Essay on Substance Abuse Prevalence and Patterns

According to the Treatment Episode Data Set (TEDS) report, it was established that about 2.5 percent of American adults who admitted for substance abuse treatment are Native Americans (Bureau of Indian Affairs, 2016). However, this group of people only makes less than 1 percent of the US population. Most of these people who sought treatment for substance abuse had not done it willingly as they were referred to the program by the criminal justice system as part of their reformation process for the crimes that they had committed (under the influence of these drugs). However, there was a relatively low percentage that had referred them to the treatment program. National survey studies on substance abuse indicate that American Indians/ Alaska Natives have the highest rates of abusers as compared to the other racial groups. In 2013, the National Survey on Drug Use and Health (NSDHU) found out that 12.3 percent of Native Americans were using illicit drugs. This is in comparison with 9.5% of whites, 8.8% of Hispanics and 10.5% of African Americans (Lewis, Litt, Blayney, & Granato, 2011).

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

In another study that was conducted by NIDA in 33 schools during 2009-2012, it found out that the American Indian youth were being initiated to alcohol and other drugs at a younger age than children from other racial and cultural backgrounds. In the study, it was revealed that 56.2 8th graders and 61.4 10th graders had used marijuana at least once in their lifetime. This was a high percentage as compared to the national data that had been provided in this survey, which showed that only 16.4% of 8th graders and 33.4% of 10th graders had smoked marijuana at least once in their lives before the survey (Lewis, Litt, Blayney, & Granato, 2011). In addition to that, the Native Americans have a two or three times higher chance than the national average of abusing drugs such as heroin and Oxycontin.

The prevalence rates of alcohol abuse among Native American and Native American adults may be hard to establish due to; measurement errors and stereotypes that have been associated with the practice. However, it has been established that death as a result of alcohol abuse is higher for the AI/AN group than for the other types of ethnic categories. In fact, studies have shown that 75% of AI/AN deaths are alcohol-related, and it is greater in men than it is in women (Bureau of Indian Affairs, 2016). Also, it has been established that; women who have alcohol problems or are addicted to alcohol are highly likely to be abusing other drugs such as heroin, cocaine, and amphetamines. The environmental setting of an individual plays a key role regarding substance abuse problems. For instance in a study comparing AI/AN women in different settings found out that; women in rural settings, drink more than women in urban settings (Lewis, Litt, Blayney, & Granato, 2011).

Substance Abuse and Psychiatric Disorders

According to the data provided by the Substance Abuse and Mental Health Services Administration (SAMHSA), it provided the following statistics about mental disorders for the AI/AN group. Approximately 21.2% of AI/AN adults had reported that they had experienced mental health issues in 2014 (Bureau of Indian Affairs, 2016). Of those who had reported incidences of mental health illness, approximately 4% had stated that they had serious mental illness issues. It was also established that approximately 8.8% of AI/AN adults had reported co-occurring past-year mental and substance use disorders. It was in stark comparison with the national average that was 3.3%.

Post-Traumatic Stress Disorder (PTSD)

Among the AI/ANs, studies have shown that PTSD can be a causative factor or for drug users, it can exacerbate addictions, depression, and even cases of violence. Traumatizing events occur at a seemingly high rate among the AI/AN groups (Bureau of Indian Affairs, 2016). They face the impact of trans-generational stressors that are related to issues such as genocide, racism, poverty and death. Studies have shown that historical trauma that affected earlier generations continue to accumulate and affect the current generations leaving them emotionally vulnerable, and therefore they use drugs and alcohol as a means to cope. These traumatic experiences have resulted in PTSD, which has led to both substance abuse and alcoholism.

Mood Disorders

According to the National Comorbidity Survey, it showed the AI/ANs reported the highest rate of serious psychological distress and major depressive episode (MDE). Additionally, in a study period of 2005-2010, 15.1% of AI/ANs who resided in the Urban Indian Health Organizations (UIHO) reported experiencing at least 14 poor mental health days in the past 30 days in comparison to 9.9% of people from other races (Lewis, Litt, Blayney, & Granato, 2011). Untreated depression is the leading cause of suicide in the United States. According to the CDC, suicide is the eighth leading cause of death among the AI/AN. Also, it is the second leading cause of death among the people of ages 10 and 34. The primary reason why there is a high suicide rate among the AI/AN group is mainly that of the lack of adequate mental health services in the reservations. Therefore an individual who is suffering from a serious condition such as depression, psychoses, and paranoid ideation will not receive the assistance that he or she requires, and ultimately it may lead him or her to commit suicide.

