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Alcohol and Drug Abuse Among Native Americans

Signs of substance abuse and addiction are mostly universal. Some people might be able to hide them in the beginning, until the severity of their SUD gets out of control. This usually depends on factors like environment, education level, social class, genetic predisposition, and others. There’s a certain level of prejudice about widespread alcoholism in Native Americans, as well as the use of other substances like illicit street drugs.1

Current Native American drug abuse is connected to their position in a predominantly white society, even though Native Americans historically used natural psychedelic drugs for thousands of years. Hallucinogenic substances are used both recreationally and ceremonially as part of religious and spiritual ceremonies in American Indian cultures. The most common one is mescaline, made from peyote cactus. Religious or spiritual use does not include the use of other drugs.2

Native American Substance Abuse Statistics

The statistics, unfortunately, fuel the prejudice about Native American substance abuse. Even though they comprise only 1.7% of the US population, their risk of substance abuse is higher in comparison with other races.3 

Alcohol is the most frequently abused substance, and the use of illicit drugs is rising, most notably among young Native Americans.4 Illicit drug use is widespread across all age groups and higher than in any other racial/ethnic group. People of Native American descent also have the highest rate of methamphetamine use, as well as the highest rates of marijuana and cocaine use disorders.5, 6

Even though about 20% of Native Americans need SUD treatment, only 12% receive it.7

What Are the Causes of Alcohol and Drug Addiction in Native Americans?

Stressful life events are typically associated with depression, substance use, and risky behavior.8 Following either Christian beliefs or American Indian traditional spiritual beliefs is associated with anti-drug attitudes and lower levels of substance use.9

Throughout US history, Native American societies have been affected by genocide, forced removal from homelands and placement into boarding schools, and the breakdown of traditional family systems. The effects of these historically-based traumas have a significant impact on the well-being, various psychosocial issues, and are one of the factors for substance abuse among Native Americans.6

Aside from historical trauma, multiple factors play a part in high rates of substance abuse. There’s an entire range of social and economic conditions, like poverty, under-employment, access to health care, lower education, homelessness, and violence.10

Lack of Education

Compared with the general population, Native Americans have low rates of high school completion and are less likely to graduate from college. Education is one of the protective factors against substance abuse and other behavioral and mental health problems.11


Native Americans are more likely to suffer from trauma. For example, reports of experiencing at least one traumatic life event are common among this ethnic group and the historical trauma carries on across generations. Rates of trauma exposure are particularly high for Native American women.11


The unemployment rate is high among both American Indians and Alaska Natives and even higher for Native Americans living on tribal lands. In a lot of states, fewer than 50% of Native Americans living on reservations are employed. This is associated with a higher risk for substance abuse, and it may contribute to other behavioral health problems.11

Limited Health Services

Most Native Americans get healthcare from the Indian Health Service (IHS). HIS has limited resources and is not available in rural areas. Even though most Native Americans live in urban areas, IHS provides care at a limited number of sites.11

Additionally, IHS covers only members of federally recognized tribes, and that excludes about two-thirds of Native Americans. Most of those who don’t receive IHS services don’t have any medical insurance and can’t afford any healthcare treatment.11

Family History 

Family history of alcohol or drug use is also a significant risk factor for substance abuse in general, not just for Native Americans.11

What Are the Effects of Drug Addiction on Native Americans?

Early initiation of Native American youths to alcohol or drug use increases the likelihood of use in adulthood and developing a SUD. Some of the consequences of SUD-related behavior are criminal court charges (most commonly DUIs and DWIs). Young Native Americans are more likely to need substance abuse treatment than all other US racial/ethnic groups.12

Suicide and Overdose

Suicide is the second leading cause of death among Native American youth ages 8 to 24.13 Suicide and suicide attempts often accompany substance abuse in Native American communities. Men ages 15–24 account for nearly 40% of all suicide deaths among natives. Alaska Natives have suicide rates that are more than double than US average.11

The rate of drug overdose deaths is above the national average and most recent data suggests that this trend is continuing.14 Native Americans are at least twice as likely to become addicted to drugs and alcohol than any other population group, and three times more likely to die of a drug overdose.3


Native Americans are more likely to experience violent crime compared to members of every other racial or ethnic group. They are more likely to experience interracial violence (at least 70% of violent crimes), as well as violence from strangers. This interracial violence rate is significantly higher than violence rates for Caucasians or African Americans.15

They are also more likely to experience domestic violence and intimate partner violence. Native American women experience higher rates of victimization than women belonging to any other US racial/ethnic group.11

Health Complications

Among the most common consequences of drug abuse and addiction are heart and lung disease. Native Americans are also more likely to have other health problems, most commonly tuberculosis, diabetes, and cardiovascular disease. In comparison to the general population, they have higher death rates related to:11

  • Alcohol (higher by 520%).
  • Diabetes (by 177%),
  • Chronic liver disease and cirrhosis (by 369%)
  • Tuberculosis (by 450%).

What Are the Barriers to Addiction Treatment for Native Americans?

