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Substance use disorders, including alcoholism, are one of the top primary health concerns within many American Indian and Alaska Native (AI/AN) tribes and communities.

According to figures from the federal government, approximately 18 percent of AI/AN adults require substance use disorder treatment, almost twice the national average. Deaths from complications related to alcoholism, homicide, and suicide are two to six times as high among Native Americans as they are among other populations, according to various studies.

Substance use and mental health disorders exist within a complex and shifting landscape. There are economic, social, and cultural realities that must be understood if treatment is to be available and effective to those who need it.

Historical research suggests that many indigenous tribes have been altering their mental states for centuries, via methods like sleep deprivation, fasting, and the use of psychotropic substances like tobacco and peyote. Such activities were undertaken for spiritual or shamanic purposes.

However, with the degradation and loss of American indigenous culture, substance abuse has become a way of coping with crises of identity, financial despair, and the demands of everyday life. Fortunately, the addiction treatment providers are slowly yet surely shifting to accommodate the needs of the AI/AN population. JourneyPure at the River’s sister company JourneyPure Emerald Coast is proud to offer addiction and alcohol treatment specifically for Native Americans.

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Native Americans and Substance Abuse

As it stands today, nearly 15 percent of the AI/AN population meets the diagnostic criteria for a substance use disorder, compared to 4.6 percent for Asians, 7.4 percent among blacks, and 8.4 percent among whites.

Despite representing less than 1 percent of the U.S. population, AI/AN make up 2.5 percent of all American adults admitted for substance use disorder treatment. This figure is especially alarming in light of the fact that the majority of AI/AN people entering rehab do so under orders from the criminal justice system, not because they have acknowledged the need for professional help.

Stereotypes depict Native Americans as binge drinkers, and while alcohol remains the most-abused substance—nearly 30 percent of the AI/NA population admits to binge drinking—drug abuse is also on the rise.


Like most groups, alcohol is by far the most common drug for AI/NA adults admitted to treatment. From 2002 to 2008, it was the primary drug for 56 percent of Native American rehab admissions, compared to 46 percent for non-Native Americans.

A 1998 study by Fred Beauvais, Ph.D., American Indians and Alcohol, proposed that AI/AN drinkers tend to fall into two categories: anxiety drinkers and recreational drinkers. Anxiety drinkers abuse alcohol as a means of self-medicating or coping with mental pain, while recreational drinkers binge drink, usually socially, and so abstaining from alcohol is associated with alienation from one’s family, friends, or community.

According to findings by the Urban Indian Health Institute, alcohol-related mortality rates are 178 percent higher than the national average.

Substance abuse patterns among AI/AN youth suggested that alcohol was the second-most-used drug, after marijuana.

alcohol was the primary drug for 54% of native american treatment admissions in 2002 to 2008


According to treatment admissions numbers from recent years, the second most common primary drug among the AI/AN population was opiates, increasing from 1 percent in 2002 to 15 percent in 2008.

The current opioid-related overdose death rate is 13.7 deaths per 100,000 Native Americans, which exceeds the national rate of 13.1 per 100,000, according to the Centers for Disease Control and Prevention.

Co-Occurring Mental Health Disorders

In addition to elevated addiction rates, AI/AN are also more likely to have co-occurring disorders like depression, anxiety, and bipolar disorder. Contributing to these disorders are the exposure to trauma and acculturation hardship.

The risks are even more troubling among AI/AN youth, who display higher rates of depressive episodes compared to any other ethnic group.

Treatment providers can best help those of the AI/AN population by adopting a culturally sensitive treatment approach. Effective treatment for AI/AN people combines such understanding with evidence-based practices like medically assisted detox, residential care, individual therapy, and support groups.

Effects of Substance Abuse on Native Americans

The physical health effects of alcoholism and substance use disorder include:

  • A liver disease rate that is up to four times higher than that of the general population
  • Higher rates of drinking and driving
  • Higher-than-average rates of heart and lung disease

Beyond the individual damage that substance abuse can have, the effects of such abuse also undermines the stability of the Native American community as a whole.

Serious family problems arise when a person develops alcoholism or a substance use disorder. While alcoholism is notorious for tearing families apart, opiate abuse can damage families even more, due to its longer-lasting effects. Because the user is incapacitated for a longer period of time, the needs of the user’s children and spouse go longer without being met.

according to Indian Health Institute, alcohol-related death rates are 178% higher than national average

According to figures from Indian Health Service, the Federal Health Program for American Indians and Alaska Natives, the suicide rate among the AI/NA population is 72 percent higher than the national average, while the homicide rate is 92 percent higher than the national average.

How JourneyPure Can Help

When enrolled with JourneyPure Emerald Coast, people are provided with the tools needed to achieve and maintain sobriety and wellness. Our treatment programs are accredited by the Joint Commission and CARF as a rehabilitation facility, assuring clients that their care is in keeping with the highest treatment standards.

JourneyPure at the River offers medical detoxification, residential drug rehab, partial hospitalization (PHP), intensive outpatient (IOP) programming, outpatient treatment, and medication-assisted therapy (MAT). Each plan is comprehensive and multidisciplinary, with individual therapy, group therapy, and family therapy all playing their roles in treating not just the addiction but any and all co-occurring mental health issues.

Of course, many people who have gone through treatment wind up finding life “outside the clinic” challenging, as the problems that led to the addictive behavior are still there. This increases the danger of relapse.

JourneyPure’s answer to this danger is our slate of aftercare support programs, which help people continue to learn new ways of handling emotions and dealing with stress. This support includes our state-certified peer recovery coaching and free access to our JourneyPure Coaching™ mobile app.

The proprietary JourneyPure Coaching™ app includes private, HIPAA-compliant messaging between patient and coach, a daily recovery log, nutritional guidance, games, and collaborative care management with local healthcare providers.

Select JourneyPure locations directly address the AI/AN population with specialized treatment involving therapists of AI/AN descent who hold certification in certain AI/AN rituals.


Substance use disorders are highly complex. They can often leave those affected feeling helpless, hopeless, and isolated. Fortunately, there exists a variety of resources to assist AI/AN people through the treatment process.

Centers for Disease Control and Prevention (CDC): American Indian & Alaska Native Populations collects statistics and information on the health-related and social challenges that AI/AN people face.

Indian Health Service: The Affordable Care Act: This website presents information on the health insurance options available under the Patient Protection & Affordable Care Act (ACA), including Indian health or tribal programs, marketplace health plans, and Medicare/Medicaid.

The mission of the Native American Aid (NAA) is to improve quality of life and increase self-sufficiency among the AI/AN population through a variety of social services programs aimed at strengthening Indian communities.

Substance Abuse and Mental Health Services Administration (SAMHSA): American Indian and Alaska Native: Tribal Affairs is a federal agency that provides resources on mental health, substance abuse, and national survey results pertaining to American Indians and Alaska Natives.

Based in Colorado, the grassroots nonprofit White Bison offers resources on addiction prevention, sobriety, recovery, and wellness to indigenous peoples. Its website includes information about the program, listings of meetings, and daily meditations.