Factors associated with readmission to alcohol and opioid detoxification in the Alaska Interior

Background and objectives: A “revolving door” of repeated admissions to detoxification treatment facilities has long plagued alcohol and drug use patients, yet few studies examine factors associated with readmission. This study examined risk factors for readmission to alcohol and opioid detoxification in a sample from the Alaska Interior.
Methods: Data were extracted from electronic medical records for admissions between 2012 and 2016 at an inpatient detoxification facility in Fairbanks, Alaska. Data from 1014 patients admitted for alcohol detoxification and 267 patients admitted for opioid detoxification were analyzed. The analysis employed descriptive statistics for risk factors (substance use history, adverse life experiences, and psychosocial functioning) and prevalence of readmission to either alcohol or opioid detoxification. Inferential analyses used marginal standardization to calculate differences in readmission risk by patient characteristics.
Results: Male, Alaska Native/American Indian, single-never married patients, and those seeking work were at higher risk for readmission to alcohol detoxification, while those with stable housing were at reduced risk. Being single-never married and completing detoxification treatment reduced readmission to opioid detoxification. Family involvement in detoxification reduced readmission risk for both alcohol and opioid patients.
Discussion and conclusions: Further research that investigates the mechanism(s) by which family may act as a protective factor may be efficacious in eliminating the “revolving door” of detoxification. Scientific significance: This study is the first to examine both alcohol and opioid use risk and protective factors in the Alaska Interior. The results can be used in the development of interventions for subpopulations with high detoxification readmission rates.

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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.

Learn more at their website here

Quantifying opioid use disorder Cascade of Care outcomes in an American Indian tribal nation in Minnesota

The opioid use disorder (OUD) epidemic has significantly affected American Indian communities in Minnesota. A public health framework called the Cascade of Care helps measure OUD risk, treatment engagement, retention, and recovery outcomes. However, no studies have measured this framework within tribal communities.

This study used data from the Minnesota Drug and Alcohol Abuse Normative Evaluation System (DAANES) to quantify the Cascade of Care for an American Indian tribal nation in Minnesota and the state as a whole. In 2018, 269 individuals in the tribal community received treatment for opioid-related issues. Of those, an estimated 65-99% started medications for OUD, and an estimated 13-41% stayed in treatment for at least 180 days. The existing state-level data can provide insight into OUD care stages for American Indian communities, but more data sources are needed to understand population-level OUD risk, recovery, and factors influencing treatment and recovery.

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Health Equity for Abenaki Indigenous People: Improving Access to Quality Mental Health and Substance Use Services

In this study, researchers explored how members of the Abenaki Indigenous communities in Vermont access mental health and substance abuse services.

They conducted two focus groups in the spring of 2020 with community members and tribal leaders from various Abenaki Bands. Participants shared their perspectives on the challenges they face due to the loss of their culture and a lack of trust in community support services. The study found that these factors impact how the Abenaki community views health and wellness, affecting parenting, youth substance use, and opioid misuse. The results suggest that recruitment of Abenaki individuals into the healthcare workforce could help address these challenges. Additionally, efforts to support and preserve Abenaki culture may aid in substance use and suicide prevention within the community.

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IHS Opioid Stewardship Hospital Plan Builder

This template is designed to assist sites and committees with evaluation of current opioid prescribing practices and facilitate discussion surrounding opportunities for improvement.  The interactive tool is designed to guide team discussions as users consider core elements of opioid stewardship programs.

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Indigenous Evaluation Toolkit: An Actionable Guide for Organizations Serving American Indian / Alaska Native Communities through Opioid Prevention Programming

Seven Directions, with the support of the Centers for Disease Control & Prevention and the National Network of Public Health Institutes, has produced an Indigenous Evaluation Toolkit. This Toolkit provides step-by-step guidance, worksheets and concrete examples to support communities looking to Indigenize and decolonize their program evaluation. All examples in this edition of the toolkit focus on opioid overdose prevention.

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Overdose Prevention Hub for Tribes and Native Communities

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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 Native Overdose Resource 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

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