An annotated bibliography of papers on drug abuse among Indian youth by staff of the Tri-Ethnic Center for Prevention Research.

References and abstracts of articles on drug and alcohol use of American Indian youth that have been published by staff of the Tri-Ethnic Center for Prevention Research are provided. Publications begin in 1978, noting high rates of use, particularly of inhalants. Subsequent papers are concerned with epidemiology, psychosocial correlates of use, prevention, and treatment. The number preceding each entry refer, to the reprint filing system of the Tri-Ethnic Center. Requests for reprints may simply list the number of each article desired. Address reprint requests to: Reprint Request Tri-Ethnic Center for Prevention Research C-78 Clark Building Psychology Department Colorado State University Fort Collins, CO 80523 Fax: (303) 491-0527 1. Goldstein, G. (1978). Inhalant abuse among the Pueblo tribes of New Mexico. In C. Sharp & L. Carroll (Eds.), Voluntary inhalation of industrial solvents. Rockville, MD: National Institute on Drug Abuse. Inhalant abuse is a significant problem in the pueblos, particularly among younger children and females. Inhalant users were like users of other heavy drugs on social questions. They may have chosen inhalants because of poverty and unavailability of other drugs. 2. Goldstein, G., Oetting, E. R., Edwards, R., & Garcia-Mason, V. (1979). Drug use among Native American young adults. International Journal of the Addictions, 1979, 14(6), 855-860. American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh) 69 ANNOTATED BIBLIOGRAPHY Young adult American Indian students at a postsecondary educational institute showed a very high level of use of all drugs when compared with other samples of college-age youth. Alcohol, marijuana, and amphetamines were drugs of choice; 31% had tried inhalants, though there was little present use; 10% were involved in a drug subculture, using multiple drugs relatively heavily. The authors' interpretation of these findings is that either the institution attracts drug users or young American Indians from relatively isolated environments have higher susceptibility to drugs when they enter an urban (non-reservation) culture. 3. Oetting, E. R., & Goldstein, G. (1979). Drug use among Native American adolescents. In G. Beschner & A. Freidman (Eds.), Youth drug abuse. Lexington, MA: Lexington Books. American Indians have higher rates of use of alcohol, marijuana and inhalants and less barbiturate use. Drug use was related to family breakdown, school problems, peer drug use, religious identification, and deviant attitudes and behavior. Inhalant users had a particularly low expectancy of meeting their life goals. 4. Oetting, E. R., Edwards, R., Goldstein, G., & Garcia-Mason, V. (1980). Drug use among adolescents of five southwestern American Indian tribes. International Journal of the Addictions, 15(3), 449-455. Drug use by American Indian adolescents from five southwestern tribes is compared with a large national sample. American Indians show higher use of alcohol, marijuana, and inhalants from the 7th through the 12th grade. They show lower use of barbiturates. Peyote may be seen as less dangerous than LSD. There are no significant differences for other drugs. Cultural characteristics that may influence potential danger from drug use and intervention strategies are noted. 5. Oetting, E. R., Velarde, J., & Beauvais, F. (1980). Research shows increased drug use among Native American youth. National Indian Health Board Health Reporter, 2(7), 4-5. Drug abuse is known to be a severe problem throughout the country; its effects are especially detrimental to the health and well-being of young people. Results and implications of research on drug abuse among American Indians are discussed. Among other things, the writers conclude that drug abuse is at least as prevalent among American Indian adolescents as it is among youth in the general population. 6. Oetting, E. R., Beauvais, F., & Velarde, J. (1982). Marijuana use by reservation Native American youth. Listening Post, 4(3) (Albuquerque, NM: Indian Health Service). There is, at present, an epidemic of marijuana use among American Indian youth. When compared with non-Indian young people, American Indians are experimenting more with the drug, more of them are using it routinely and more are using it on a daily basis. The epidemic is national in scope. Although there are some differences in drug use across tribes, American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh) ANNOTATED BIBLIOGRAPHY 70 recent surveys show very high marijuana use in every tribe that we have surveyed. 