Indigenous peoples the world over have and continue to experience the devastating effects of colonialism including loss of life, land, language, culture, and identity. Indigenous peoples suffer disproportionately across many health risk factors including an increased risk of substance use. We use the term "Big Event" to describe the historical trauma attributed to colonial policies as a potential pathway to explain the disparity in rates of substance use among many Indigenous populations. We present "Big Solutions" that have the potential to buffer the negative effects of the Big Event, including: (1) decolonizing strategies, (2) identity development, and (3) culturally adapted interventions. Study limitations are noted and future needed research is suggested.

In North America, substance abuse is a public health crisis with annual costs in the billions. Individuals suffer from substance use disorders for multiple years throughout their lifespan. This suggests that neither historical, community-based interventions, nor current, evidence-based behavioral modalities are successful in healing the causes of addiction. A growing corpus of research has established that traumatic early-childhood experiences and insecure attachments are both independent and interrelated risk factors for developing substance abuse disorders. An impressive literature is emerging exploring potential applications of attachment theory-informed intervention. There has yet to be widespread adoption of such techniques. By examining the scholarly literature, this paper synthesizes existing work on attachment theory in the treatment of substance use disorders. A clinical case application is provided to highlight the potential for attachment-informed therapy. Recommendations for using attachment-informed approaches in the treatment of substance use disorders with various groups are offered.

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Children in out-of-home care due to familial maltreatment and other developmental and behavioral problems remain at risk for abuse and neglect in the very placements designed for care and treatment.