Culture As Prevention
We recognize and uplift Indigenous culture as a primary form of prevention for opioid misuse and its related harms. Although there is not a standard measurement for “culture,” evidence-based interventions that are grounded in Indigenous cultural understanding, and/or are culturally adapted, have resulted in significant improvements in a variety of health outcomes in the communities within which they were developed and tested.
The following are opportunities to incorporate culture in substance abuse prevention (as identified in a 2023 listening session with Tribal partners):
- Provide access to learn and practice cultural values early in life to prevent substance use,
- Organize alternative substance-free socializing spaces,
- Build community capacity in harm reduction, and
- Normalize the incorporation of cultural components in substance use prevention.
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Key Statistic
American Indian and Alaska Natives experience some of the highest opioid-related overdose rates of any race in the U.S (CDC, 2022)
How to Address
Well before the current federal public health emergency declaration on opiate use, Tribal governments have enacted their right as sovereign nations to declare a state of emergency, to mobilize efforts and funding to address opioid overdose and related mortality.
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Key Statistic
Across all tribal nations, the impact of colonization and ongoing underfunding of tribal health systems within AI/AN community has adversely affected these communities’ ability to respond to the opioid crisis (Goodkind et al, 2012).
How to Address
Several tribal nations have declared public health emergencies to address opioid overdoses in their respective communities. These declarations include commitments to respond to the crisis at the local community level using culturally congruent interventions, trauma-informed behavioral health, and evidence-based best practices such as naloxone for harm reduction.
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Key Statistic
Issues with racial misclassification in data sets may underestimate drug overdose rates among AI/AN by up to 40% (Joshi et al, 2018).
How to Address
The Community Assessment Tool: NORC, shows opioid overdose rates across the nation at the county level, and can display an overlay of AI/AN reservation boundaries. It provides a visual of where opioid overdoses are occurring at the highest rates, and how that information coincides with AI/AN population density across geographic areas, including reservations.
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Key Statistic
Stigma surrounding opioid misuse limits the ability of all communities to meaningfully respond to the opioid crisis.
How to Address
Local champions and leaders who advocate for drug harm reduction strategies, provide overdose education, safer alternative drugs, and inclusion of people who use drugs in cultural activities, may reduce stigma against those battling addiction (Welshula, 2021)
This website is brought to you by Seven Directions
Seven Directions is an Indigenous Public Health Institute (PHI) located at the University of Washington in Seattle. As an Indigenous PHI, we recognize the roles culture and communities play in prevention, and ensure we are representing this lens through our current and future work, and interactions with partners.
Indigenous Social Determinants of Health
In further efforts to also include Indigenous approaches to wellness, a group of Seven Directions’ team members created this Indigenous Social Determinants of Health (IsDOH) model (now available).
The six-module IsDOH training provides material and resources which center Indigenous perspectives and views on health, healing, and well-being. The goal of this training is to give public health practitioners, community members, and organizations the opportunity to reevaluate social determinants of health from an Indigenous perspective.