Native Research Network 2011 Annual Conference Frankie Kropp & Michelle Moore

1. 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-DA013732 to the University of Cincinnati

2. 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 • 143 - standard intake questionnaire (de-identified) • 77 - ASI-NAV • 9 - focus group (client)

3. Study Participants

4. Substance Use Patterns(ranked by % clients reporting use, all samples) 1st - 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) 2nd - Marijuana • Average age onset = 15 yo* (ASI) 3rd - Stimulants (Cocaine and/or Meth) • Focus group females reported greater meth use than focus group males 4th - Opioids • Greater proportion of Rx opioids than heroin • Females begin using >1 substance/day earlier than males (14 yovs 18 yo – ASI) • Over half of the clients identified themselves as cigarette smokers (58% - ASI)

5. 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%

6. 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

7. 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

8. 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.

9. THANK YOU! Please feel free to contact us: Frankie Kropp kropp@carc.uc.edu Michelle Moore NIDARA@co.pennington.sd.us

10. Clinical Trials Network ∙ Dissemination Library NationalDrugAbuseTreatment A copy of this presentation will be available electronically after the meeting from the: CTN Dissemination Library http://ctndisseminationlibrary.org