Abstract: American Indian and Alaska Natives (AIAN) are a rapidly growing and diverse population: There are 9.7 million AIANs in the United States (including 5.9 million people who identify as AIAN and one or more racial groups), constituting 2.9%of the total population. In 2018, 10.8% of AIANs were classified as having a substance use disorder (SUD) in the past year. As SUD rates continue to increase along with premature mortality, AIAN communities are deeply and actively committed to the health of future generations and to developing solutions that incorporate culturally meaningful strategies that push toward integrated, multilevel recovery and healing. This chapter provides an overview of substance use and SUDs in AIAN communities, including historical background and prevalence. It explores factors that may contribute to SUDs and highlights factors related to resiliency and recovery. Finally, the chapter provides an overview of some promising interventions and implications for policy and practice.
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