SUBSTANCE ABUSE LESSON BY SANELE DLAMINI

REFERENCE LIST

Abbott, P. J. (2006) Co- morbid Alchohol./Other drug Abuse/ Dependence and psychiatric disorders in adolescent American Indian and Alaska natives. Alchoholism Treatment Quarterly, 24(4), 3- 23/ http://impurplehawk.com/naspirit.html

DRUG ABUSE!

Unlike many other ethnic minorities, Native Americans had resources and means to survive.

500+ tribes with 175 languages.

Europeans introduced disease that decreased native populations to 10% of what they were at the end of the eighteenth century.

In 1887, U.S. Government judged that Indians couldn’t manage land, so they placed the property in a trust.

By removing land and forming reservations, families were displaced and separated.

HISTORY

(Sue & Sue, 2003)

• Focus on external family and community when raising children

• Matriarchal/Patriarchal households

• 27% single female run households

– High fertility rate– High # of out-of-wedlock births• Trouble passing down

traditions/values• According to the 1997

Congressional Record, “In 1978 90% of Native American children placed in state courts and child welfare were placed in non-Native American homes.”

• 60% of Native Americans are of mixed heritage

• High Rates of domestic violence, physical and sexual assault

– Native American women experience 3 ½ x that of the rest of the population (Bhungalia, 2001).

FAMILY DYNAMICS

• 66% of Native Americans are high school graduates

• Native Americans have 3x the poverty rate of the rest of the population(U.S. Census Bureau, 1995)

• 50% of Native Americans living on or near a reservation are unemployed (Juntunen et al., 2001)

• The median family income in 2000 was $19,897(IHS, 2000).

• 31% are living below the U.S. poverty level

• Many Native Americans take up traditional employment such as fishing, farming and forestry

• Many Native Americans drop out of high school or do not finish college

CULTURE AND SOCIETY

IMPLICATIONS FOR INCREASED SUBSTANCE ABUSE• Both historical factors, such as the colonial practice of introducing

heavy alcohol consumption to tribes during trading, and contemporary factors, such as acculturation stress and decreased economic or educational opportunities on reservations, have been implicated in understanding the increased risk for substance abuse among American Indian youth (Beauvais, 1992,1998).

• Native American youth may encounter even more complicated developmental tasks than non-Native youth because they are typically raised in two, often contradictory, cultures and challenged to assimilate and function successfully in both (Nieto, 1992).

• Together, these models of causality provide a broad cultural and historical context for understanding the challenges faced by youth in Native communities.

• High rates of obesity and diabetes are prevalent on reservations due to the lack of activities available (Balderes, 2000).

• Tobacco is one of the most frequently used drugs by Native youth. According to data for 12–17-year-olds from the last available NHSDA, 27.5% of American Indians/Alaska Natives were current smokers, compared with 16.0% of Whites, 10.2% of Latinos, 8.4% of Asian Americans, and 6.1% of African Americans (SAMHSA, Office of Applied Studies, 2002).

• Tobacco is used in a number of ceremonies, including ones related to religion.

• Native Americans have the highest prevalence of smoking among adults 36%

• 42.5% of women and 29.1% of men are smokers (Centers for Disease Control and Prevention, 2002).

• “It is ironic that the wine that is the Christians' most sacred substance, used in the Mass to represent the blood of their God, has caused such a trail of devastation within Native populations. And the Natives' most sacred substance, tobacco, has caused major health problems for so many Christians” (http://impurplehawk.com/naspirit.html).

TOBACCO

• Alcohol-related motor vehicle fatalities are highest in the Native American population, 68.1% (National Highway Traffic Safety Administration, 1999).

• Attitudes toward drinking vary amongst tribes, however, those living on reservations drink less often, but are more likely to binge drink or drink more per occasion (May & Gossage, 2001).

• Native Americans are 6x more likely to die of alcohol related causes than the general population (Frank et al., 2000).

• Cirrhosis is the 6th leading cause of death in Native Americans.

• Native Americans also have a disproportionately high rate of fetal alcohol syndrome (Morbidity and Mortality Weekly Report, 1994).

• The “Firewater Myth” states that Native Americans cannot hold their liquor because of different metabolism and enzyme patterns, though no research confirm this (NSDUH, 2007).

