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The American Indian/Alaska Native National Resource Center for Substance Abuse and Mental Health Services

The Indian Country Methamphetamine Initiative:

Addressing a Problem Uniquely Affecting

Indian Country Dale Walker, MD Michelle Singer Patricia Silk Walker, PhD

Douglas Bigelow, PhD

ATNI Winter Conference: January 24, 2008Yakima, Washington

Six Behaviors That Contribute to Serious Health

Problems:• Tobacco use• Poor nutrition• Behaviors resulting in intentional or unintentional

injury• Physical inactivity• Risky sex • Alcohol and other drug abuse –

Methamphetamine!

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Methamphetamine Use, by State inYoung Adults (18 to 25)

Source: SAMHSA, 2002-2005 .

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Methamphetamine: Epidemiology

Past Month Illicit Drug Use among Youths Aged 12 to 17, by Race/Ethnicity: 2002

Methamphetamine: Epidemiology

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Methamphetamine/Amphetamine Admissions by Ethnicity and

Urbanization: 2004 Race/

Ethnicity

Large Central Metro

Large Fringe Metro

Small Metro

Non-Metro with City

Non-Metro without

City

White 56% 77% 78% 86% 87%

Black 5% 3% 2% 1% 1%

Hispanic 28% 14% 11% 6% 4%

American Indian/ Alaska Native

2% 1% 3% 4% 6%

Asian Pacific Islander

3% 2% 3% 2% 1%

Other 6% 3% 3% 1% 1%

Source: 2003 SAMHSA Treatment Episode Data Set (TEDS).

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The Methamphetamine Effect

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Methamphetamine Identified as the Primary Health/Community

Concern

• In 2006, Tribal Round Table sessions, HHS Regional Tribal Consultations, and numerous tribal community gatherings with SAMHSA, OMH, and IHS identified Methamphetamine abuse as the primary health concern in Indian Country.

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“Tribal leaders unveil new meth Initiative” Indian Country Today  

NCAI President, Joe Garcia Anchorage, Alaska June 15, 2007

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Indian Country Methamphetamine Initiative

(ICMI)• $1.75 million awarded to Association of Indian

Physician (AAIP) its partners (National Congress of American Indians, One Sky Center, South and Eastern Tribes, and Northwest Portland Area Indian Health Board)

• Tribal Sites– Navajo Nation – Winnebago Tribe – Northern Arapaho Tribe– Crow Nation – Choctaw Nation

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ICMI Project Description

• Create a National education and information outreach campaign for all Native communities.

• Establish and transfer knowledge from community based, promising practices for prevention, intervention and treatment.

• Work across Federal agencies for a coordinated and consistent outreach strategy.

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The Indian Country Methamphetamine Initiative:

Project Partners

SAMHSA

AAIP

USET NPAIHB OSC NCAI

Choctaw Crow Navajo Northern Arapaho Winnebago

IHS OMH HHS

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Winnebago

Navajo

Choctaw

Crow

Northern Arapaho

NPAIHB

AAIP

USET

OSC

NCAI

ICMI Partners

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ICMI Major Project Deliverables

• Outreach/Education Kit for Tribes and others • Identification of Partners/Advisory Groups• Coordinated Federal-Tribal-State-Local Indian

Country Communication and Training• Minimum 5 Tribal Specific Projects Identified

and Evaluated for Potential Transfer to Other NA Communities

• Final Project Evaluation• Year 3 - Promising Practices Transfer Kits

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Toolkit Essentials

• Leadership Information• Methamphetamine Basics• Tribal Code-Policy • Media• Educational Materials and Presentations

Prevention and Treatment

Educational for Students, Parents, Community• Community Organizing • Fun Youth Items•  Additional Resources

                                                                                                                         

                            

                                                                                           

                                                           

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How to Use the Toolkit

• Leadership and decision making• Overview of each module• Specific topics, issue pages• Promising Practice approaches• What the culture and science says• Training, technical assistance, and consultation• Reference documents • Toolkit webpage

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ID Best Practice

Best Practice

Clinical/servicesResearch

TraditionalHealing

MainstreamPractice

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Choctaw Nation of Oklahoma

• “Natural Highs Program”• Transformation process • Experiential activities• Relationship building• Changing the way you live

and think • Changing how you think

and you believe about life and yourself

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METH FREE CROWALITON Unity in Our

“War Against Meth”

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Meth Free Crow Walk: Youth

as our Warriors in Reclaiming our Nation

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Dine Nation Methamphetamine Initiative

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What Works

• Community Education – Age-appropriate presentations, brochures, ads

• Enforcement (NLE Drug Unit) – Arrest and detainment for trafficking

• Caring members of the community

• Partnerships – Communities, chapters, private businesses and tribal divisions

and programs.

Methamphetamine Initiative

A System of “Works”

Northern Arapaho Tribe

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The concept of “WorksWorks”in a Comprehensive Systems Plan

The Problem: – “turf” – gaps – duplications – crossed purposes

Fragmented Service System

The Solution:– client-centered – multi-agency– comprehensive– coordinated– efficient

“WorksWorks”

The Solution:– client-centered – multi-agency– comprehensive– coordinated– efficient

“WorksWorks”

Winnebago Tribe

Together, WE Make A Difference:

Methamphetamine Prevention on the

Winnebago ReservationTipi Means,

Tribal Health Educator

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Goals and Objectives Winnebago Meth Task Force

• Develop/maintain a Comprehensive Methamphetamine Prevention Strategy

• Collectively plan and implement • Use Proactive measures• Use available funds - take immediate

action• Working together to determine what fits for

tribal members and the reservation

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Next Steps• Add two additional Tribes

• NCAI provide PSAs and house the Tribal Meth Taskforce

• USET and NPAIHB will gather baseline data on methamphetamine use

• One Sky Center:

– TA for writing best practices

– Create a training curriculum

– Train additional tribes in ICMI best practices

– Develop a cultural methamphetamine abuse education kit

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Contact us at503-494-3703

E-mailDale Walker, MDonesky@ohsu.edu

Or visit our website:www.oneskycenter.org