The U.S. is experiencing an alarming opioid epidemic, and although American Indians and Alaska Natives (AI/AN) are especially hard hit, there is a paucity of opioid-related treatment research with these communities. AI/ANs are second only to Whites in the U.S. for overdose mortality. Thus, the National Institute on Drug Abuse convened a meeting of key stakeholders to elicit feedback on the acceptability and uptake of medication assisted treatment (MAT) for opioid use disorders (OUDs) among AI/ANs. Five themes from this one-day meeting emerged: (1) the mismatch between Western secular and reductionistic medicine and the AI/AN holistic healing tradition; (2) the need to integrate MAT into AI/AN traditional healing; (3) the conflict between standardized MAT delivery and the traditional AI/AN desire for healing to include being medicine free; (4) systemic barriers; and (5) the need to improve research with AI/ANs using culturally relevant methods. Discussion is organized around key implementation strategies informed by these themes and necessary for the successful adoption of MAT in AI/AN communities: (1) type of medication; (2) educational interventions; (3) coordination of care; and (4) adjunctive psychosocial counseling. Using a community-based participatory research approach is consistent with a “two eyed seeing” approach that integrates Western and Indigenous worldviews. Such an approach is needed to develop impactful research in collaboration with AI/AN communities to address OUD health disparities.

Few studies have addressed OxyContin use among American Indians (AIs) on reservations. Eight focus groups were conducted as "talking circles" (2006 and 2007 ) with 49 AI adults and youth. An emergent design was utilized in which the initial two circles were planned, but the subsequent six circles evolved from tribal members' input. Participants reported an increase in OxyContin use; negative effects on individuals, families, and the tribe; a lack of treatment options; and a growing problem on other reservations. Results indicate the need to further research prevalence and patterns of use to design interventions to curtail OxyContin abuse on reservations.

Indigenous scholars and others who study the experiences of Indigenous communities have long criticized the psychocentric approach to trauma held by most clinical professionals. A recent example of this was the Canadian government's reparations for Indian Residential School system (IRS) survivors, which focused largely on individual psychological harms rather than broader effects of colonial oppression. Beginning in 1867 and continuing throughout the latter half of the twentieth century, Indigenous children were routinely removed from their home communities in Canada and placed into the IRS system, where they were frequently subject to physical, psychological, and sexual abuse. Using thematic analysis, this study draws on survivor testimonies from one residential school to explore how their descriptions of the effects and healing from IRS abuses differ from psychocentric understandings of trauma and loss. Results indicate that survivors describe IRS effects in sociocentric, ecocentric, and cosmocentric terms more so than psychocentric ones and place deep importance on healing through connection to family, culture, and community. To decolonize itself as a discipline and better serve Indigenous communities, the field of psychology must open up to understandings of trauma, loss, and healing that decentralize the individual, a difficult task given the discipline's psychocentric nature.

Purpose American Indian (AI) adolescent girls have higher rates of sexual activity, births and STIs compared to the national average. The purpose of this study was to explore factors that influence urban adolescent AI girls' sexual risk behavior (SRB). Design A qualitative study was conducted using grounded theory methodology to reveal factors and processes that influence SRB. Methods Talking circles, individual interviews, and event history calendars were used with 20 urban AI 15-19 year old girls to explore influences on their sexual behavior. Findings The generated theory, Framing Sexual Risk Behavior, describes both social and structural factors and processes that influenced the girls' sexual behaviors. The theory extends Bronfenbrenner's ecological model by identifying microsystem, mesosystem, and macrosystem influences on sexual behavior, including: Microsystem: Being “Normal,” Native, and Having Goals; Mesosystem: Networks of Family and Friends, Environmental Influences, and Sex Education; and Macrosystem: Tribal Traditions/History and Federal Policy. Discussion Urban AI girls reported similar social and structural influences on SRB as urban adolescents from other racial and ethnic groups. However, differences were noted in the family structure, cultural heritage, and unique history of AIs. Implications for Practice This theory can be used in culturally responsive practice with urban AI girls.