7. Beauvais, F., Oetting, E. R., & Edwards, R. (1982). Boredom, poor self-image, lead young Indian girl to drugs. National Indian Health Board Health Reporter, 3(2), 5-6,9. The article graphically describes a young Indian girl who has become involved with drugs. It illustrates the problems that are faced by many American Indian children. 9. Oetting, E. R., & Beauvais, F. (1983). The drug acquisition curve: A method for the analysis and prediction of drug epidemiology. International Journal of the Addictions, 18(8), 1115-1129. A method is presented to chart how a group acquires exposure to a drug. The resulting drug acquisition curve has a number of different parameters that describe the group's drug involvement. Key parameters include: (1) the age of exposure when members of the group begin to use the drug in greater numbers, probably because of exposure to drug-using peers; (2) the acquisition rate (the percent of the group members who are newly exposed each year), a rate that is surprisingly constant over as many as five years; and (3) the asymptote, establishing the total percent of the group members who will eventually try the drug. Acquisition curves for sequential age cohorts show changing trends In these parameters and can also be used to predict future drug epidemiology. A four-year prediction based on this method proved to be very accurate for two of three drugs. For the third drug a large increase in use was predicted, but the increase was even greater than expected. (Later research confirms the value of the acquisition curve for describing age of drug involvement but suggests that the prediction results were fortuitous. The differences between acquisition curves probably occur because of dropouts.) 11. Beauvais, F., & LaBoueff, S. (1985). Drug and alcohol abuse intervention in American Indian communities. International Journal of the Addictions, 20(1), 139-171. Indian culture is vital and growing, but federal policy has helped lead to inertia in community action. A strong activist climate can be used to revitalize Indian culture. Alcoholism is a critical problem and drug abuse a serious problem. Interventions must attempt to restore traditional harmony with nature and include self-determination, bolstering of community spirit, and grass-roots involvement. 12. Oetting, E., Edwards, R., & Beauvais, F. (1985). Reliability and discriminant validity of the children's drug-use survey. Psychological Reports, 56, 751-756. The Children's Drug Use Survey assesses involvement with alcohol, marijuana, Inhalants, and "pills" and includes experimental psychosocial items. It is short, easy to read and constructed so that it does not encourage drug use. Data are presented showing that the drug-use items have high reliability and discriminant validity. The scales should be useful American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh) 71 ANNOTATED BIBLIOGRAPHY for studying drug involvement among both minority and non-minority youth; the scales possess adequate reliability for use as low as the 4th grade. 13. Beauvais, F., Dotting, E. R., & Edwards, R. W. (1985). Trends in the use of inhalants among American Indian adolescents. White Cloud Journal, 3(4), 3-11. Four large samples of American Indian adolescents have been surveyed since 1975 regarding their use of inhalants. When compared with non-Indian youth, Indian young people have shown much higher rates of inhalant use. Inhalant use is increasing for Indian youth, begins at a very early age and is often associated with use of other drugs. Peer and family attitudes do influence inhalant use and may possibly be employed as a means of reducing use of these dangerous chemicals. 14. Beauvais, F., Oetting, E. R., & Edwards, R. W. (1985). Trends in drug use of Indian adolescents living on reservations: 1975-1983. American Journal of Drug and Alcohol Abuse, 11 (3 & 4), 209-230. Anonymous surveys on drug use were administered to 7th-12th grade students in Indian reservation schools. A large number of tribes were surveyed from 1975 through 1983. There is reason to believe the results are reasonably representative of Indian youth living on reservations. Lifetime prevalence for most drugs is higher than that for non-Indian youth throughout this period; and rates for alcohol, marijuana and inhalants, the most frequently tried drugs, were particularly high. Since 1981 there has been a slight drop in lifetime prevalence for most drugs. Current-use figures show the same trends, with increasing current use through 1981 and a drop since that time. Analysis of patterns of drug use — classifying youth according to number, type and depth of involvement with drugs — shows a similar trend, with radical increases until 1981 and then a drop in all but one of the more serious drug use types. Despite this drop, 53% of Indian youth would still be classified as at risk" in their drug involvement, compared with 35% of non-Indian youth. Reasons probably relate to severely detrimental conditions on reservations: unemployment, prejudice, poverty, and lack of optimism about the future. 