American Indian and Alaska Native Mental Health Research: The Journal of the National Center

The devastating impact of substance abuse on American Indians and Alaska Natives (AI/ANs) is reviewed with an emphasis on psychological and physical effects. Comorbidity of substance abuse, trans-generational trauma, Post -Traumatic Stress Disorder, and depression among AI/ ANs is also discussed since each condition may cause, impact, and/or exacerbate the others. The Medicine Wheel, one respected and accepted treatment approach developed by AI/AN communities, is described in detail since it helps address all of the co-morbid issues discussed. Diversity and AI/AN Nations Although AI/ANs are reportedly less than 1% of the total U.S. population, they comprise over 280 separate cultural groups consisting of 478 tribes (Liepman, et al., 1996). While the research literature frequently reports that alcohol abuse and its consequences are the primary health problems faced by AI/ANs today, one must remember that the patterns of substance use vary widely from group to group and that research has been conducted with only a limited number of AI/AN nations. Furthermore, the specific issues related to the cultural and individual history of each person must be considered as research findings may vary for that particular individual. It is also important to emphasize that substance abuse is only one of many problems experienced by a number of AI/AN Nations. As substance abuse progresses, however, it may become an allencompassing disease. Substance abuse and its consequences may be seen as a cyclic result and cause of trans-generational trauma, depression, poverty, and a powerful destructive force in the lives of individuals, families, and communities.