From Johns Hopkins: Understanding the Relationship between Substance Use and Self-Injury in American Indian Youth

http://www.ncbi.nlm.nih.gov/pubmed/22931073

Am J Drug Alcohol Abuse. 2012 Sep;38(5):403-8.

Understanding the Relationship between Substance Use and Self-Injury in American Indian Youth.

Barlow A, Tingey L, Cwik M, Goklish N, Larzelere-Hinton F, Lee A, Suttle R, Mullany B, Walkup JT.

Source

Center for American Indian Health, Johns Hopkins University , Baltimore, MD , USA.

Abstract

Background: American Indian communities compared to other US populations are challenged by the largest health disparities in substance abuse and suicidal behavior among youth ages 15-24. 

Objectives: This article examines the co-occurrence of substance use and self-injury among reservation-based youth in the US. Methods: White Mountain Apache tribal leaders and Johns Hopkins University formed a partnership to address self-injury and substance abuse among Apache youth. Data on suicide (deaths, attempts, ideation), non-suicidal self-injury, and substance use were analyzed from the White Mountain Apache tribally mandated self-injury surveillance registry from 2007 to 2010, including 567 validated incidents from 352 individuals aged 15-24 years. Findings regarding characteristics of co-occurrence - including differences in the type of self-harm behavior, gender, and reported reasons for the act - were interpreted through a community-based participatory research process. 

Results: From 2007 to 2010, 64% (n = 7/11) of Apache youth ages 15-24 were "drunk or high" at the time of suicide death with data missing for 2/11 deaths; 75.7% (n = 118/156) were "drunk or high" during suicide attempt; 49.4% (n = 83/168) during suicidal ideation; and 49.4% (81/166) during non-suicidal self-injury. Co-occurrence of substance use was higher for more lethal acts and among males. 

Conclusion: High rates of co-occurring self-injury and substance use within this population highlight the importance of research to understand relationships between these behaviors to design preemptive and integrated interventions. Scientific Significance: Tribal-specific and culturally informed data on the co-occurrence of self-injury and substance use hold promise for reducing the combined toll of years of productive life lost among American Indian youth.