A Review of the Solutions to Substance Abuse in Tribal Communities

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Neal Ray
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1 A Multidisciplinary Approach to Address Substance Abuse in Tribal Communities Melissa E. Riley, Principal Native Community Development Group, LLC

2 Purpose and Objectives To identify multidisciplinary team members necessary for addressing substance abuse. To analyze the effectiveness of current approaches to substance abuse. To assess community resources for effective responses to substance abuse in tribal communities. To establish or enhance plans for multidisciplinary approaches to address substance abuse.

4 Important stuff about substance abuse in tribal communities Substance abuse is a part of a c0-occurring disorder (dual diagnosis) Substance abuse is a coping mechanism Substance abuse is often associated with suicide or suicide attempts Substance abuse was the 2 nd highest cause of Native American deaths in 2009 Substance use was the leading cause of death in car crashes in

5 Health Disparities in Indian Country National Rate Retrieved from hhs.gov 72 % higher suicide rate 92 % higher homicide rate 149 % higher unintentional injury rate (includes motor vehicle crashes) 195 % higher diabetes rate 500 % higher tuberculosis rate 519 % higher alcoholism rate

6 Substance abuse and poverty Retrieved from gov/data/2k10/182/ AmericanIndian.htm Substance abuse among Native Americans living in poverty, 18 years and older compared to the national rate (2 nd column) Alcohol Use 42.2% 39.8% Binge Alcohol Use 36.1% 25.2% Illicit Drug Use 15.1% 11.7%

Substance abuse and gender Retrieved from http://www.samhsa. gov/data/2k10/182/ AmericanIndian.

Gender Substance Use American Indians or Alaska Natives National Average Female Alcohol Use 38.6% 48.

7 Substance abuse and gender Retrieved from gov/data/2k10/182/ AmericanIndian.htm Substance abuse among Native Americans by gender, ages 18 and older, compared to national average. Gender Substance Use American Indians or Alaska Natives National Average Female Alcohol Use 38.6% 48.5% Female Binge Alcohol Use 24.2% 15.9% Female Illicit Drug Use 8.5% 5.7% Male Alcohol Use 49.5% 62.3% Male Binge Alcohol 37.6% 33.8% Use Male Illicit Drug Use 14.1% 10.2%

8 Strategies for MDT Function(s) Scanning What is the problem you are addressing? Analysis How big is the problem, who is involved, and how? Where is the problem? Response What should and can be done about the problem? Who should be involved in responding to the problem? Assessment Is the response happening as planned? Is the problem declining/increasing? What are next steps?

9 Activity

10 Team Composition Behavioral Health Law Enforcement Schools/Higher Education Include additional programs as available and needed Social Services Recreation Programs Family Support Programs Court/ Probation Family/Community

11 Team Roles & Responsibilities

12 Blueprint for realistic approaches Ideal community blueprint Current community blueprint

13 Tree Top Bottom Stop Approach

14 Tree Top Bottom Stop Approach Approach requires looking at individuals and identifying the good/bad that we can see or observe Also, requires providers to look at the trunk of the individual and how its rooted into the ground Trunk is everything that makes us up as an individual in a present state of being Roots represent history (good/bad) that contribute to behavior how we came to be

15 Tree Top Bottom Stop Approach Teamwork Provider/MDT work together to identify issues Provider/MDT select areas of expertise to respond to specific needs of an individual Provider/MDT responsible for doing their job and working with others Everyone should be prepared to address the root(s) of the problem to increase chances of wellness

17 Areas For Team Growth

18 Knowing Individual MDT Member Behaviors Seeking Attention ("I will be a team player if you give me credit ) Power Plays ("I am in control, you re not my supervisor!") Seeking Revenge ("I can humiliate or show my power over others for something they did to me") Appear Inadequate ( Don t expect too much from me, I don t want to be put on the spot )

20 External influences to an MDT Political/Legal Economic Socio-cultural Technological Environmental Others

21 Team Evaluation Are we following the mission, vision, goals, objectives of the group? Who is the team leader? (Sets the meeting, facilitates, coordinates information, etc.) Do you meet regularly or often? Are you sanctioned/acknowledged by the tribe/community? Are team members consistent in attendance and participation? Others

22 Closing Know your groups purpose Know your target group of consumers Be clear about what you are able to contribute to the group (professional responsibility) Know your boundaries Assess MDT, often Address problems/issues as they arise Develop policies/procedures/protocols/agreements

24 P.O. Box New Laguna, NM (505) nativecda@gmail.com

Alcohol. HP 2010 Objectives:

Alcohol. HP 2010 Objectives: Alcohol Alcohol is one of the most commonly used substances during adolescence. Though underage drinking is against the law, alcohol may be easily accessible to many teens. Binge drinking (defined by the