Addiction in Native American Youth During the COVID-19 Pandemic

by Jeena Kar, DO

The COVID-19 pandemic has severely impacted substance use disorder patients, as nearly all of the resources they normally rely on have become limited. Patients are being asked to stay home, which directly impacts their ability to attend AA meetings, go to methadone clinics, or visit their regular healthcare providers. Although there are certain adjustments being made to help extend prescriptions or provide tele-health meetings, COVID-19 has created unprecedented hurdles and has limited the access to traditional help for patients¹. Notably, one group that will be particularly impacted by the pandemic is the Native American Youth (NAY). The Navajo Nation actually has the highest coronavirus infections per capita in the United States, ahead of even New York and New Jersey². Furthermore, their numbers are considered grossly underestimated due to misclassification of Native Americans under the category “Other” category on coronavirus census reporting³. Beyond the statistics on the Navajo Nation, officials are unsure how rampant and severe coronavirus cases actually are in Native American reservations across our country.

Even before the coronavirus pandemic, the drug rehab Santa Monica CA has had consistently higher rates of addiction. A study by Colorado State University found lifetime drug use among NAY to be higher than the general sample at every grade level for all illicit substance use, with the exception of tranquilizers and amphetamines. At the same time, 30-day rates of substance use were higher in NAY for nearly all substances⁴.

There are several theories as to why NAY have continuously grappled with higher-than-average rates of substance use in their communities. These high addiction rates can be attributed to combined factors of social isolation, lack of healthcare services, negative cultural stereotypes/racial discrimination, and poverty in their respective reservations⁵.

In consideration of these factors– specifically focused on “social isolation” and “lack of healthcare services”, the situation with regards to NAY becomes very worrisome given our current health crisis. Both social isolation and lack of health outreach will become more severe as the Native American communities continue to battle the pandemic.

It is important for mental healthcare providers to advocate for this often-overlooked minority. A great place to start is to look into getting involved with SAMHSA’s Tribal Technical Advisory Committee (TTAC). This forum allows tribal leaders and healthcare workers to have an open exchange about public health issues⁶.

Additionally, the ACGME requires trainees to get involved in scholarly activity⁷, so this could be a great subgroup to choose for research poster presentations or workshop ideas. Native American Youth are understudied, so trainees can make a huge difference by participating in and implementing research initiatives that are centered on this population. The more awareness grows about this minority group and the unique issues that affect them, the more advocacy there can be for their resource allocation.

There are several initiatives in AAAP that trainees can endorse and take advantage of as well. The AAAP has a five-year grant to help minority physicians get involved in Addiction Psychiatry, which would greatly help Native American populations. This is called “The Recognizing and Eliminating disparities in Addiction through Culturally-informed Healthcare (REACH)” training program, and applications are currently open for anyone interested in working with underserved populations⁸. AAAP also has travel grants available to attend the College on the Problems of Drug Dependence (CPDD), which focuses on minority populations and how to best serve them⁹. These are great avenues for trainees to get involved with.

To conclude- mental health professionals must take special care and consideration for vulnerable populations, especially with ongoing COVID-19 in our midst. By working through avenues such as SAMHSA and AAAP, providers can begin to address mental health disparities in Native American Youth and other minorities. Mental health professionals can have a voice in this public health issue and can make a significant contribution.