Concerns About Medications for Opioid Use Disorder Among American Indian Community Members: A Qualitative Secondary Analysis

Opioid use disorder and mortality due to opioid overdose pose significant public health problems in the United States, particularly among American Indian/Alaska Native (AI/AN) communities that experience disproportionately high rates of opioid overdose deaths. Such health inequities are related to centuries of ongoing colonization and oppression that inform social determinants of health today. Using medications to treat opioid use disorder (MOUD) has broad support among health professionals due to substantial evidence of its effectiveness and benefits to patients. However, most AI/ANs who need MOUD never receive it. This analysis sought to identify concerns related to the use of MOUD and how they inform barriers to implementing MOUD in a rural AI reservation community. Secondary analysis of qualitative data was conducted using reflexive thematic analysis. Findings reveal key themes related to conditions for when to use MOUD, recovery, distrust of Western medicine, and individual viewpoints on MOUD. Implications of these findings for reducing barriers to MOUD in AI/AN communities are discussed.