Culturally Responsive Practices in Treatment of Substance Use Disorders: Serving Indigenous Populations in the United States.

Abstract

This article highlights the limitations of culturally relevant care for Indigenous people in the prevention, treatment, and recovery of substance use disorders. It provides recommendations for consideration that expand the capacity for cultural humility. The "one-size-fits-all" approach to providing services, employed by most health and human service providers who are non-Indigenous, has failed. These limitations are often because of a lack of understanding of the larger historical and cultural context of Indigenous people. The authors emphasize the importance of health and human service providers' acquisition of the requisite knowledge about the impact of colonization and trauma that guides a trauma-informed approach to treatment. Sixteen suggestions are provided to serve as a guide when serving Indigenous populations. They include expanding the body of literature on evidence-based practices to include the voice of Indigenous populations through the application of a Community-Based Participatory Action Research approach. Critical to achieving these outcomes is an expansion of the number of behavioral health providers who are Indigenous through the adoption of pedagogical practices that better serve the educational needs of this population. In addition, expanding the capacity of the preservice workforce to understand the impact of colonialization and cultural genocide is paramount. The goal is to prevent the perpetuation of negative attitudes and beliefs that result in addiction treatment providers becoming frustrated with the outcome and blaming the patient. These suggestions, based on the literature, will maximize positive outcomes and can be adapted by a broad spectrum of providers of substance use disorder services.