ALCOHOL

PEYOTE• Peyote is a small, spineless round cactus with psychedelic properties, containing more than

fifty alkaloids – most notably mescaline. It grows naturally in the deserts of southwestern United

States (especially south Texas) and northwestern Mexico. It was called ‘peyote’ by the Aztec,

hence its current name. ‘Dry Whisky’, ‘Divine herb’, ‘Devil’s Root’ and ‘Medicine of the Gods’

are other terms used to describe peyote. This cactaceae plant species was first documented by

Hernandez in 1651, who called it ‘Peyote zacatecensis’. It was given its current name, Lophophora

Williamsii, by John Coulter in 1894. Hernandez noted that it appeared to have a sweetish

and hot taste and, when ground up, was used to alleviate joint pain. He also noted its hallucinogenic

properties and its use in sacred rituals by medicine men to foresee and predict things. It

was also used by warriors, providing them with courage to fight and the ability to abate thirst,

hunger and fear (French, 2008).

• The use of hallucinogens has an important role in some Native American religious rituals.

• http://www.youtube.com/watch?v=9rYdgHx8yrw

• There is no word for hallucination in the

Native American Language.

OTHER SUBSTANCES• Native American youth have twice the prevalence of cigarette, alcohol,

marijuana, and cocaine use as that of Hispanics, Blacks or Whites (Frances, Miller & Mack, 2005).

• Native American past month drinkers had the highest rate of illicit drug use concurrent with last alcohol use (NSDUH, 2009).

• Inhalants are commonly among the first substances used by Indian youth, often preceding the use of alcohol (Beauvais et al.,1989).

• Beauvais (1992a) reported that Indian youth living on reservations had higher lifetime inhalant use rates than did Indian youth not living on reservations or White youth. Among 8th graders, 34% of reservation Indians reported lifetime inhalant use, compared with 20% for non-reservation Indians and 13% for Whites. 

• Marijuana use is also significantly higher among American Indian and Alaska Native adolescents than other groups. Beauvais (1996) found that nearly 50% of Indian students in the 7th through 12th grades reported having used marijuana on at least one occasion.

• In another study (Beauvais, 1992a) he found that of the 8th graders surveyed, 47% of reservation Indians, 26% of non-reservation Indians, and 13% of Whites reported lifetime marijuana use.

SUICIDE

• Native Americans are 2x more likely to attempt and complete suicide than the general population (Sue & Sue, 2003).

• Low self-esteem, cultural identity conflicts, lack of positive role models, abuse history, social pressures to use substances, hopelessness and breakdown in the family (Swinomish Tribal Mental Health Project, 1991; Yee et al., 1995), are contributors to substance abuse that lead to increased suicidality and engagement in risky behaviors.

DRUGS –WHAT THEY ARE AND WHAT THEY DO ?

A drug, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. Drugs are chemicals that change the way a person's body works by altering emotions and thoughts.

TREATMENT/PREVENTION

• American Indian AA Traditional AA

• Uncritical attitude Critical attitude

• Cooperation Competition

• Sharing Ownership

• Humble presentation Outgoing/Self-righteous

• Happiness Success

• Honor elders Honor self

• Silence Verbalism

• Tribal values Individualism

• Simplicity Complexity

• Tradition Innovation

• Spiritual values Material values

• Learning from elders Formal education

• Few rules Many rules

• Mysticism Empiricism

• Smallness Bigness

• Natural medicine Synthetic drugs

• Unity with nature Separateness with nature

• Accept others as they are Change others

• Indian AA Steps Traditional AA Steps

• We come to believe that the

power of the Pipe is greater than

ourselves and can restore us to

our Culture and Heritage.

• Be entirely ready for the Great Spirit

to remove all the defects of an alien

culture.

REFERENCES• Retrieved June 10, 2009, from http://impurplehawk.com/naspirit.html

• Abbott, P. J. (2006). Co-morbid Alcohol/Other drug Abuse/Dependence and psychiatric disorders in adolescent American Indian and Alaska natives. Alcoholism Treatment Quarterly, 24(4), 3-23.

• Balderas, J. B. (2001, American Indians' enemy: Diabetes, lifestyle, diets blamed as 50% of native Americans over 45 are affected. The Washington Post,

• Beauvais, F. (1992). Characteristics of Indian youth and drug abuse. American Indian and Alaska Native Mental Health Research, 5, 51-67.

• Beauvais, F., Chavez, E. L., Oetting, E. R., Deffenbacher, J. L., & Cornell, G. R. (1996). Drug use, violence and victimization among white American, Mexican American, and American Indian dropouts, student with academic problems, and students in good academic standing. Journal of Counseling Psychology, 43, 292-299.

• Beauvais, F. Comparison for drug use rates for reservation Indian, non-reservation Indian and Anglo youth. American Indian and Alaska Native Mental Health Research, 5, 13-31.

• Beauvais, F. (1992a). Characteristics of Indian youth and drug use. American Indian and Alaska Native Mental Health Research, 5, 51-67.

• Beauvais, F. (1996). Trends in drug use among American Indian students and dropouts, 1975-1994. American Journal of Public Health, 86, 1594-1598.

