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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