https://jamanetwork.com/journals/jama/articlepdf/2587685/jama_Murthy_2016_vp_160166.pdf

Surgeon General's Report on Alcohol, Drugs, and Health.

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. We collected, as part of a larger community-based participatory research project to address substance use disparities in rural AI communities, qualitative interview data from 25 AI key informants from a frontier reservation in Montana. Using a semistructured interview guide, we asked participants to discuss their perceptions of the causes of substance use problems and barriers to recovery on the reservation. Although no questions specifically asked about discrimination, key informants identified stress from racism as an important precipitant of substance use and barrier to recovery. As one participant stated: "Oppression is the overarching umbrella for all sickness with drugs and alcohol." Participants also identified historical trauma resulting from colonization as a manifestation of race-based stress that drives behavioral health problems. Findings suggest that interventions for AIs with substance use disorders, and possibly other chronic health problems, may be more effective if they address social determinants of health such as racial discrimination and historical trauma. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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

American Indians and Alaska Natives (AI/ANs) experience high rates of trauma and posttraumatic stress disorder (PTSD) We reviewed existing literature to address three interrelated questions: (1) What is the prevalence of PTSD and PTSD symptoms among AI/ANs? (2) What are the inciting events, risk factors, and co-morbidities in AI/ANs, and do they differ from those in the general US population? (3) Are studies available to inform clinicians about the course and treatment of PTSD in this population? We searched the PubMed and Web of Science databases and a database on AI/AN health, capturing an initial sample of 77 original English-language articles published 1992–2010 After applying exclusion criteria, we retained 37 articles on prevalence of PTSD and related symptoms among AI/AN adults We abstracted key information and organized it in tabular format AI/ANs experience a substantially greater burden of PTSD and related symptoms than US Whites Combat experience and interpersonal violence were consistently cited as leading causes of PTSD and related symptoms PTSD was associated with bodily pain, lung disorders, general health problems, substance abuse, and pathological gambling In general, inciting events, risk factors, and co-morbidities appear similar to those in the general US population Substantial research indicates a strikingly high incidence of PTSD in AI/AN populations However, inciting events, risk factors, and co-morbidities in AI/ANs, and how they may differ from those in the general population, are poorly understood Very few studies are available on the clinical course and treatment of PTSD in this vulnerable population

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Posttraumatic stress disorder and symptoms among American Indians and Alaska Natives: A review of the literature.

The consequences of alcohol use disorder (AUD) and suicide create immense health disparities among Alaska Native people. The People Awakening project is a long-term collaboration between Alaska Native (AN) communities and university researchers seeking to foster health equity through development of positive solutions to these disparities. These efforts initiated a research relationship that identified individual, family, and community protective factors from AUD and suicide. AN co-researchers next expressed interest in translating these findings into intervention. This led to development of a strengths-based community intervention that is the focus of the special issue. The intervention builds these protective factors to prevent AUD and suicide risk within AN youth, and their families and communities. This review provides a critical examination of existing literature and a brief history of work leading to the intervention research. These work efforts portray a shared commitment of university researchers and community members to function as co-researchers, and to conduct research in accord with local Yup'ik cultural values. This imperative allowed the team to navigate several tensions we locate in a convergence of historical and contemporary ecological contextual factors inherent in AN tribal communities with countervailing constraints imposed by Western science.

People Awakening: Collaborative Research to Develop Cultural Strategies for Prevention in Community Intervention

Future directions for medication assisted treatment for opioid use disorder with American Indian/Alaska Natives

Recovery from addiction to alcohol and other drugs is taking place with the assistance of culture-specific methods in American Indian and Alaska Native communities in North America. These communities utilize many of the recovery approaches that make up today's best practices, but they also use their own cultural and ethnic strengths as an important part of their addictions recovery. The Wellbriety Movement among Native people is one such expression of culture-specific healing for North Americans having the heritage of indigenous peoples. The rallying call, "Our culture is prevention," expresses an approach unique in addictions recovery processes anywhere.

/pdf/the-native-american-healing-experience-1r78x406tl.pdf

The Native American Healing Experience

The Wellbriety Movement in Native American communities draws on the wisdom and participation of traditional elders Beginning with a basic community teaching called the Four Laws of Change and the Healing Forest Model, the Wellbriety Movement blends Medicine Wheel knowledge with the 12 Steps of Alcoholics Anonymous to provide culture-specific addiction recovery help for Native Americans The four Journeys of the Sacred Hoop brought the Wellbriety Movement to Native and non-Native people alike from 1999 to 2003

Richard Simonelli

Papers

The Native American Healing Experience

Rebuilding native American communities