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Barriers to Treatment Access for Native Americans with Substance Use Disorders

Substance use disorders have been a longstanding problem for many Native American communities. The Native American population has higher rates of substance abuse when compared to other ethnic populations. Of all the substances, alcohol is the most prevalent amongst Native Americans and thus, the most abused.

Even with the high incidence of substance use disorders among Native Americans, the percentage of those who receive treatment is very low. This is partly due to the many barriers Native Americans encounter that make it difficult for them to access treatment.

Understanding these barriers is crucial for developing effective solutions and improving treatment access for Native American communities.

Lack of Culturally Sensitive Treatment Options

One of the primary barriers for Native Americans who seek out substance abuse treatment is the lack of culturally sensitive treatment options. Unfortunately, many treatment programs fail to incorporate the cultural practices, traditions, and/or values of the Native American culture, making it difficult for Native Americans to maintain motivation and engagement throughout the treatment process. Culturally sensitive treatment may include:

  • Traditional healing practices
  • Cultural competency for treatment providers
  • Culturally adapted interventions
  • Language translation services
  • Family involvement

Geographical Isolation and Limited Resources

Another significant barrier is the lack of access to treatment due to geographical isolation. Many Native Americans reside in rural communities with limited (if any) treatment options. Additionally, financial resources, or the lack thereof, can play a large role in Native Americans’ inability to access treatment.  Some communities may not have the resources to fund treatment programs, making it that much more challenging for individuals with substance use disorders to receive the care they need.

Historical Trauma

Historical trauma also plays a considerable role in why many Native Americans in need of substance abuse treatment do not get adequate care. Historical trauma refers to the ongoing intergenerational effects of genocide and colonization. These experiences, over time, often contribute to feelings of mistrust towards non-Native individuals and institutions, including mental health providers and treatment programs.


Stigma and Shame

It is also important to note how shame and stigma create barriers to treatment for Native Americans with substance use issues. Substance use disorders are often viewed in a negative light and attributed to an individual’s moral weakness or failure rather than an addiction or medical condition. This stigma often creates a fear of judgment and thus becomes another block to anyone’s willingness to seek treatment, including Native Americans.

Language and Communication Barriers

Language barriers can pose significant challenges for Native Americans seeking treatment. Many treatment programs may not have staff or resources to provide services in Native American languages, making it difficult for individuals to effectively communicate their needs and understand treatment options. Language translation services and bilingual staff are essential in addressing this barrier.

Lack of Culturally Appropriate Aftercare and Support Services

After completing a formal treatment program, individuals often require ongoing support and aftercare services to maintain their recovery. However, the availability of culturally appropriate aftercare and support services may be limited for Native Americans. Lack of access to culturally relevant support networks and resources can undermine the progress made during treatment and increase the risk of relapse.

Systemic Barriers and Disparities

Native Americans may face systemic barriers and disparities that limit their access to quality healthcare, including substance abuse treatment. Socioeconomic disadvantages, discrimination, and unequal distribution of resources can create additional hurdles for Native Americans seeking treatment. Addressing these systemic barriers requires comprehensive efforts to promote equity and eliminate healthcare disparities.

Limited Insurance Coverage and Financial Resources

Many Native Americans may lack adequate health insurance coverage or face financial constraints that limit their ability to pay for treatment services. Limited insurance coverage and financial resources can be significant barriers to accessing comprehensive and long-term treatment for substance use disorders. Increasing access to affordable insurance options and expanding funding for treatment programs can help alleviate this barrier.

Cultural Mistrust and Beliefs about Healing 

Native American communities often have unique beliefs and approaches to healing that may differ from Western medical models. Some individuals may prefer traditional healing practices or have cultural mistrust towards mainstream treatment programs. Integrating traditional healing practices and working collaboratively with Native American healers and community leaders can help bridge these cultural gaps and promote holistic and culturally appropriate treatment approaches.

Native Americans with substance use issues face numerous barriers that challenge accessing treatment. Culturally sensitive treatment options, increased accessibility to treatment facilities, recognizing the impact of historical trauma, and addressing stigma and shame are all crucial to breaking down the many barriers to equitable treatment for Native Americans. By recognizing and addressing these barriers, it is possible to improve treatment access for Native Americans with substance use disorders.


In conclusion, addressing the barriers to treatment access for Native Americans with substance use disorders is essential in improving their overall well-being and reducing the disproportionate rates of substance abuse within their communities. Culturally sensitive treatment options, increased accessibility to treatment facilities, language support, recognition of historical trauma, and addressing stigma and systemic disparities are all critical steps in ensuring equitable and effective treatment for Native Americans. By overcoming these barriers, we can create a more inclusive and supportive environment that empowers Native Americans to seek and receive the help they need to overcome substance abuse and thrive in their journey toward recovery. It is through collaborative efforts and a commitment to cultural understanding that we can make meaningful strides in improving the lives of Native Americans affected by substance use disorders.

Sources Cited

  • Priester, M. A., Browne, T., Iachini, A., Clone, S., DeHart, D., & Seay, K. D. (2016). Treatment Access Barriers and Disparities Among Individuals with Co-Occurring Mental Health and Substance Use Disorders: An Integrative Literature Review.

Journal of Substance Abuse Treatment, 61, 47-59.

  • Browne, T., Priester, M. A., Clone, S., Iachini, A., DeHart, D., & Hock, R. (2016). Barriers and Facilitators to Substance Use Treatment in the Rural South: A Qualitative Study. The Journal of Rural Health
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  • (2011). Holistic System of Care: A Ten-Year Perspective. Journal of Psychoactive Drugs, 4(43), 302-308.

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