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10 March 2026
Kase Cragg
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Categories: Resource

Culture is Medicine: The United Katehnuaka Longhouse Good Mind Initiative as a Model of Indigenous Harm Reduction in Practice

The United Katehnuaka Longhouse is a Native-led, North Carolina-based nonprofit providing Indigenous harm reduction services in North Carolina and South Carolina through their Good Mind Initiative.

This report describes their approach to Indigenous harm reduction, their program model and impacts, considerations for funders and other prospective Indigenous harm reduction providers. It is a resource for other Indigenous communities looking to develop or expand harm reduction services or learn more about Indigenous harm reduction.

Indigenous-Harm-Reduction-in-Practice-GuideDownload

Learn more at their website here

27 January 2026
Kase Cragg
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Categories: Resource

Participant Perceptions of the Acceptability, Feasibility, and Perceived Impact of the Thiwáhe Gluwáš’akapi Substance Use Prevention Program for American Indian Youth

(1) Background: This study aimed to examine adult participants perceptions of the Thiwáhe Gluwáš’akapi (TG) program. We recruited 13 of 85 (15.3%) adult participants from various previous cohorts of the TG program, separated into lower and higher participation groups. Qualitative semi-structured interviews were conducted. This study was conducted on a Northern Plains reservation, and interviews took place via phone. (2) Methods: Semi-structured interviews with 13 adult participants with children aged 10–12 were completed. Audio files were transcribed and analyzed with ATLAS.ti. (3) Results: Qualitative analysis of these interviews revealed several themes: positive reception by families, enhanced connections to Lakota culture and community, and improved familial relationships. Several barriers to participation emerged, such as difficulties with transportation, scheduling conflicts, and lack of time, which can inform implementation strategies. Observed themes showcase positive impacts of TG on parent–child relationships and cultural connection, aiding overall wellbeing and substance use discourse. (4) Conclusions: Participants in the TG program expressed high satisfaction with the program, gained new skills, and improved family dynamics. Future implementation of TG should include additional transportation support and session scheduling options, in addition to updated implementation strategies to further improve Lakota families’ mental health and wellbeing.

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23 July 2025
Kase Cragg
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Categories: Resource

Early-Onset Alcohol Use among Native American Youth: Examining Female Caretaker Influence

This article investigates the influence of female caretaker substance use on early-onset youth drinking among Native American families in the Northern Midwest. Data include 603 Native American families, with reports from female caretakers and youths aged 10-13 years. Two potential caretaker influences are taken into account: adolescent modeling of caretaker behaviors and the effects of caretaker substance abuse on parenting.

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23 July 2025
Kase Cragg
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Categories: Resource

Perceived Discrimination and Early Substance Abuse among American Indian Children


This study investigated internalizing and externalizing symptoms as potential mediators of the relationship between perceived discrimination and early substance use among 195 American Indian 5th through 8th graders from three reservations that share a common culture (e.g., language, spiritual beliefs, and traditional practices) in the upper Midwest.

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Students and community members may request article access here.

22 July 2025
Adrián Sibaja
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Categories: Resource

Substance Use Among American Indians and Alaska Natives: Incorporating Culture in an “Indigenist” Stress-Coping Paradigm

This article proposes a new stress-coping model for American Indians and Alaska Natives (AIs) that reflects a paradigmatic shift in the conceptualization of Native health. It reviews sociodemographic information on AIs, rates of substance abuse and related health outcomes, and the research supporting the model’s pathways.

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20 June 2025
Kase Cragg
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Categories: Resource

Practical Ways to Implement “The 2022 CDC Clinical Practice Guidelines for Prescribing Opioids for Pain” among American Indian and Alaska Native Patients

This guidance on implementation of the 2022 CDC Clinical Practice Guideline is intended to support health care providers at all levels of care who address pain management among adult AI/AN patients.

7D_PrescriptionGuidelines_080825_WebDownload

9 June 2025
Kase Cragg
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Categories: Resource

Formative Research and Cultural Tailoring of a Substance Abuse Prevention Program for American Indian Youth: Findings from the Intertribal Talking Circle Intervention

ABSTRACT: Substance use among American Indians (AIs) is a critical health issue and accounts for many health problems such as chronic liver disease, cirrhosis, behavioral health conditions, homicide, suicide, and motor vehicle accidents. In 2013, the highest rates of substance use and dependence were seen among AIs when compared to all other population groups, although these rates vary across different tribes. Among AI adolescents, high rates of substance use have been associated with environmental and historical factors, including poverty, historical trauma, bi-cultural stress, and changing tribal/familial roles. Our project, the Intertribal Talking Circle intervention, involved adapting, tailoring, implementing, and evaluating an existing intervention for AI youth of three tribal communities in the United States.

