The American Indian Alaska Native National Resource Center for

The American Indian/Alaska Native National Resource Center for Substance Abuse and Mental Health Services The Indian Country Methamphetamine Initiative: Addressing a Problem Uniquely Affecting Indian Country Dale Walker, MD Michelle Singer Patricia Silk Walker, Ph. D Douglas Bigelow, Ph. D ATNI Winter Conference: January 24, 2008 Yakima, Washington

Six Behaviors That Contribute to Serious Health Problems: • Tobacco use • Poor nutrition • Behaviors resulting in intentional or unintentional injury • Physical inactivity • Risky sex • Alcohol and other drug abuse – Methamphetamine! 2

Methamphetamine Use, by State in Young Adults (18 to 25) 3 Source: SAMHSA, 2002 -2005.

Methamphetamine: Epidemiology

Methamphetamine/Amphetamine Admissions by Ethnicity and Urbanization: 2004 Large Central Metro Large Fringe Metro White 56% Black Race/Ethnic ity Small Metro Non-Metro with City Non-Metro without City 77% 78% 86% 87% 5% 3% 2% 1% 1% Hispanic 28% 14% 11% 6% 4% American Indian/ Alaska Native 2% 1% 3% 4% 6% Asian Pacific Islander 3% 2% 1% Other 6% 3% 3% 1% 1% Source: 2003 SAMHSA Treatment Episode Data Set (TEDS).

The Methamphetamine Effect 6

Methamphetamine Identified as the Primary Health/Community Concern • In 2006, Tribal Round Table sessions, HHS Regional Tribal Consultations, and numerous tribal community gatherings with SAMHSA, OMH, and IHS identified Methamphetamine abuse as the primary health concern in Indian Country. 7

“Tribal leaders unveil new meth Initiative” Indian Country Today NCAI President, Joe Garcia Anchorage, Alaska June 15, 2007 8

Indian Country Methamphetamine Initiative (ICMI) • $1. 75 million awarded to Association of Indian Physician (AAIP) its partners (National Congress of American Indians, One Sky Center, South and Eastern Tribes, and Northwest Portland Area Indian Health Board) • Tribal Sites – – – Navajo Nation Winnebago Tribe Northern Arapaho Tribe Crow Nation Choctaw Nation 9

ICMI Project Description • Create a National education and information outreach campaign for all Native communities. • Establish and transfer knowledge from community based, promising practices for prevention, intervention and treatment. • Work across Federal agencies for a coordinated and consistent outreach strategy. 10

The Indian Country Methamphetamine Initiative: Project Partners SAMHSA OMH IHS HHS AAIP USET Choctaw Crow NPAIHB OSC NCAI Navajo Northern Arapaho Winnebago 11

ICMI Partners 12

ICMI Major Project Deliverables • Outreach/Education Kit for Tribes and others • Identification of Partners/Advisory Groups • Coordinated Federal-Tribal-State-Local Indian Country Communication and Training • Minimum 5 Tribal Specific Projects Identified and Evaluated for Potential Transfer to Other NA Communities • Final Project Evaluation • Year 3 - Promising Practices Transfer Kits 13

Toolkit Essentials • Leadership Information • Methamphetamine Basics • Tribal Code-Policy • Media • Educational Materials and Presentations Prevention and Treatment Educational for Students, Parents, Community • Community Organizing • Fun Youth Items 14 • Additional Resources

How to Use the Toolkit • Leadership and decision making • Overview of each module • Specific topics, issue pages • Promising Practice approaches • What the culture and science says • Training, technical assistance, and consultation • Reference documents • Toolkit webpage 15

ID Best Practice Clinical/services Research Mainstream Practice Traditional Healing 16

Choctaw Nation of Oklahoma • • • “Natural Highs Program” Transformation process Experiential activities Relationship building Changing the way you live and think • Changing how you think and you believe about life and yourself 17

METH FREE CROWALITON Unity in Our “War Against Meth” 18

Meth Free Crow Walk: Youth as our Warriors in Reclaiming our Nation

Dine Nation Methamphetamine Initiative

What Works • Community Education – Age-appropriate presentations, brochures, ads • Enforcement (NLE Drug Unit) – Arrest and detainment for trafficking • Caring members of the community • Partnerships – Communities, chapters, private businesses and tribal divisions and programs. 21

Northern Arapaho Tribe Methamphetamine Initiative A System of “Works” 22

The concept of “Works” in a Comprehensive Systems Plan The Problem: – – “turf” gaps duplications crossed purposes Fragmented Service System The Solution: – – – client-centered multi-agency comprehensive coordinated efficient “Works” Works 23

Winnebago Tribe Together, WE Make A Difference: Methamphetamine Prevention on the Winnebago Reservation Tipi Means, Tribal Health Educator 24

Goals and Objectives Winnebago Meth Task Force • Develop/maintain a Comprehensive Methamphetamine Prevention Strategy • Collectively plan and implement • Use Proactive measures • Use available funds - take immediate action • Working together to determine what fits for tribal members and the reservation 25

Next Steps • Add two additional Tribes • NCAI provide PSAs and house the Tribal Meth Taskforce • USET and NPAIHB will gather baseline data on methamphetamine use • One Sky Center: – TA for writing best practices – Create a training curriculum – Train additional tribes in ICMI best practices – Develop a cultural methamphetamine abuse education kit

Contact us at 503 -494 -3703 E-mail Dale Walker, MD onesky@ohsu. edu Or visit our website: www. oneskycenter. org