Demographic Differences of Substance Use Rates for American Indian Youth

Introduction. Previous research examining reservation-based AI substance use has found demographic differences including regional differences. This study uses a large sample of students attending schools on or near reservations to examine differences in the likelihood of substance use by age, gender, and region. Knowing these patterns of use is important as it serves as a foundation for understanding the etiology of use, and it can guide policy, resources, and prevention intervention development as it concerns this population.

Methods. This study uses cross-sectional data from students in grades 7-12 enrolled during the 2015-2017 school years in schools on or near reservations. Schools with at least 20% AI students enrolled were randomly sampled across six cultural regions, with recruitment in each region approximating the percentage of AIs residing there. Using a multilevel analysis, lifetime and 30-day alcohol, marijuana, and illicit drug use, in addition to binge drinking, were examined for differences by gender, grade, and region.

Results. For all measures, likelihood of use increased with age but at a decreasing rate, especially for females. Across all alcohol measures, similar patterns emerged, with females generally having higher likelihoods of current alcohol use, drunkenness and heavy drinking, except for the Southwest (SW) region where female and male use was similar. There were no other regional differences for alcohol use measures. AI youth residing in the Northern Plains (NP), Upper Great Lakes (UGL) and SW were more likely to have used marijuana in the last 30 days than their counterparts in other regions, with NP females having the highest likelihood of use. Finally, youth living in the SW were significantly more likely to use “any illicit drug” and “any illicit drug excluding marijuana”.

Conclusions. Significant differences by region, age, and gender in the likelihood of alcohol, marijuana and illicit drug use were found. Similar to recent studies, females were more likely to use, especially at younger ages. Unlike previous studies that found that NP youth were more likely to have gotten drunk and used marijuana in the last 30 days, this study found that NP youth were no more likely to get drunk than AI youth in other regions, and NP youth had a similar likelihood for 30-day marijuana use as UGL and SW youth. Whether these differences reflect reductions in use for NP youth compared to other youth or increased use by youth in other regions needs further examination. On the other hand, SW youth reported more use of illicit drugs, in general. As data from more schools becomes available this year, we will present up-to-date findings with a larger sample of AI schools, along with a more in-depth exploration of these findings.