Substance Abuse & Native Americans



Despite only representing 2% of the U.S. population, Native Americans have the highest rates of alcohol, marijuana, cocaine, and hallucinogen use disorders and the second highest methamphetamine abuse rates. Additionally, Natives are exceedingly vulnerable to the consequences of substance abuse, including high dropout rates, violence, chronic health issues, and suicidal behavior — all issues that are commonplace on reservations, undermining the strength and stability of Native communities living there.

There are a number of factors that feed into Native American substance abuse problems. The history of First People (particularly the past 300 years) is filled with violence, oppression, displacement, and loss of self-determination. This legacy of trauma, as well as the social isolation, poverty, education, high incarceration rates, and inadequate access to health care on reservations are all root factors of substance abuse. Additionally, studies have shown that Native youths are abusing drugs and alcohol at a much earlier age than non-native populations.


Though some First Nations tribes did produce fermented beverages prior to the arrival of European settlers, they were produced mainly for ceremonial purposes and were most likely significantly weaker than alcoholic beverages today. As European colonists settled, they rapidly introduced Natives to regular, social alcohol consumption with distilled beverages of significantly higher alcohol content. Native attitudes toward alcohol began to shift, becoming less about spirituality and more about social bonding experiences. Binge drinking became the norm as it became widely acceptable.


A developing study illustrates that drinkers may fall into two categories — anxiety drinkers who self-medicate and recreational drinkers who often binge drink. Anxiety drinkers are more likely to feel detached from their traditional roots and feel alienated from both their own native roots and mainstream culture. Though recreational drinkers feel more connected and can function better within mainstream culture, they’re more likely to suffer substance abuse related consequences, including violence and legal issues.


A troubling study conducted from 2009–2012 highlighted the substance abuse patterns of Indigenous teenagers living on or near reservations compared to teenagers of the general population. The prevalence of alcohol and marijuana use among Native youth was significantly higher, especially among eighth grade students, with 56.2% reporting use compared to the reported 16.4% use of the general population. In addition to marijuana use, another emerging problem among junior high and high school students is the abuse of prescription opiates like heroin and oxycodone, also about two-to-three times higher than the national averages.


Today, Indigenous individuals have disproportionately high rates of alcohol-related incarcerations compared to many other racial groups — between 70% and 95% of all arrests are alcohol-related crimes. And while contact with federal and tribal justice systems remains high, treatment remains insufficient, with only 45% of First People receiving care, whether in the form of rehabilitation or Alcoholics Anonymous. As a result, natives are more likely to be involved with courts than they are with treatment settings.


Native American communities face significant challenges in pursuing quality substance abuse treatment that is culturally sensitive. Though there is a higher level of need than for the general population, there is a distinctive lack of access. Only 12% of Native adults receive needed treatment at specialized facilities. When this is compared to the national average, Indigenous communities’ health services receive significantly lower funding. Geographical remoteness, poverty, poor transportation infrastructure, a shortage of qualified providers, and a general mistrust of non-Native institutions of care all further impede treatment.

Additionally, sensitivity to culture plays an important role in the decision to seek medical care. Differing tribal views of mental illness and recovery approaches stand as significant barriers for individuals that may need help. Effective treatment for First People must incorporate evidence-based practices, while being culturally sensitive and honoring tribal culture to find a balance between medical and holistic care.

The information and statistics covered on this page are just the tip of the iceberg that is substance abuse among our people. Until something systematically is done about it, it will be an endless cycle. To read more about the scope of the problem, click here.


The Red Road is firmly committed to targeting both the root problems that lead to alcohol and substance abuse, as well as the day-to-day management of addiction problems for each individual member of our tribes. We aim to help natives confront their addiction and develop a plan for a drug-free and sober lifestyle.