Native Americans and tribal communities have had higher rates of substance abuse over the general population for years. This is often the result of generational abuse, which puts a large strain on communities, law enforcement, and general health and wellbeing.1
Among Alaska Natives and American Indians, drug overdose deaths are higher than the national average as well.2
Overall, Native Americans struggle with higher rates of drug abuse, overdose, and dependence than the general population.
Statistics on Native American Drug Abuse & Dependence
In 2018, nearly 11 percent of the American Indian/Alaska Native (AI/AN) population battled a substance use disorder (SUD).3
The most used drug in the AI/AN population is marijuana followed by:3
- Nonmedical use of prescription drugs
Native American youth are particularly at risk for substance abuse, with studies showing that Native American children in 8th, 10th, and 12th grades living on or near a reservation have a higher incidence of lifetime and past 30-day use of cigarettes, alcohol, marijuana, and other illicit drugs than a national sample of American youth.4
Native American communities are often spread out, and substance abuse treatment and prevention services are not as easily accessible. Poverty, lower levels of education, and higher rates of mental health issues and trauma can also impact drug abuse and addiction rates in this population.15
On a positive note, Native Alaskans and American Indians who enter a treatment program are more likely to complete it than other races, with a completion rate of over 60 percent.5 Prevention programs aimed at families and Native American youth are particularly important.
Marijuana continues to be the number one drug of abuse and dependence among Native Americans. In 2019, more than 20 percent of the AI/AN population used marijuana, with the biggest age demographic of past-month marijuana use being young adults between the ages of 18 and 25.6
Marijuana use has remained fairly steady among all age groups for the past several years. There was a spike in daily use for young adults in 2019, up to 11.4 percent from 9 percent in 2018.6
Native American youths are more likely to try marijuana and become regular users younger. Marijuana use rates in adolescents between the ages of 12 and 17 nearly doubled from 2018 to 2019.7 Younger use is associated with a higher potential for drug dependence and addiction as an adult.
The rate of marijuana use in Native American adolescents is almost twice that of national averages: 13.8 percent versus 6.9 percent.7
AI/AN 8th graders living on the reservation are more than three times as likely to try marijuana than national averages. Native American adolescents living on reservations have some of the highest levels of marijuana use compared to other ethnic groups.8
This is likely partly related to parental approval of the drug, and the fact that marijuana is often not viewed negatively in these communities.8 Marijuana use is prevalent and often socially acceptable on the reservation.
Nonmedical Use of Prescription Drugs
Abuse of pharmaceutical medications, including sedatives and prescription painkillers, is high among the entire United States population. In the Native American community, just over 5 percent report misuse of prescription opioid drugs in 2019.6 Native American youth between the ages of 12 and 17 also abuse prescription medications at nearly double the rate of the general American adolescent population (6.1 percent as opposed to 3.3 percent respectively).6
Some statistics on prescription opioid abuse among the AI/AN population include the following:
- Hydrocodone and oxycodone products are the most widely abused prescription painkillers.
- Since 2001, opioid overdose rates for the AI/AN population have increased at a more rapid rate than the general population.9
- Between 2013 and 2015, AI/AN opioid overdose deaths were nearly three times as high as that of whites.9
- A study of New Mexico Native American high schoolers in 2015 found that more than 1 out of every 10 students misused a prescription painkiller in the month prior to the survey.10
- In 2017, opioid overdose rates among AI/AN populations were second highest in the United States of all racial/ethnic groups.11
- With exception of the 12-to-17 age group, all other AI/AN age groups showed decreased prescription opioid misuse between 2018 and 2019.6
Access for services, such as medication-assisted treatment (MAT), are improving for Native American communities, as the opioid crisis within this population receives more attention and funding. While opioid use disorder rates remain stable at this point, better access to services and more education on opioid and prescription drug misuse can help to turn the tide.
Methamphetamine, or meth, is a highly addictive substance created in illicit laboratories on both small and large scales. The rural nature of tribal reservations, combined with how spread thin and far apart law enforcement can be, makes these areas prime targets for meth labs, manufacturing, and distribution.
Proportionally speaking, more Native Americans struggle with meth addiction than the rest of the American population.12
The good news is that over the past several years, adult meth use in AI/AN populations is going down. Meth use among Native Americans spiked in 2017 and declined in both 2018 and 2019.6
While meth is still cheap and easy to obtain, its popularity and abuse rates are decreasing.
Cocaine use has dropped significantly in the AI/AN population from 2017 to 2019, particularly for young adults between the ages of 18 and 25. In 2017, over 13,000 AI/AN young adults used cocaine, but by 2019, this number dropped to less than 500.6
Cocaine abuse among Native American adolescents is almost a non-issue as well. In general, stimulant misuse is less common in the Native American communities.
Hallucinogenic drug abuse is not very common in the general population, including such drugs as LSD, “magic” mushrooms, and peyote.