• Beauvais, F. (1998). American Indians and alcohol. Alcohol Health & Research World, 22, 253-259.

• Beauvais, F., Oetting, E. R., Wolf, W., & Edwards, R. W. (1989). American Indian youth and drugs, 1976-1987: A continuing problem. American Journal of Public Health, 79, 634-636.

• Bhungalia, L. (2001). Native American women and violence. National NOW Times, (33), 5-13.

• Centers for disease control and prevention. (2002). Annual smoking-attributable mortality, years of potential life lost, and economic costs-united states, 1995-1999 No. 51)Morbidity and Mortality Weekly Report.

• Congressional Record. (1997). Indian child welfare act amendments of 1997—Hon. George Miller. Washington, D.C.: Author.

• Frances, R. J., Miller, S. I., & Mack, A. H. (2005). Clinical textbook of addictive disorders (3rd ed.). New York, NY: Guilford Press.

• Frank, J. W., Moore, R. S., & Ames, G. M. (2000). Historical and cultural roots of drinking problems among American Indians. American Journal of Public Health, 90, 344-351.

• French, L. A. (2004). Alcohol and other drug addictions among native Americans: The movement toward tribal-centric treatment programs. Alcoholism Treatment Quarterly, 22(1), 81-93.

• French, L. A. (2008). Psychoactive agents and native American spirituality: Past and present. Contemporary Justice Review, 11(2), 155-163.

• Galliher, R. V., Evans, C. M., & Weiser, D. (2007). Social and individual predictors of substance use for native American youth. Journal of Child & Adolescent Substance Abuse, 16(3), 1-17.

• Indian Health Services. (2000). Trends in Indian health-1998-1999. Washington, DC: US DHHS, Public Health Service.

• Juntunen, C. L., Barraclough, D. J., Broneck, C. L., Seibel, G. A., Winrow, S. A., & Morin, P. M. (2001). American Indian perspectives on the career journey. Journal of Counseling Psychology, 48, 274-285.

• May, P., & Gossage, J. (2001). The epidemiology of alcohol consumption among American Indians living on four reservations and in nearby border towns. Drug and Alcohol Dependency, 63(Suppl 1)(S100)

• Morbidity and Mortality Weekly Report. (1994). Prevalence and characteristic of alcohol consumption and fetal alcohol awareness-Alaska, 1991 and 1993 No. 43)

• National Highway Traffic Safety Administration. (1999). An analysis of alcohol-related motor vehicle fatalities by ethnicity. Annals Emerg Med, 34, 550-553.

• National Survey on Drug Use and Health. (2007). Substance use and substance use disorders among American Indians and Alaska natives

• National Survey on Drug Use and Health. (2009). Concurrent illicit drug use and alcohol use

• Nieto, S. (1992). Affirming diversity: The sociopolitical context of multicultural education. New York, NY: Longman.

• Sue, D. W., & Sue, D. (2003). Counseling the culturally diverse: Theory and practice (4th ed.). New York, NY: John Wiley & Sons.

• Swiminosh Tribal Mental Health Project. (1991). A gathering of wisdoms. LaConner, WA: Sinomish Tribal Community.

• U.S. Bureau of the Census. (1995). Population profile of the united states. Washington, DC: U.S. Government Printing Office.

• Vicks, S., R., Smith, L. M., & Herrera, C. I. R. (1998). The healing circle: An alternative path to alcoholism recovery. Counseling and Values, 42(2), 133-141.

• Whitbeck, L. B. (2006). Some guiding assumptions and a theoretical model for developing culturally specific preventions with native American people. Journal of Community Psychology, 34(2), 183-192.

• Yee, B. W. K., Castro, F.G., Hammond, W.R., John, W., G.E., & Yung, B. R. (1995). Risk-taking and abusive behavior among ethnic minorities. Health Psychology, 14, 622-631.

Guiding Assumptions for Prevention Research Partnerships With Native American Communities

• 1. Prevention efforts must proceed nation by nation.

• 2. Native American cultures contain all the necessary knowledge to socialize mentally healthy, alcohol-and drug-free children. This knowledge need not be replaced with information and socialization techniques derived from European culture.

• 3. Cultural ways and knowledge must be viewed as equal to social science prevention knowledge.

• 4. There exist within Native American cultures developmental risk and protective factors, which

operate independently and in interaction with key risk and protective factors known in the majority population. Failure to identify these factors and consider them will mean that prevention efforts will not address important mechanisms affecting the prevention outcome.

• 5. Ownership must exist for culturally specific prevention programs to be successful.

• 6. There is a “hunger” among Native American adults and adolescents for their cultural knowledge (Whitbeck, 2006).

TREATMENT/PREVENTION CONT’D