Perspectives on Drug Treatment Among Indigenous Peoples in Recovery Residing in the Northern Midwest United States

Evidence-based drug treatment is a vital component of an effective response to substance use inequities in the United States (US). Unfortunately, many drug treatment models were developed in western contexts and may fail to account for Indigenous cultures and values. The experiences of Indigenous peoples in drug treatment programs have not been well studied, leading to a dearth of knowledge about factors that facilitate or impede recovery. We aim to explore perceptions about drug treatment and associated experiences among Indigenous peoples in recovery in the northern Midwest US.

Semi-structured interviews with Indigenous peoples in recovery and residing in the northern Midwest US (n=17) were conducted to explore perceptions about drug treatment and associated experiences and challenges. Participants were recruited on or near the reservation lands of a collaborating Tribal Nation. Interviews were analyzed using an inductive thematic analysis.

Indigenous peoples in recovery were often motivated to seek drug treatment after experiencing significant life events. Access to drug treatment was severely limited. Few participants reported having used medications for opioid use disorder (MOUD); however, many described conflicting attitudes about MOUD utilization with tensions arising between how they perceived it as a pathway to recovery and as replacing one form of drug dependence with another. People explained that they engaged in cultural practices while in drug treatment programs and emphasized the need for gender-specific services.

Mitigating harms of the addiction crisis in Indigenous communities requires enhanced access to evidence-based drug treatment services.