Alcohol and drug abuse treatment for urban American Indians and Alaska Natives

Although most American Indians and Alaska Natives live in metropolitan areas, there are few if any recent data about substance abuse treatment for this population. The present study recruited and is following quarterly for 12 months adult Native clients (57 female, 88 male, 92% between ages 21 and 49) entering long term residential substance abuse treatment programs designed for American Indians and Alaska Natives living in two cities in the Western United States. The programs (with 90-day minimum recommended length of stay) offer culturally specific services such as sweat lodges. Baseline and follow-up client data are obtained with the Global Appraisal of Individual Need (GAIN) augmented with extensive cultural information. Collateral data from friends and family are used to facilitate follow-up. Staff and services data are also being collected. Most (81%) participants are enrolled tribal members and half (50%) reported their blood quantum (a measure of Native ancestry) as 50% or greater. Few (32%) have graduated from high school. Very few (20%) are currently married. Many (44%) were unemployed at admission. Most (57%) have ongoing criminal justice system involvement. Alcohol was the primary substance of abuse for most (61%) with amphetamine the next most common drug (16%). Most (68%) participants satisfied diagnostic criteria for alcohol abuse or dependence as did many (32%) for amphetamine abuse or dependence. Nearly all (93%) have had prior substance abuse treatment and most (63%) have had prior mental health treatment. Physical health problems were also common (47%). Follow-up results will be reported.