American Indian 8th Grade Students Have High Rates of Substance Abuse Interview with:
Randall C. Swaim, Ph.D.
Senior Research Scientist and Director
Linda R. Stanley, Ph.D.
Senior Research Scientist

Tri-Ethnic Center for Prevention Research
Department of Psychology
Colorado State University                   What is the background for this study?

Response: American Indian adolescents consistently report the highest levels of substance use compared with other US racial/ethnic groups. The harm associated with these high rates of use include higher risk of developing a substance use disorder, more alcohol-related problems, including alcohol-attributable death, and other negative outcomes such as school failure. These findings point to the importance of continuing to monitor this group, particularly given changing trends in perceived harmfulness of illicit substances as new statutes alter access to medical and recreational use of cannabis. What are the main findings?

Response: We found substantially higher lifetime and last-30-day substance use rates compared with a national sample of youth from the Monitoring the Future study. The greatest disparities were found at eighth grade with relative risk ratios of 2.1 for alcohol, 4.2 for marijuana, and 2.4 for other illicit drugs. In addition, the gap between American Indian and MTF adolescents in other illicit drug use appears to have increased substantially from 2009-2012 to 2016-2017. What should readers take away from your report?

 Response: The higher rates of substance use among American Indian students compared with MTF students at grade 8 stresses the critical need for early prevention intervention efforts for American Indian youths living on or near reservations. Yet, few interventions have been developed and tested for this group. In addition, it is important to closely monitor and screen American Indian youths for substance use. What recommendations do you have for future research as a result of this work?

Response: Because we found much higher rates of use for American Indian 8th grade students compared to US eighth graders in general, continuing surveillance of this group should begin at the later elementary school years. Is there anything else you would like to add?

Response: By continuing to monitor and report rates of substance use among this population, we hope not only to continue to inform key audiences about this issue, but also to spur action and increase resources for prevention and intervention. The costs to these youths, their families, and their communities is simply too high for these disparities to continue.

Authors: The authors have no conflicts to report in related to this research study.


Swaim RC, Stanley LR. Substance Use Among American Indian Youths on Reservations Compared With a National Sample of US Adolescents. JAMA Network Open. 2018;1(1):e180382. doi:10.1001/jamanetworkopen.2018.0382 

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Last Updated on June 6, 2018 by Marie Benz MD FAAD