Content analysis of perceptions of substance-use treatment among American Indian people who have used opioids.

Abstract

Objectives: American Indian (AI) people are disproportionately impacted by opioid use disorder (OUD) and its associated consequences. However, there is a dearth of published research about substance-use treatment and its efficacy for AI people with OUD. People with OUD, especially those with a longer substance-use history, often have widely variable experiences in their access to and engagement in substance-use treatment. Furthermore, there is a paucity of literature on AI people's perceptions of their substance-use treatment experiences. This study seeks to fill this research gap.

Method: Conventional content analysis was used to document perceptions of substance-use treatment among AI people who have used opioids (N = 45) as well as their suggestions for the improvement of treatment moving forward.

Results: Participants highlighted the importance of connection to nonjudgmental counselors and peers with lived experience, challenges of logistical barriers to treatment (e.g., cost, distances to facilities), the importance of intrinsic versus extrinsic motivation for recovery, and a preference for treatment as respite versus punishment. Participants felt substance-use treatment could be enhanced through the incorporation of Native-centric cultural programming, the integration of social services into substance-use treatment (e.g., housing and vocational training), provision of robust individual and group counseling options, and healing settings that include nature and flexible structures.

Conclusions: Findings should be taken into consideration when establishing and designing substance-use treatment for AI people who have used opioids to ensure appropriate accessibility, feasibility, and implementation concerns are addressed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).