Native Americans are faced with many barriers to accessing health care and behavioral health services.11 They also have difficulty accessing substance abuse treatment, particularly if they live on reservations.5

There are also significant challenges when it comes to Native Americans’ access to substance abuse treatment. Some of those are, for example:6

  • Transportation barriers.
  • Low insurance coverage rates.
  • Low socioeconomic status.
  • Discomfort in the “westernized” treatment system.
  • Lack of integrated culturally relevant SUD treatment models.
  • Issues of cultural insensitivity and acceptability.
  • Stigma, shame, and prejudice are associated with substance abuse and mental health issues.
  • Lack of treatment centers in reservations or rural areas.

Most of the nation’s 2.9 million Native Americans living on and off reservations have little to no access to basic health care, much less mental health and addiction services.6     


How Does Native American Youth Abuse Drugs?

Rates of substance abuse among Native American youth, in comparison with same-aged peers, have been high for decades. Significantly higher use was reported for most substances.2

Young Native Americans experience high rates of trauma (suicide, accidents, violence), in addition to adverse childhood experiences like child abuse and household dysfunction. Relationships between such experiences and high rates of substance abuse and addiction have been established by numerous studies.12

Teenagers who live on or near reservations use nearly all substances at significantly higher rates than other US adolescents.12 Compared to the national average, Native American teens and young adults show the highest rates of marijuana and prescription medication abuse (like opioid painkillers or psychotherapeutic drugs).16 Rates for cocaine, crystal meth, and psychedelics are 7.3 to 8.3 times higher than the national average.12

What to Expect in Native American Rehab Centers?

According to SAMHSA’s National Survey on Drug Use and Health, from 2010, the percentage of Native Americans who needed drug or alcohol rehab during the past year was higher than the national average for adults (18% vs. 9.6%).6

Most licensed alcohol and drug rehab centers offer comprehensive evidence-based care to treatment-seeking individuals while taking into consideration their particular needs and circumstances, to provide a comfortable and safe environment for all patients, including Native Americans. Rehabilitation treatment usually consists of:1

A Packing List for a Native Americans Rehab Center 

The packing list for a longer, residential stay at a rehab facility doesn’t vary between different races/ethnicities. Treatment centers have their own policies about what items are allowed on the premises and what is banned. To find out what to pack, it’s advised to call the rehab center you’ll be attending and ask about their rules. The staff will check your bags for any banned items during the intake process when you arrive at the facility.1

You usually need to bring:1

  • Weather-appropriate, comfortable clothing (according to the facility’s dress code).
  • Personal hygiene products.
  • Your prescription medication, in the original packaging, with the information label intact. You should also bring a list of all your medications and dosages.
  • Some form of ID.
  • A list of names and phone numbers of people helping you during recovery (family, friends, 12-step program sponsors).

How Can Native Americans Pay for Rehab?

Native Americans are usually covered for healthcare services by The Indian Health Service (IHS). This is a federal program for American Indians and Alaska Natives. As an agency within the Department of Health and Human Services, HIS is responsible for providing healthcare to Native Americans. It’s their main federal healthcare provider.17

IHS has an Alcohol and Substance Abuse Program (ASAP) that aims to improve the quality of care and make it more easily accessible. More than 90% of ASAP is managed by Tribes.18

The Affordable Care Act provides Native Americans with more insurance choices. Depending on eligibility and different coverage available in each state, patients can:19

  • Use IHS, Tribal, or Urban Indian Health Programs.
  • Enroll in a qualified marketplace health plan.
  • Use Medicare or Medicaid coverage.

When insurance doesn’t cover the full cost of treatment, or if someone doesn’t have any insurance, there are other private financing options to consider. This is particularly important since getting addiction treatment is time-sensitive and early intervention significantly improves chances of good outcomes and lasting recovery.1

Family and community ties are a particularly important element of Native American culture, so it’s possible to get support by raising money from the community or getting loans from family and friends. Tribe support is another option since more than 50% of the mental health programs and more than 90% of Native American recovery programs are Tribally operated. Some rehab centers offer flexible payment plans and sliding fee scales as an option for those with low income.18

How to Find Native American Rehab Near Me?

One of the sources Native Americans can reach out to is SAMHSA’s National Helpline. This is a 24/7 information service that is both free and confidential. You can find out more about various treatment options, get referrals to local rehab centers, support groups, community organizations and find out about insurance coverage for addiction treatment. Visit their website or call their hotline number: 1-800-662-HELP (4357).20

Furthermore, American Addiction Centers has treatment programs designed for individualized care and tailor their approach to accommodate specific needs and certain cultural values and beliefs. Rehab facility staff training in cultural competency guarantees culturally respectful programs and creates a safe environment. So, patients feel free to include elements of the tribal way of life. This may help struggling Native Americans open up about traumatic experiences or mental health issues.5 

Rehab centers are increasingly including elements of Native American culture into their recovery programs.5 The Indian Health Service (IHS) has partnered with specialized facilities to develop innovative approaches that take into account the different backgrounds of each tribe.19

Since health insurance providers don’t always cover the full cost of rehab, you can call the AAC helpline to find out about your payment options, or you can check your coverage by filling out an online form. In case there’s no appropriate treatment program in your area, you can look into treatment centers that might be further away from home. A good way to do this is by calling free, confidential addiction hotlines to get guidance and information about different options. Some of AAC’s popular, high-quality choices include: 

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