Substance-abuse therapies need to reflect culture, tribes say

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Substance-abuse therapies need to reflect culture, tribes say

'One size fits all' interventions lack strength of communities' values and traditions, UW study finds
Michael McCarthy

Programs seeking to address alcohol- and substance-abuse in American Indian communities should harness the strengths of local tribal culture, traditions and values, members of four Washington state tribal communities told University of Washington researchers. 

Many substance-prevention and treatment programs do not take local tribal culture into account, said Sandra Radin, a scientist at the UW Alcohol and Drug Abuse Institute. She was lead author of the study, published in the Journal of Ethnicity in Substance Abuse.

By and large, substance-abuse programs fail to incorporate tribal cultures and values, said lead author Sandra Radin.
picture of Sandra Radin

“American Indians have thousands of years of experience dealing with adversity and have customs and traditions that have helped them to survive,” Radin said. “There is a lot that they know about their communities and their communities’ needs that outside researchers don’t.”

Most interventions have been developed for non-Native individuals, Radin noted; even programs developed in one Native American community might not work for another with a different culture and history.

“There’s a tendency to view all tribal communities as the same, and they can be very different,” she said.

The UW researchers conducted interviews and focus groups with more than 150 members of four participating Northwest-area tribes: the Swinomish Indian Tribal Community, the Cowlitz Indian Tribe, and two others that did not want to be publicly identified. 

One finding was that the nature of substance abuse in these communities is constantly evolving. For example, before the study started, methamphetamine was seen as a major problem in some communities, but during the study, abuse of alcohol and of prescription pain medications such as oxycontin and hydrocodone emerged as paramount concerns. 

“Today, there is growing concern about the rise of heroin use,” Radin said, reflecting a trend being seen across the country and across population demographics. 

Substance-abuse interventions routinely lack culturally relevant components, the UW study found.
drawing of a directional sign that says Rehabilitation

The researchers found one constant, too: the importance that tribal members place on values of “sharing, caring, loving and giving,” which extend beyond individual families, Radin said.

Successful interventions, tribal members told the researchers, would incorporate tribal communities' strengths by recognizing those values and incorporating cultural practices into treatment and prevention, such as traditional ceremonies, healing rituals, and practices such as beading, weaving, and drumming, she said.

Tribal members also called for services to be located within the community, for greater family and community involvement in the programs, and for mental health and other healing services to address the historical trauma and injustices that American Indians have experienced.

“Native  communities know what works for them,” Radin said. “We need to respect their views and honor their perspectives.”
The study’s co-authors include representatives of the partnering tribal communities as well as Lisa Rey Thomas and Dennis Donovan of the UW institute.