15. Oetting, E. R., & Beauvais, F. (1985, September). Epidemiology and correlates of alcohol use among Indian adolescents living on reservations. Paper presented at Epidemiology of Alcohol Use and Abuse Among U.S. Minorities Conference, Bethesda, MD. Indian adolescents are compared with their non-Indian counterparts for lifetime prevalence, recent use, age of first use, and daily use of alcohol over the past 10 years. Sex differences between and within the samples are also examined. Exploration of the relationship between alcohol use and the use of other drugs shows similarities and differences between the use of alcohol and various other licit and illicit substances. A further understanding of the context of alcohol use is provided by showing the relationship of alcohol use to a variety of psychological and social factors. General domains of interest include cultural identification, family relationships, school adjustment, peer encouragement and sanctions, American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native HealthColorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh) ANNOTATED BIBLIOGRAPHY72 personal adjustment, tolerance of deviance and deviant behavior, andexpectations for the future. Implications for interventions are discussedbriefly. The final sets of data provide insights into the reasons or rationalesIndian adolescents give for their use of alcohol and the specific socialcontexts in which alcohol is used. These data sets are especially useful inunderstanding the forces that initiate and perpetuate Indian adolescentalcohol use. 16. Beauvais, F. (1986, April). Social and psychological characteristics ofinhalant abusers. Paper presented at World Health Organization AdvisoryGroup meeting on Adverse Health Consequences of Volatile Solvents/In-halants, Mexico City. No single description can include everyone who used inhalants.Inhalants are cheap, easily available and an easy route to relief. Thosemost susceptible are marked by having families from ghetto or marginalareas, poor school performance, and few opportunities to develop self-es-teem. Inhalant users seek support from peers and are likely to choosedysfunctional peers. These peer clusters actively encourage each otherand provide few sanctions against use. Theft and other crimes becomecommon. Once a group use is firmly established, some youth enterlong-term chronic patterns of inhalant use that extend into adulthood. 20. Oetting, E., & Beauvais, F. (1986a). Peer cluster theory: Drugs and theadolescent. Journal of Counseling and Development, 65(1), 17-22. The authors review several theories advanced to explain adoles-cent drug use to provide background for describing peer cluster theory.Peer clusters — small subsets of peer groups, including pairs — dictatethe shared beliefs, values, and behaviors that determine where, when, andwith whom drugs are used and the role that drugs play in defining clustermembership. Peer cluster theory incorporates those psychosocial factorsthat promote or inoculate against drug use by youth. 21. Oetting, E. R., & Beauvais, F. (1986b). Clarification of peer cluster theory:A response to Peele, Cohen and Shaffer. Journal of Counseling andDevelopment, 65(1), 29-30. There is no one research paradigm or "grand theory" that will leadto progress in understanding substance use. It has multiple causes, andmultiple methods are needed to understand the physical, social, andpsychological factors that lead to adolescent substance use. Peer clustertheory leads to statements that can be falsified and that should be tested.Peer cluster theory implies that like children group together and that theirinfluence on each other then determines their behavior. The youth is bothseduced by and seduces his or her friends into substance use. 23. Beauvais, F. (1977). Counseling psychology in a cross cultural setting.Counseling Psychologist, 7(2), 80-82. The author summarizes his experiences working as a counselorat a Navajo Community College and discusses health care training, learn-ing problems, career development, values related to education, learning American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native HealthColorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh) 73ANNOTATED BIBLIOGRAPHY behaviors, and cognitive patterns of Navajo students. Counselors need abroad background of training, and evaluators of programs need to beinvolved in the assessment of the complex and subtle interactions betweenpeople, systems, and programs rather than in controlled experimentalresearch. 