment.

The Johns Hopkins Center for American Indian Health offers programs and research studies to help treat addictions and prevent future addictions. Since the center’s offerings include community feasts, it offers assistance that incorporates the culture of the Native American populations that it serves.

Contacting organizations can also be a good way to find rehab programs and recovery resources. Organizations such as Native American Connections have their own rehab centers and programs and can help people find various treatment options.

If people are interested in particular addiction treatment centers or programs, they might consider contacting them to learn more about the services they offer. Some may have options that appeal to Native American communities.

Finding treatment that respects people’s cultures and addresses their addictions can help them create fulfilling lives without alcohol or drugs.

Sources

  1. census.gov – Intergovernmental Affairs: Tribal Affairs — American Indian and Alaska Native (AIAN)
  2. americanindian.si.edu – Frequently Asked Questions
  3. oprahmag.com – Should You Use Native American or American Indian? That Depends on Who You Ask
  4. ncai.org – NCAI Response to Usage of the Term Indian Country
  5. livescience.com – How 250 Siberians Became the First Native Americans
  6. smithsonianmag.com – The Fertile Shore
  7. pbs.org – First Americans Arrived at Least 16,000 Years Ago, and Probably by Boat
  8. census.gov – American Indian and Alaska Native Alone or in Combination with One or More Other Races
  9. minorityhealth.hhs.gov – Profile: American Indian/Alaska Native
  10. ncbi.nlm.nih.gov – American Indians/Alaska Natives and Substance Abuse Treatment Outcomes: Positive Signs and Continuing Challenges
  11. ihs.gov – Trends in Indian Health 2014 Edition
  12. ihs.gov – About Us
  13. ncai.org – Indian Country Demographics
  14. news.berkeley.edu – In the Fight for Racial Justice, Native Stories Should Not Be Ignored
  15. aacap.org – Alcohol and Drug Abuse
  16. heart.org – Is Drinking Alcohol Part of a Healthy Lifestyle?
  17. ncbi.nlm.nih.gov – Medical Mistrust and Less Satisfaction With Health Care Among Native Americans Presenting for Cancer Treatment
  18. ajmc.com – Population-Based Health Policy: Minorities/Cultural Issues
  19. ncbi.nlm.nih.gov – Chapter 229 – Dealing with Patients from Other Cultures
  20. ncjrs.gov – IV. Potential Cross-Cultural Pitfalls and Dangers
  21. ncbi.nlm.nih.gov – Therapist Ethnicity and Treatment Orientation Differences in Multicultural Counseling Competencies
  22. newhavennativeamericanchurch.org – New Haven Native American Church – Home Page
  23. npin.cdc.gov – Cultural Competence in Health and Human Services
  24. ncbi.nlm.nih.gov – Integrating Spiritual and Western Treatment Modalities in a Native American Substance User Center: Provider Perspectives
  25. naigso-aa.org – Introduction
  26. naigso-aa.org – NAIGSO’s Vision of AA Service to Native Americans
  27. caih.jhu.edu – Programs – Behavioral Health
  28. nativeconnections.org – Behavioral Health

Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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