Counseling

According to various studies, some of which have been highlighted in this paper, it has been established that there is a high rate of alcoholism, drug addiction, and mental health issues among the Native American community-co-occurring disorders as compared with the general population. Although most of the Native Americans who are facing these issues are seeking treatment for their addiction and mental health issues, positive treatment outcomes are being hindered due to lack of cultural understanding (Lewis, Litt, Blayney, & Granato, 2011). Most of the treatment centers for both the alcohol and drug treatment fail to offer specialized practices and considerations for Native Americans. They fail to take into consideration the importance of culture, traditional beliefs, and ceremonies in the lives of Native Americans, and therefore, the treatment methods or practices that they prescribe to this group have a low success rate.

Impact of Culture on Treatment

Sociocultural beliefs of a certain group of people play a primary role in their approach and behavior about substance use and abuse. Cultural values normally play a critical role in informing individuals about the potential problems that they face as a result of drug use. The Native American elders have the notion that the high rate of substance abuse among the Native Americans is closely related to their loss of traditional culture (Volkow, & Warren, 2012). This belief has been confirmed by studies that show the higher rates of substance abusers has been found in Native American people who do not value their Native American cultural values, and they associate themselves more to the non-Native American values. It also showed the lowest rates of substance abuse users were in bicultural individuals who value both their Native and non-Native American values.

Studies conducted on immigrants reveal how cultural values play an important role in substance abuse. The study focused on Hispanics who have moved to the United States. The study showed that because of acquiring a new set of cultural norms and values that are in the United States, Hispanic women would often be acclimatized to the drinking behavior, and it will eventually lead them to have alcohol abuse disorders. In a study in the Washington State, it showed that there was an increase regarding alcohol and substance abuse among the acculturated Hispanics (7.2%) than for the non-acculturated Hispanics (<1%) (Volkow, & Warren, 2012). The low alcohol and substance abuse that was seen in non-acculturated Hispanics was attributed to them being more family-oriented and still held on to their indigenous cultural values than the acculturated Hispanics.

During the assessment for both substance abuse and dependence, it is important to take into consideration an individuals cultural background. The DSM-IV publication on cultural psychiatry identifies five major of culturally relevant considerations that need to be addressed. These are an individuals cultural identity, the cultural explanation of an individuals illness, the cultural factors that are associated with an individuals psychosocial environment, the relationship between the clinician and the patient, and overall cultural assessment for both the diagnosis of the patient and care (Volkow, & Warren, 2012).

When dealing with a patient from a Native American background, it is important first to identify the tribe of the individual. The mistake that most counselors make when dealing with Native American patients is assuming that Native Americans fall under one tribe. However, it is not the case as there are many tribes among the Native Americans, and as a psychiatrist, it will be important to establish the tribe or ethnic group of that person- he may be an Apache, Cherokee or a Spokane and they speak different languages and have different cultural beliefs. It is also important to establish the language that the patient is comfortable communicating in during the treatment sessions. If the psychiatrist and the patient do not speak a common language fluently, then the patient may feel alienated, and it can create a barrier to their communication. Screening and diagnosis can be ascertained by asking the patient about the frequency of their alcohol and drug use over a certain period and then the treatment process can begin.

Other Important Things to Take Into Consideration

Stigma Associated with Mental Health

When dealing with AI/AN groups about the treatment of mental illness, it is important to take into consideration the stigma related to psychiatric disorders. As was mentioned earlier, psychiatrists should not assume a one size fits all approach when dealing with the AI/AN group. The difference between two Native American ethnic groups may be greater than the difference between two European cultures of different countries such as the German and the French (Lewis, Litt, Blayney, & Granato, 2011). They also share different perspectives about mental disorders, their causes, and how they can be treated, and all these need to be taken into consideration. However, it has been noted that; for the Native Americans who consider themselves to be less associated with their cultural and ethnic values are more inclined to accept the diagnosis and treatment process, especially if they have accepted the treatment process of the dominant culture.

By the stigmatization of the mental illness by the different Native American ethnic groups, there are tribal groups that attach very little or no stigma to the mental disorders because; they do not have any distinctions between physical and mental illness (Volkow, & Warren, 2012). They feel that being sick is part of life and therefore an individual should not face stigmatization because he or she has been diagnosed with a certain mental disorder. However, other tribal groups stigmatize people who have been diagnosed with mental health issues. Additionally, the ethnic groups that normally attach high levels of stigmatization to psychiatric disorders are more willing to accept the diagnosis and treatment methods that are offered by the Western medicines, than for the communities that place little or no stigmatization to mental health issues (Lewis, Litt, Blayney, & Granato, 2011). Stigmatization to mental hea...