72. Oetting, E. R., Edwards, R. W., & Beauvais, F. (1988). Social and psycho-logical factors underlying inhalant use. In R. A. Crider & B. A. Rouse (Eds.),Epidemiology of inhalant abuse: An update. Rockville, MD: National Insti-tute on Drug Abuse. (Research Monograph No. 85) Literature is reviewed and data from a study of inhalant users arepresented. "Ever tried" rate drops after 8th grade, perhaps because ofdropouts. Young users use with peers, and use is related to local commu-nity epidemics, disrupted families, school performance, deviance, aliena-tion, and emotional adjustment. 73. Beauvais, F., & Oetting, E. R. (1988a). Indian youth and inhalants: Anupdate. In R. A. Crider & B. A. Rouse (Eds.), Epidemiology of inhalantabuse: An update. Rockville, MD: National Institute on Drug Abuse. Indian youth are more susceptible to inhalant use, and rates ofuse are increasing among younger children. About 4% of high schoolseniors are using inhalants heavily enough to warrant serious concern. Alarger number of dropouts may be using inhalants heavily. Inhalant usemay begin when children are very young, and prevention efforts need tostart very early if they are to succeed. 74. Beauvais, F., & Oetting, E. R. (1988b). Inhalant abuse by young children.In R. A. Crider & B. A. Rouse (Eds.), Epidemiology of inhalant abuse: Anupdate. Rockville, MD: National Institute on Drug Abuse. (Research Mono-graph No. 85) Six published studies indicate that there is significant inhalant useby children younger than 12, particularly minority children. Nothing isknown about the correlates of this use. 75. Binion, A., Miller, C. D., Beauvais, F., & Oetting, E. R. (1988). Rationalesfor the use of alcohol, marijuana and other drugs by Indian youth. Interna-tional Journal of the Addictions, 23(1), 47-64.This study examined rationales for alcohol, marijuana and otherdrug use among Indian and non-Indian youth. Differences were foundbetween reservation Indian and rural non-Indian rationales for alcohol,marijuana, and other drug use. A majority of both Indian and non-Indian8th graders indicate that they use drugs to enhance positive affectivestates, for excitement, for parties, to be with friends, to relax, and to handlenegative affective states including worries and nervousness. Indian youthappear to use drugs also to cope with boredom. Unlike non-Indian youth,Indian youth have no strong rationales for their use of other drugs. Inter-ventions will have to be impactful and pervasive in order to counter themany positive and negative rationales associated with drug use. American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native HealthColorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh) ANNOTATED BIBLIOGRAPHY74 79. Loretto, G., Beauvais, F., & Oetting, E. R. (1988). The primary cost of drugabuse: What Indian youth pay for drugs. American Indian and AlaskaNative Mental Health Research, 2(1), 21-32. Based on responses to a 1984 survey on a large Indian reserva-tion, conservative estimates are made of the total dollars spent by Indianyouth (grades 7 through 12) across the country on drugs and alcohol. Thetotal figure estimated for one year is $8.3 million. These are only out-of-pocket expenditures and do not include other costs associated with sub-stance abuse such as medical care, loss in productivity, accidents, oremotional and social consequences. 80. Beauvais, F., & Oetting, E. R. (1987). Toward a clear definition of inhalantabuse. International Journal of the Addictions, 22(8), 779. The study of the nature and extent of the use of volatile psychoac-tive substances such as glue, gasoline, anesthetic gases and nitrites haveall been discussed under the single rubric of "inhalant abuse." A classifica-tion scheme is proposed that differentiates users of substances such asvolatile hydrocarbons (gasoline, glue, etc.) from users of the anestheticgases and the amyl and butyl nitrites. As users of these three types of volatilechemicals differ in predisposing factors, level of dysfunction, and conse-quences of use, the former group should be classed generically as "inhalant"users, and the latter should be diagnosed as users of a specific drug. 81. Oetting, E. R., Beauvais, F., & Edwards, R. W. (1988). Alcohol and Indianyouth: Social and psychological correlates and prevention. Journal of DrugIssues, 18(1), 87-101. Reprinted as a chapter in Alcohol Problems ofMinority Youth in America, R. Wright, Jr., & T. D. Watts (Eds.), 143-163,Vol. 2 of Interdisciplinary Studies in Alcohol Use and Abuse. Lewiston, NY:Edwin Mellon Press. This chapter relates psychosocial correlates to