Review of Substance Use Disorder Treatment Research in Indian Country: Future Directions to Strive toward Health Equity

Abstract

Background: American Indians and Alaska Natives (AI/ANs) have disproportionately high rates of substance use disorders (SUDs). Effective treatment can help to reduce these disparities. Objective: To review and summarize the AI/AN SUD treatment research literature. Methods: The literature between 1965 and 2011 was reviewed to identify AI/AN SUD treatment articles. Results: Twenty-four unique studies were identified. Earlier treatment research focused on clinical ratings of improvement; later studies employed formal assessment measures. Poor outcomes were attributed to psychosocial factors. Where treatment outcomes appeared to be similar to comparison samples, interpretation was hampered by methodological concerns. Conclusions: The research has improved across the decades, as has the inclusion of cultural adaptations. Future research should examine factors that influence treatment effectiveness and improve retention to bolster confidence in findings. Scientific Significance: AI/ANs experience SUD-related health disparities. Understanding what factors contribute to positive treatment outcomes can help to address these disparities.

• American Indians
• Alaska Natives
• Native Americans
• alcohol
• drug
• substance use disorder
• treatment
• culture

ACKNOWLEDGMENTS

This research was supported in part by grants T32AA018108-01A1 and R01 DA021672. The authors are grateful to Steven Verney and Judy Arroyo for reviewing an earlier versions of this manuscript.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.