MOD in New Mexico

University of New Mexico Center on Alcoholism, Substance Abuse and Addiction Albuquerque, NM

Na’Nizhoozhi Center Inc. Gallup, NM

Totah Behavioral Health Authority Farmington, NM

San Juan County Alternative Sentencing Division Farmington, NM

Who are we?

WE ARE SPONSORED BY…

Project PartnershipsAIAN MOD

RESEARCH

PROJECT

Na’ NizhoozhiCenter Inc.

Totah BehavioralHealth Authority

UNMCASAA

San Juan CountyAlternativeSentencing

Division

We want to thank everyone who assisted in this project

Four Navajo chapters

Char James

Alberta Curley

Navajo Nation Department of Behavioral Health Services Meth Project

Patrick Lynch

of Indian Health Services Health Promotion and Disease Prevention Department.

Study Overview Aim One: COMPLETE

Collect 300 ASIs at three treatment programs

Aim Two: COMPLETE Collect 100 Telephone Surveys across 26 counties

Aim Three: COMPLETE Conduct 9 Focus Groups in three cities

Treatment Providers, Clients/Relatives, Community Members(We originally intended to collect 400 ASIs and conduct focus groups at four sites. Also, the aim to conduct telephone surveys was added after initial collaboration with study

partners. The N of aims one and two was modified based on study partners who were able to collaborate with us for this project.)

Study Data Collection Addiction Severity Index Addiction Severity Index

Data Collection Data Collection (pink)(pink) Farmington, GallupFarmington, Gallup N=300N=300 100/site100/site

Focus Group Facilitation Focus Group Facilitation (blue)(blue) Albuquerque, Albuquerque,

Farmington, GallupFarmington, Gallup Providers, Community

Members, Patients n=81 Three groups at each site

Phone Survey Collection Phone Survey Collection (grey)(grey) n=100 Covers twenty-six counties in

the Four Corners Region

UT

AZ

CO

NM

MOD in New Mexico

FOCUS GROUPS

How much of a problem? Gallup

More of a problem five years ago than today The newness has worn off Still being used, especially in jobs requiring long shifts

Albuquerque All drug use on the rise, not just meth More prevalent in the ‘club scene’ and with the gay community Alcohol is still a larger problem than meth

Farmington Has become a very large problem in recent years Perceived as more problematic than in other regions Belief that use is resulting from occupational demands

Treatment Provider Themes Treatment have an element of confrontation

Little knowledge of meth user signs Unable to differentiate a meth user vs. different stimulant

What should be done to decrease meth use Community involvement Education especially about heritage Control ingredients

Treatment Provider Themes Most effective treatment methods

Confrontational approaches best Incorporate traditional healing practices Some advocated western based practices

Treatment Provider Themes Treatment providers felt education and confrontation most effective. This contradicts evidence based practices Confrontation and education are often ineffective Can sometimes have a negative impact on treatment see “Mesa Grande” article, Bill Miller, et al.)

Client/Relative Themes Intrinsic motivation the key to recovery Had the most knowledge

Black stains on fingers/clothes Look older Terrible hygiene Pick at their face Steal pens Jitters

Client/Relative Themes Effective treatments

Tradition and spirituality Shared experience of recovery

What should be done to decrease meth use Intrinsic Motivation

Up to the individual Individual motivation Community support Some early age education

Shock value and scare tactics

Community Member Themes Largely based on a media influence

Integration of billboards Television commercials TV programs Radio advertisements Stronger law enforcement presence Harsher laws

Signs of meth use Picking, cleaning, ‘meth mouth’ Unable to distinguish between various stimulants use “You can’t [tell the difference] ‘cause they’re both the same, I mean, they’re both

stimulants, speed…”

Community Member Themes Decrease meth use?

education of the community Especially focusing on anti-drug education with younger generations advertisements and billboards Without significant shock value or a scare tactic

Strong advocates of increased law enforcement and stiffer penalties for drug users

Strengths Rehab Jobs Law enforcement Youth programs Strong family Companion Traditions Spirituality/Religion Active Community Involvement Fishing/Sports Neighborhood Watch Chapter House Access to Treatment Focus on strengths Being in recovery Native American Culture

Strengths Gallup

“On the reservation, each community has a chapter house…it’s like a town hall. If they keep the chapter houses open…’til late…seven or eight for the kids…”

Albuquerque “The strengths of all addicts. They’re resilient. They’re still alive.” “…when you look at the Native American communities and consider…not having

freedom of their own…We have so much to learn from them.” Farmington

“I think that if its our nature of our culture to be accepting and loving, and to stay as a family and work together, then teaching family members how reinforce that with loved ones that are trying to recover.”