prevention. YoungAmerican Indian heavy alcohol users (ages 12 to 16) were matched withnon-users. Alcohol users did not have more emotional problems, did notexperience less alienation or did not feel less self-confident or less sociallyaccepted than non-users, but they did use other drugs and were moredeviant. Alcohol users more often came from broken families, felt lessfamily caring, and had fewer family sanctions against substance use, hadpoorer school adjustment, had less hope for the future and had friendsencouraging alcohol and drug use. Prevention programs should start veryearly and should focus on increasing family strength, improving schooladjustment, providing opportunities for the future, breaking up deviant peerclusters, and building peer clusters that discourage alcohol and drug use. 84. Beauvais, F., & Oetting, E. R. (1987). High rate of drug use among NativeAmerican youth. National Institute on Drug Abuse, NIDA Notes, 2(2), 14. The authors provide a brief review of data on drug use and Indianyouth showing that, even though rates of use finally seem to be declining,nearly half of young American Indians are still at risk of becomingseriously involved in drug abuse. American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native HealthColorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh) 75ANNOTATED BIBLIOGRAPHY 96. Oetting, E. R., Swaim, R. C., Edwards, R. W., & Beauvais, F. (1989). Indianand Anglo adolescent alcohol use and emotional distress: Path models.American Journal of Alcohol and Drug Abuse, 15(2), 153-172. Anonymous surveys of alcohol use and emotional distress of11thand 12th-grade students were administered to 327 reservation Indianadolescents and 524 Anglo adolescents. Path models based on peercluster theory were developed and tested. Results argue against a self-medication theory of adolescent alcohol use. Emotional distress variableshad little effect on alcohol involvement, with the exception of anger, whichoperated in opposite directions for the two groups. The highest relationshipwith alcohol involvement in both groups was with peer alcohol associa-tions, confirming the a priori hypothesis that much of adolescent alcoholuse is linked to peer associations. Those relationships, however, weremuch stronger in Anglo youth, suggesting that alcohol may be used morefrequently in non-peer situations by Indian youth or at least in situations inwhich the peers are not those close friends who have very similar patternsof alcohol use. The most important difference between Indian and Angloyouth, however, may be the role that anger plays in alcohol involvement.In Anglo youth, anger may be associated with problem behaviors includingalcohol use. In Indian youth, higher anger is linked to higher self-esteemand tends to reduce alcohol use. (This last finding may be specific to onlyone or two locations, or it may be a random result. It has not been confirmedin one other sample. Further studies are in progress.) 97. Beauvais, F., Oetting, E. R., Wolf, W., & Edwards, R. W. (1989). AmericanIndian youth and drugs: 1975-1987 — A continuing problem. AmericanJournal of Public Health, 79(5), 634-636. Continuing surveillance of drug use among American Indian ado-lescents living on reservations show them to have rates of use higher thanthose of their non-Indian counterparts. Marijuana use is particularly highamong Indian students. By the 7th grade a significant number of Indianyouth have tried drugs, particularly marijuana and alcohol, and there arefew significant differences by gender. Observed patterns of use indicatethat intervention strategies need to begin in the elementary school yearsand target both males and females equally. 99. Oetting, E. R., Edwards, R. W., & Beauvais, F. (1989). Drugs and Native-American youth. Drugs and Society, 3(1-2), 5-38. Reprinted as a chapterin Perspectives on Adolescent Drug Use, B. Segal (Ed.). New York:Haworth Press. Reservation American Indian youth (ages 12-17) use drugs morethan other youth, particularly marijuana, inhalants, stimulants, and co-caine. Anti-drug messages may have influenced light users, whose usehas dropped, but not heavy users; one in five Indian youth use drugs otherthan marijuana, a rate constant since 1981. Drug use is linked neither toemotional distress nor to acculturation stress. It is related to peer drugassociations, though less strongly than in Anglo youth, and is linked moredirectly than in Anglo youth to family influence. Root causes may be poverty,prejudice, and lack of social, educational, and economic opportunity on American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native HealthColorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh) ANNOTATED BIBLIOGRAPHY76