These drugs are often used in Native American religious and spiritual ceremonies. Peyote is legal for use by the Native American Church (NAC).13 These substances have been used for thousands of years by Native Americans during prayer ceremonies and for healing purposes.13
When it comes to reporting purposes, religious or spiritual use and illicit drug use are often interchanged, making it difficult to discern how commonly these drugs are actually being abused or used recreationally.
One study did find that while peyote use is rare among the general population (at rates between 1 and 2 percent), it is much more common in Native American communities, at rates closer to 10 percent.13 Native American adolescents are more likely to use peyote than other ethnic groups as well.
Inhalants are often common household products that are sniffed or huffed, such as paint thinner, solvent, or glue. These substances are typically abused by adolescents.
While inhalant use in general is fairly uncommon, AI/AN adolescents between the ages of 12 and 17 are nearly twice as likely to misuse these products than the general population.14
Despite the rise in opioid use, abuse, and overdose in the United States, heroin use is actually relatively low compared to use of prescription or other illicit opioid drugs. This trend remains about the same in Native American communities. Prescription and synthetic opioids are often more popular and commonly abused than the natural opiate heroin. The AI/AN community had the second highest opioid overdose death rate in 2017.9
The opioid crisis continues to take lives across the United States. Tribal leaders and the national government are working to address this issue and provide better access to prevention and substance abuse treatment programs, including MAT.
1 (2021). Alcohol & Substance Abuse. National Congress of American Indians (NCAI). Retrieved April 2021 from https://www.ncai.org/policy-issues/education-health-human-services/alcohol-substance-abuse
2 (October 2020). Injury Prevention in American Indian and Alaska Native Communities. Centers for Disease Control and Prevention (CDC). Retrieved April 2021 from https://www.cdc.gov/injury/tribal/index.html
3 2018 National Survey on Drug Use and Health: American Indians and Alaska Natives (AI/Ans). U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved April 2021 from https://www.samhsa.gov/data/sites/default/files/reports/rpt23246/1_AIAN_2020_01_14_508.pdf
4 Substance Use Among American Indian Youths on Reservations Compared with a National Sample of US Adolescents. JAMA Network. Retrieved April 2021 from https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2682593
5 (2018). Treatment Episode Data Set (TEDS) 2018). Department of Health and Human Services. Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved April 2021 from https://www.samhsa.gov/data/sites/default/files/reports/rpt31097/2018_TEDS/2018-TEDS-R.pdf
6 2019 National Survey on Drug Use and Health: American Indians and Alaska Natives (AI/ANs). U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved April 2021 from https://www.samhsa.gov/data/sites/default/files/reports/rpt31098/2019NSDUH-AIAN/AIAN%202019%20NSDUH.pdf
7 (January 2014). Ethnicity and Health in America Series: Substance Abuse/Addiction in Native American Youth. American Psychological Association (APA). Retrieved April 2021 from https://www.apa.org/pi/oema/resources/ethnicity-health/native-american/substance-use
8 (May 2017). The Role of Norms in Marijuana Use Among American Indian Adolescents. Prev Science. Retrieved April 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5471621/
9 (December 2018). Drug, Opioid-Involved, and Heroin-Involved Overdose Deaths Among American Indians and Alaskan Natives- Washington 1999-2015. Centers for Disease Control and Prevention (CDC) Mortality and Morbidity Weekly Report (MMWR). Retrieved April 2021 from https://www.cdc.gov/mmwr/volumes/67/wr/mm6750a2.htm
10 (March 2018). The Opioid Crisis Impact on Native American Communities. Albuquerque Area Southwest Tribal Epidemiology Center (AASTEC). Retrieved April 2021 from https://tribalepicenters.org/wp-content/uploads/2018/03/AASTEC-opioids-fact-sheet.pdf
11 Opioid Crisis Data: Understanding the Epidemic. Indian Health Service. U.S. Department of Health and Human Services. Retrieved April 2021 from https://www.ihs.gov/opioids/data/
12 (April 2016). The Devil on Your Shoulder: Battling Meth Addiction in Indian Country. Voice of America (VOA). Retrieved April 2021 from https://www.voanews.com/usa/devil-your-shoulder-battling-meth-addiction-indian-country
13 (May 2019). Examination of Recreational and Spiritual Peyote Use Among American Indian Youth. Journal of Studies on Alcohol and Drugs. Retrieved April 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614926/
14 (June 2017). Short Report Understanding Adolescent Inhalant Use. Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved April 2021 from https://www.samhsa.gov/data/sites/default/files/report_3095/ShortReport-3095.html
15 (2008). Poverty and Health Disparities for American Indian and Alaskan Native Children: Current Knowledge and Future Prospects. Annals of the New York Academy of Sciences. Retrieved April 2021 from https://pubmed.ncbi.nlm.nih.gov/18579879/
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