1 The American Indian/Alaska Native National Resource Center for Substance Abuse and Mental Health Services The Indian Country Methamphetamine Initiative: Addressing a Problem Uniquely Affecting Indian Country Dale Walker, MD Michelle Singer Patricia Silk Walker, PhD Douglas Bigelow, PhD ATNI Winter Conference: January 24, 2008 Yakima, Washington

Six Behaviors That Contribute to Serious Health Problems: Tobacco use Poor nutrition Behaviors resulting in intentional or unintentional injury Physical inactivity Risky sex Alcohol and other drug abuse – Methamphetamine!

3 Methamphetamine Use, by State in Young Adults (18 to 25) Source: SAMHSA,

4 Methamphetamine: Epidemiology

5 Methamphetamine/Amphetamine Admissions by Ethnicity and Urbanization: 2004 Race/Ethnic ity Large Central Metro Large Fringe Metro Small Metro Non-Metro with City Non-Metro without City White56%77%78%86%87% Black5%3%2%1% Hispanic28%14%11%6%4% American Indian/ Alaska Native 2%1%3%4%6% Asian Pacific Islander 3%2%3%2%1% Other6%3% 1% Source: 2003 SAMHSA Treatment Episode Data Set (TEDS).

6 The Methamphetamine Effect

7 Methamphetamine Identified as the Primary Health/Community Concern In 2006, Tribal Round Table sessions, HHS Regional Tribal Consultations, and numerous tribal community gatherings with SAMHSA, OMH, and IHS identified Methamphetamine abuse as the primary health concern in Indian Country.

8 “Tribal leaders unveil new meth Initiative” Indian Country Today NCAI President, Joe Garcia Anchorage, Alaska June 15, 2007

9 Indian Country Methamphetamine Initiative (ICMI) $1.75 million awarded to Association of Indian Physician (AAIP) its partners (National Congress of American Indians, One Sky Center, South and Eastern Tribes, and Northwest Portland Area Indian Health Board) Tribal Sites –Navajo Nation –Winnebago Tribe –Northern Arapaho Tribe –Crow Nation –Choctaw Nation

10 ICMI Project Description Create a National education and information outreach campaign for all Native communities. Establish and transfer knowledge from community based, promising practices for prevention, intervention and treatment. Work across Federal agencies for a coordinated and consistent outreach strategy.

11 The Indian Country Methamphetamine Initiative: Project Partners SAMHSA AAIP USETNPAIHBOSCNCAI ChoctawCrowNavajoNorthern ArapahoWinnebago IHS OMHHHS

12 ICMI Partners

13 ICMI Major Project Deliverables Outreach/Education Kit for Tribes and others Identification of Partners/Advisory Groups Coordinated Federal-Tribal-State-Local Indian Country Communication and Training Minimum 5 Tribal Specific Projects Identified and Evaluated for Potential Transfer to Other NA Communities Final Project Evaluation Year 3 - Promising Practices Transfer Kits

14 Toolkit Essentials Leadership Information Methamphetamine Basics Tribal Code-Policy Media Educational Materials and Presentations Prevention and Treatment Educational for Students, Parents, Community Community Organizing Fun Youth Items Additional Resources

15 How to Use the Toolkit Leadership and decision making Overview of each module Specific topics, issue pages Promising Practice approaches What the culture and science says Training, technical assistance, and consultation Reference documents Toolkit webpage

16 ID Best Practice Best Practice Clinical/services Research Traditional Healing Mainstream Practice

17 Choctaw Nation of Oklahoma “Natural Highs Program” Transformation process Experiential activities Relationship building Changing the way you live and think Changing how you think and you believe about life and yourself

18 METH FREE CROWALITON Unity in Our “War Against Meth”

19 Meth Free Crow Walk: Youth as our Warriors in Reclaiming our Nation

20 Dine Nation Methamphetamine Initiative

21 What Works Community Education –Age-appropriate presentations, brochures, ads Enforcement (NLE Drug Unit) –Arrest and detainment for trafficking Caring members of the community Partnerships –Communities, chapters, private businesses and tribal divisions and programs.

Methamphetamine Initiative A System of “Works” Northern Arapaho Tribe

23 Works The concept of “ Works ” in a Comprehensive Systems Plan The Problem: –“turf” –gaps –duplications –crossed purposes Fragmented Service System The Solution: –client-centered –multi-agency –comprehensive –coordinated –efficient Works “Works” The Solution: –client-centered –multi-agency –comprehensive –coordinated –efficient Works “Works”

Winnebago Tribe Together, WE Make A Difference: Methamphetamine Prevention on the Winnebago Reservation Tipi Means, Tribal Health Educator

25 Goals and Objectives Winnebago Meth Task Force Develop/maintain a Comprehensive Methamphetamine Prevention Strategy Collectively plan and implement Use Proactive measures Use available funds - take immediate action Working together to determine what fits for tribal members and the reservation

26 Next Steps Add two additional Tribes NCAI provide PSAs and house the Tribal Meth Taskforce USET and NPAIHB will gather baseline data on methamphetamine use One Sky Center: –TA for writing best practices –Create a training curriculum –Train additional tribes in ICMI best practices –Develop a cultural methamphetamine abuse education kit

27 Contact us at Dale Walker, MD Or visit our website: