Understanding American Indian Youth in Residential Recovery from Substance Use Disorder: Risk and Protective Experiences and Perceived Recovery Support.

Historical trauma has contributed to the reality that addiction disproportionately affects tribal communities, including American Indian youth. We sought to understand American Indian youths' own experiences and perceptions of the environments to which they return after completing residential treatment for substance use disorder. We recruited three cohorts of American Indian residents of a substance use disorder treatment facility (N = 40). These residents completed a survey that measured risk and protective factors, as well as actual risk behaviors, including drug use, gambling, and violence. Participants were at risk not only for substance use disorders, but for other negative outcomes, and had elevated scores on several community, family, and school risk factors, including perceived availability of drugs, community disorganization, family history of antisocial behavior, favorable parental attitudes toward drug use, academic failure, and low school commitment. At the same time, they were exposed to community-level and family protective factors, and they engaged in many tribal cultural activities. When compared to a national sample of American Indian students of similar age, youth in our sample scored similarly on protective factors, including indicators of community, family, and school opportunities and rewards for prosocial involvement, as well as family attachment, suggesting potential resources and strengths for supporting recovery.