American Indian and Alaska Native Substance Abuse Treatment Admissions Are More Likely Than Other Admissions to Report Alcohol Abuse

According to the 2013 American Community Survey, approximately 2.5 million people in the United States are American Indian or Alaska Native (0.8 percent of the U.S. population).1 In 2013, American Indians and Alaska Natives (AI/ANs) had the highest rate of substance dependence or abuse compared with other racial groups.2 Substance use is linked to premature death and disease among AI/ANs, making it a major public health concern.3

According to the Treatment Episode Data Set (TEDS), there were more than 1.7 million substance abuse treatment admissions in 2012. Of these, 2.5 percent (about 44,000 admissions) were AI/AN.4 About one-third (35.0 percent) of AI/AN admissions reported abuse of alcohol only, compared with about one-fifth (21.1 percent) of other admissions (Figure 1). Additionally, a higher percentage of AI/AN admissions than other admissions began using alcohol or drugs at age 11 or younger (17.3 vs. 10.0 percent, respectively; Figure 2).

Figure 1. Substances of abuse among substance abuse treatment admissions, by race: 2012
This is a bar graph comparing substances of abuse among substance abuse treatment admissions, by race: 2012. Accessible table located below this figure.

Figure 1 Table. Substances of abuse among substance abuse treatment admissions, by race: 2012
Substance of Abuse American Indian/
Alaska Native		 All other races
Alcohol only 35.0% 21.1%
Drugs only 22.7% 42.9%
Alcohol and drugs 41.6% 35.1%
NOTE.—In 2012, 0.6 percent of American Indian/Alaska Native admissions and 0.9 percent of admissions of all other races did not report a substance of abuse. Therefore, the percentages do not sum 100 percent for each race category.

Figure 2. Age at substance use initiation among substance abuse treatment admissions, by race: 2012
This is a bar graph comparing age at substance use initiation among substance abuse treatment admissions, by race: 2012. Accessible table located below this figure.

Figure 2 Table. Age at substance use initiation among substance abuse treatment admissions, by race: 2012
Age at Initiation American Indian/
Alaska Native		 All other races
11 or younger 17.3% 10.0%
12 to 17 62.8% 59.2%
18 to 24 15.6% 21.9%
25 to 34   3.1%   6.3%
35 or older   1.3%   2.6%
NOTE.—For drugs other than alcohol, age at initiation is the age of the first drug use. For alcohol, age at initiation is the age of the first intoxication.

These data suggest that adding or expanding prevention efforts that focus on alcohol use and including outreach to children aged 11 or younger may help address substance use in AI/AN communities. For more information about prevention programming for AI/AN communities, see the Substance Abuse and Mental Health Services Administration's Tribal Training and Technical Assistance Center: https://www.samhsa.gov/tribal-ttac.

End Notes
1 U.S. Census Bureau. (2013). Table B02001. Race: Universe: Total population: 2013 American Community Survey 1-year estimates. Retrieved from http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_13_1YR_B02001&prodType=table
2 Center for Behavioral Health Statistics and Quality. (2014). Results from the 2013 National Survey on Drug Use and Health: Summary of national findings (HHS Publication No. SMA 14-4863, NSDUH Series H-48). Rockville, MD: Substance Abuse and Mental Health Services Administration.
3 Whitesell, N. R., Beals, J., Crow, C. B., Mitchell, C. M., & Novins, D. K. (2012). Epidemiology and etiology of substance use among American Indians and Alaska Natives: Risk, protection, and implications for prevention. American Journal of Drug and Alcohol Abuse, 38(5), 376-382. doi: 10.3109/00952990.2012.694527
4 In this report, American Indian or Alaska Native refers to people identifying themselves as such at treatment entry, including those who also identify as Hispanic.

Source: Substance Abuse and Mental Health Services Administration (SAMHSA), Treatment Episode Data Set (TEDS), 2012, based on data received through October 17, 2013. TEDS is a compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment in the United States, primarily at facilities that receive public funding. For more information on TEDS, see https://www.samhsa.gov/data/client-level-data-teds.
The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities. The Data Spotlight may be copied without permission. Citation of the source is appreciated. Find this report and those on similar topics online at https://www.samhsa.gov/data/.