Focus Groups With American Indian/Alaska Native Adults to Discuss Substance Misuse and Access to Services

Background: After the beginning of the COVID-19 pandemic, there was a 53% increase in overdose deaths in the U.S., with the highest rates among American Indian/Alaska Natives (AI/AN) individuals compared with all racial/ethnic groups in the U.S. Historical trauma has been linked to substance use among AI/AN individuals. First cited in the 1990s, historical trauma is an intergenerational response to the loss of AI/AN communities’ land, peoples, and culture secondary to colonization in North America. Two-Eyed Seeing is the gift of multiple perspectives treasured by many Indigenous peoples, which includes storytelling. The purpose of this study was to hear from the tribal members their concerns related to substance use among youth and their ideas related to prevention and treatment. Method: The study design was a focus group methodology. Five focus groups were completed with 20 AI/AN self-identified adults over 18 years of age. Results: Several themes emerged that focused on both prevention and treatment of substance use disorder. Participants expressed concern about their invisibility in state and federal datasets, lack of access to health care, and a lack of prosocial opportunities for youth to inspire their future aspirations. They expressed concern about stigma and the potential negative influences of peers and social media. Two approaches many participants felt could help were to start prevention projects early with elementary-aged youth and to take an intergenerational approach. Conclusions: To more broadly understand the needs of the AI/AN medication for opioid use disorder clients, future investigations should include interviews with substance use disorder clients and their families. Further understanding of the experiences of individuals with substance use disorder and their treatment could advance creative treatment plans that are trauma-informed and culturally sensitive. Implementing community participatory action increases the assurance that the needs of AI/AN families are addressed.