OBJECTIVE: To understand the development of culturally based and community-based alcohol and substance abuse treatment programs for aboriginal patients in an international context. SOURCES OF INFORMATION: MEDLINE, HealthSTAR, and PsycINFO databases and government documents were searched from 1975 to 2007. MeSH headings included the following: Indians, North American, Pacific ancestry group, aboriginal, substance-related disorders, alcoholism, addictive behaviour, community health service, and indigenous health. The search produced 150 articles, 34 of which were relevant; most of the literature comprised opinion pieces and program descriptions (level III evidence). MAIN MESSAGE: Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional approaches. One promising perspective supports community-based programs or community mobile treatment. These programs ideally cover prevention, harm reduction, treatment, and aftercare. They often eliminate the need for people to leave their remote communities. They become focuses of community development, as the communities become the treatment facilities. Success requires solutions developed within communities, strong community interest and engagement, leadership, and sustainable funding. CONCLUSION: Community-based addictions programs are appropriate alternatives to treatment at distant residential addictions facilities. The key components of success appear to be strong leadership in this area; strong community-member engagement; funding for programming and organizing; and the ability to develop infrastructure for longterm program sustainability. Programs require increased documentation of their inroads in this developing field.
OBJECTIVE: To understand the development of culturally based and community-based alcohol and substance abuse treatment programs for aboriginal patients in an international context. SOURCES OF INFORMATION: MEDLINE, HealthSTAR, and PsycINFO databases and government documents were searched from 1975 to 2007. MeSH headings included the following: Indians, North American, Pacific ancestry group, aboriginal, substance-related disorders, alcoholism, addictive behaviour, community health service, and indigenous health. The search produced 150 articles, 34 of which were relevant; most of the literature comprised opinion pieces and program descriptions (level III evidence). MAIN MESSAGE: Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional approaches. One promising perspective supports community-based programs or community mobile treatment. These programs ideally cover prevention, harm reduction, treatment, and aftercare. They often eliminate the need for people to leave their remote communities. They become focuses of community development, as the communities become the treatment facilities. Success requires solutions developed within communities, strong community interest and engagement, leadership, and sustainable funding. CONCLUSION: Community-based addictions programs are appropriate alternatives to treatment at distant residential addictions facilities. The key components of success appear to be strong leadership in this area; strong community-member engagement; funding for programming and organizing; and the ability to develop infrastructure for longterm program sustainability. Programs require increased documentation of their inroads in this developing field.
Authors: Cindy L Ehlers; Jennifer R Geisler; Juan A Luna; David A Gilder; Daniel Calac; Juliet P Lee; Roland S Moore Journal: Am Indian Alsk Native Ment Health Res Date: 2020
Authors: David A Gilder; Juan A Luna; Daniel Calac; Roland S Moore; Peter M Monti; Cindy L Ehlers Journal: Subst Use Misuse Date: 2011-01-06 Impact factor: 2.164
Authors: Douglas K Novins; Gregory A Aarons; Sarah G Conti; Dennis Dahlke; Raymond Daw; Alexandra Fickenscher; Candace Fleming; Craig Love; Kathleen Masis; Paul Spicer Journal: Implement Sci Date: 2011-06-16 Impact factor: 7.327