Session: Latest Substance Use Epidemiology from a Population-Based Sample of Reservation American Indian Students (Society for Prevention Research 26th Annual Meeting)

American Indian (AI) adolescents attending schools on or near reservations consistently report the highest levels of substance use compared to other U.S. racial/ethnic groups. Risks associated with these rates include higher risk of developing a substance use disorder and more alcohol-related problems including alcohol-attributable death. These findings underscore the need for continued surveillance of this at-risk group, particularly given changing trends in perceived harmfulness of illicit substances.

This session presents the latest substance use epidemiology findings from a population-based sample of AI students living on or near reservations. Data are from 7^th–12^th grade students enrolled during the 2015-2017 school years. Schools on or within 25 miles of a reservation with at least 20% AI students were randomly sampled across six cultural regions, with recruitment in each region approximating the percentage of AIs residing there. The sample contains 37 schools and 3870 AI students.

Paper #1 compares AI substance use rates to Monitoring the Future (MTF) rates for the school year 2016-2017 for 14 substances. Rates of lifetime and 30-day use were compared to MTF rates for grades 8, 10 and 12. Lifetime and 30-day rates were significantly higher for AIs than MTF for most substances, with the largest differences for gotten drunk, binge drinking, marijuana and cigarettes. AI 8^th graders reported use of any illicit substance of 26.1% compared to 6.9% for MTF while for 12^th graders, this rate was 40.5% compared to 24.4% for MTF.

Paper #2 analyzes lifetime and 30-day use for alcohol, drunkenness, marijuana, and illicit drugs by gender, grade, and region. 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). AI youth 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. Finally, SW youth were significantly more likely to use “any illicit drug” and “any illicit drug - not marijuana”.

Paper #3 examined predictors of peyote use to identify differences between recreational and spiritual users since research to date has failed to differentiate spiritual versus recreational peyote use. Religiosity and cultural identity predicted spiritual but not recreational use, such that AI youth who identified as more religious and identified more strongly with their culture were more likely to report using peyote for spiritual purposes.

After presenting all papers, we will encourage and lead open discussion of the health, welfare, and prevention implications of these findings.