MOD in New Mexico

ADDICTION SEVERITY INDEX

DATA

ASI Results Three AIAN sites in New Mexico

N=300

Descriptives: Age: Mean 34.2 (SD = 10.96) Gender:

Male: 58.2% Female: 41.8%

Education: Mean 11.6 (SD = 1.4) 10+ years: 93.1% 12+ years: 66.7%

Amphetamine Use: Past 30 days: 3.7%

Primary Problem Substance: Alcohol: 67.0%

Site 1 Site 2 Site 3 Aggregate

Past 30 days – Composite Scores

Mean Mean Mean Mean SD

Medical 0.188 0.124 0.122 0.144 0.276

Employment 0.846 0.881 0.846 0.857 0.213

Alcohol 0.262 0.168 0.217 0.216 0.213

Drug 0.043 0.008 0.045 0.033 0.078

Legal 0.200 0.050 0.259 0.176 0.159

Psych 0.250 0.153 0.119 0.172 0.219

Family 0.190 0.084 0.153 0.144 0.167

Scale ranking 0 – 1; 0 = no problem, 1 = complete problem

ASI Results – Problem substanceSubstance f %

Alcohol 38 20.2Alcohol to intoxication 126 67.0Amphetamine 3 1.6Cannabis 4 2.1Alcohol +Drugs 11 5.9Drugs –Alcohol 5 2.7Total 188 100

Self-reported major problem substance reported by number and percentage of participants

MOD in New Mexico

TELEPHONE SURVEYS

Telephone Survey Trends Conducted in Arizona, Colorado,

New Mexico and Utah Each agency was asked to suggest most

appropriate staff member to participate in phone surveys

The participant was not required to be AI/AN, but we asked for the best person to answer our questions

Agency Distribution

Group 1 – San Juan (Utah), Coconino, Group 1 – San Juan (Utah), Coconino, Apache, NavajoApache, NavajoGroup 2 – Montezuma, La Plata, ArchuletaGroup 2 – Montezuma, La Plata, ArchuletaGroup 3 – San Juan (NM), Rio Arriba, Los Group 3 – San Juan (NM), Rio Arriba, Los Alamos, Santa Fe, SandovalAlamos, Santa Fe, SandovalGroup 4 – Taos, Colfax, Union, GuadalupeGroup 4 – Taos, Colfax, Union, GuadalupeGroup 5 – Socorro, Lincoln, Otero, Chaves, Group 5 – Socorro, Lincoln, Otero, Chaves, LeaLeaGroup 6 – McKinley, Cibola, Valencia, Group 6 – McKinley, Cibola, Valencia, BernalilloBernalillo

Telephone Survey TrendsParticipant Characteristics (N = 100)

Ethnicity White, non-Hisp.HispanicNative American Navajo Apache Isleta Ute MountainOther/Missing

542210522113

County Group

Group 1Group 2Group 3Group 4Group 5Group 6

221514121324

Gender MaleFemaleMissing

49501

Agency Type

MedicalPolice/JailSchoolTreatment

13232836

Telephone Survey Trends Respondents indicated the following*

100% alcohol is the biggest problem*

55.6% methamphetamine is “mild” problem

77.8% methamphetamine use increased in the past 5 years

25.0% “no” local production

37.5% “some” local production

44.4% methamphetamine “quite” or “extremely” available

*In the telephone surveys, each participant indicated what they thought was true about their respective community

Meth a significant community problem

Availability of meth community* significant

Alcohol ranked highest problem Second was marijuana, followed by meth

Meth use increased during the past five years

Alcohol remains most problematic substance

*In the telephone surveys, each participant indicated what they thought was true about their respective community

Telephone Survey Trends

Summary Similar results among three methods**

Substance users, treatment providers, community members differed No unanimity with useful for treatment or prevention

Focus groups: The community members meth is a concerning problem, but not exclusive

Supported by ASI and Phone Survey General non-hysterical response

Meth use third most commonly used substance in lifetime

**The telephone surveys include data that is representative of only a small portion of native community members in a large area, and therefore may not represent every perspective in these communities

***The ASI data were collected from three urban treatment centers

Summary

ASI high unemployment rates***

Local production shut down/economic shift Alcohol most significant problem Meth economically driven cheaper/easier

Future directions

Educational opportunities Address confrontational approaches Incorporate Native tradition