Exploring Binge Drinking and Drug Use among American Indians: Data from Adolescent Focus Groups

Abstract

Background: Risk factors for binge substance use and non-suicidal self-injury (NSSI) are similar, suggesting the importance of exploring how binge substance use and self-injury interrelate. Objectives: To gain insight from a sample of American Indian (AI) adolescents regarding how binge drinking and drug use function in their lives, including as overlapping forms of self-injury, and to identify community-based ideas for dual prevention strategies. Methods: A total of N = 58 White Mountain Apache (Apache) adolescents participated in ten mixed gender (n = 33 males, 55.9%) focus group discussions. Results were interpreted and categorized by Apache researchers and compared to Nock’s behavioral model of NSSI. Results: Participants reported substance use most commonly with “family” and “friends,” “at a house,” or “around the community.” Substance use was not confined to a particular time of day, and often occurred “at school.” Commonly endorsed reasons fell into two main categories: “to avoid problems” or “to reduce negative feelings,” versus “to be cool” or “to feel part of a group.” All adolescents but one thought that some youths use substances excessively as a way to harm/injure themselves (n = 25 responses). Prevention approaches included encouraging healthy relationships, teaching about consequences of use, providing alternative recreation, and changing/enforcing laws on the reservation. Conclusion: Tribal-specific data support the idea that binge substance use sometimes functions as a form of self-injury. Home/school environments are critical prevention settings, in addition to improved law enforcement and increased recreation. Scientific Significance: Understanding possible shared root causes and functions of binge substance use and self-injury may advance integrated prevention approaches.

• binge substance use
• non-suicidal self-injury
• American Indian
• qualitative research

ACKNOWLEDGMENT

We respectfully acknowledge the National Institute on Drug Abuse and the Native American Research Centers for Health for supporting this research.

Declaration of Interest

Dr. John Walkup received free medication and placebo from Lilly, Pfizer, and Abbott for NIMH-funded studies. He is a consultant for Shire Pharmaceuticals. He is a paid investigator on grants funded by Pfizer. He receives honoraria and expenses for continuing education presentations from the joint Tourette Syndrome Association and Center for Disease Control outreach program. He receives royalties from Guilford Press and Oxford Press for books on Tourette syndrome. He receives grant funding from the Tourette Syndrome Association. He serves on the advisory board of the Tourette Syndrome Association, the Trichotillomania Learning Center, and the Anxiety Disorder Association of America without pay but with travel expenses covered.

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