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9 June 2025
Kase Cragg
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Categories: Resource

Native Transformations in the Pacific Northwest: A Strength-Based Model of Protection Against Substance Use Disorder

This paper presents findings from the Native Transformations Project, an exploratory community-based participatory research study that aims to identify sources of strength and protection against substance use disorder in three tribal communities in the coastal Pacific Northwest. Preliminary results from the study describe the specific settings, acts, and behaviors that build strengths and provide protection at the family, community, individual, and spiritual levels within coastal Pacific Northwest local tribal cultures. Findings from this study give voice to stated community preferences for grassroots Native intervention programs based in local cultural knowledge, worldviews, values, and theories of change, that operate at the local level on their own terms.

NATIVE TRANSFORMATIONS IN THE PACIFIC NORTHWEST: A STRENGTH-BASED MODEL OF PROTECTION AGAINST SUBSTANCE USE DISORDER – PMC

25 July 2024
Kase Cragg
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Categories: Resource

Integrating traditional practices and social network visualization to prevent substance use: study protocol for a randomized controlled trial among urban Native American emerging adults

The study focuses on the rising concerns regarding opioid use and opioid-related disorders among American Indian/Alaska Native (AI/AN) emerging adults living in urban areas. These individuals face a higher risk of opioid misuse compared to those living in rural areas.

The study aims to address this issue by implementing a prevention program called Traditions and Connections for Urban Native Americans (TACUNA).  In the study, urban AI/AN emerging adults aged 18-25 will participate in a randomized controlled trial. They will either receive the TACUNA program, which consists of three virtual workshops incorporating motivational interviewing, social network visualization, traditional practices, and a wellness circle, or a single virtual workshop on culturally sensitive opioid education. The effects of the interventions will be evaluated over a 12-month period by analyzing the frequency of opioid, alcohol, and cannabis use, as well as social network characteristics and cultural connectedness.  The project aims to provide culturally appropriate support to address opioid, alcohol, and cannabis use among urban AI/AN emerging adults. By integrating traditional practices and culturally sensitive strategies into the program, the study hopes to enhance resiliency and reduce substance use within this population. This research can improve substance use interventions and contribute to the well-being of AI/AN communities.  The study is registered with ClinicalTrials.gov under the identifier NCT04617938, with the aim of expanding opioid, alcohol, and cannabis services for urban AI/AN emerging adults while addressing the opioid epidemic and substance use at both community and individual levels.

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25 July 2024
Kase Cragg
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Categories: Resource

Exploring substance use disorder discussions in Native American communities: a retrospective Twitter infodemiology study

The study looked at how social media, specifically Twitter, can help in detecting and responding to substance use disorder (SUD)-related issues, such as overdoses, within American Indian and Alaska Native (AI/AN) communities.

Researchers analyzed over 146,000 tweets that mentioned ‘overdose,’ focusing on those geolocated from US Tribal lands. They found that 9.4% of these tweets met the study criteria, with most coming from Oklahoma and North Carolina. The majority of the tweets described firsthand accounts of overdose, and some mentioned specific substances like alcohol, marijuana, and heroin. While these findings are preliminary, they could help in identifying trends and warning signs related to the opioid epidemic among AI/AN populations. It is crucial to protect the privacy of individuals and communities when using such data for public health purposes.

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Overdose Prevention Hub for Tribes and Native Communities

created by staff at Seven Directions: A Center for Indigenous Public Health

© All Rights Reserved Seven Directions
Website by TDG Agency

Who We Are

The initiative for establishing an online one-stop native overdose prevention resource hub came about as one component of the U.S. Centers for Disease Control’s Opioid Overdose Prevention in Tribes. Learn More

Acknowledging Urban and Rural Native Communities

The TA Opioid Hub aims to provide culturally inclusive and tailored resources regarding Opioid Prevention for Indigenous communities, both urban and rural. Seven Directions recognizes the strengths and unique needs of Indigenous communities on both traditional lands and in urban areas. Learn More

How to Help

Data Sovereignty Statement

As Indigenous scholars and allies, one of our main priorities is privacy and data sovereignty for those who visit our website. All the information on the Overdose Hub can be viewed without revealing or sharing personal information. Learn More