Methamphetamine Abuse in American Indian and Alaska Native Populations

United States

NIDA Organizer: Kathy Etz, Ph.D.

Meeting Purpose and Intent:

The primary goals of this meeting were to:

• Review existing research and current knowledge of methamphetamine abuse in American Indian and Alaska Native (AI/AN) populations;
• Assess what data are currently available to characterize this problem;
• Determine what data collection plans are underway;
• Identify existing infrastructures that might be tapped to collect data on this issue; and
• Identify gaps in the knowledge and begin to plan a research agenda.

Questions that were addressed included:

• To the extent that data are available, what is the scope of the problem?
• What are gap areas, including data from diverse age groups, gender groups, regionally distinct groups, and child-bearing women?
• How can we better assess regional and tribal variation in use?
• What infrastructures exist that might be resources for data collection?
• How should research proceed?
• How can data be collected to ensure a link to services for prevention and treatment?

Brief Discussion of Meeting Outcome:

Participants presented the state of the science revealing:

• National level data (NSDUH, AddHealth) indicate higher rates of abuse for AI/AN compared to other subgroups. Geographic variation in rates of use map onto locations where AI/ANs live.
• AI/AN girls and women appear to use methamphetamine at higher rates than women in other subgroups, with rates that are typically equal to male use.
• Rates of methamphetamine abuse vary greatly by region and tribe. In one study, rates for one group were 45% compared to 15% in another group (names for these groups can not be provided because tribal approval was not obtained to share broadly).
• Anecdotal reports of methamphetamine abuse in communities do not always match available data. This appears to be largely a function of problems with the data that are currently available, which do not accurately reflect rates of use.
• Some datasets indicate that use is more prevalent in older groups (20-29), while other datasets indicate that use is more prevalent in the 12-17 year old group.
• Spirituality and some traditional practices might protect against methamphetamine abuse.
• Indian communities have responded to the methamphetamine problem by developing many local level interventions and trainings. Many of these are not being evaluated.

Participants made suggestions for future research directions including:

• As a general rule, research in AI/AN populations must reflect community concerns, be developed with the input of the community, and be linked to preventive and intervention services.
• Studies must be designed with the ability to reflect variations in use by region, tribe, and urban or rural location. These need not take the place of studies that focus on one area, group or tribe.
• Consequences of methamphetamine abuse must be better understood, including exposure to environmental toxins, the impact on housing, the judicial system, etc.
• Consequences for children must be better understood, including the above as well as implications for child neglect and abuse.
• Methamphetamine abuse occurs in the context of other problem behaviors, including alcohol and other drugs of abuse. For example, participants indicated prescription drug abuse as a newly emerging problem. Thus, the study of methamphetamine abuse in this population must attend to these issues as well and identify newly emerging issues.
• Methamphetamine abuse research should take better advantage of the Indian Health Service clinical tracking data system. New web-based applications should be developed and greater encouragement for tribes to submit behavioral and clinical data should be provided to facilitate this.
• Data from the criminal justice system should be better accessed to assess the severity of this problem.
• Evaluations of current treatment and prevention approaches are necessary.

Brief Description of Resulting Publications:

• None