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. 2025 Apr 4;22(1):48.
doi: 10.1186/s12954-025-01194-z.

Quantifying the size and characteristics of a population of people who use drugs on the reservation lands of a tribal nation in the southern plains (USA)

Sean T Allen  1 , Molly C Reid  2 , Kristin E Schneider  2 , Allison O'Rourke  3 , Brady A Garrett  4 , Maisie Conrad  5 , Coleman Cox  6 , Kendra Lewis  7 , Sierra Lewis  7 , Lisa Wilson  8 , Melissa Walls  5
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Quantifying the size and characteristics of a population of people who use drugs on the reservation lands of a tribal nation in the southern plains (USA)

Sean T Allen et al. Harm Reduct J. .

Abstract

Background: Reversing trends in substance use-related health inequities among Indigenous Peoples requires investments in epidemiological research anchored in community-based participatory research (CBPR) methodologies. There is scarce literature that describes how to implement population estimation methods on American Indian reservation lands.

Objective: This research describes how we leveraged CBPR throughout the implementation of a population estimation study conducted in collaboration with a Tribal Nation in the southern plains to quantify the size and characteristics of persons with histories of illicit substance use on reservation lands.

Methods: We used the capture and recapture population estimation methodology in April-May 2023 to estimate the size of the population of people who used illicit substances in the past six months in a county within the collaborating tribe's jurisdiction. Participant recruitment occurred in areas where people who use drugs were known to congregate. Participants completed a survey that included measures pertaining to sociodemographics, substance use, harm reduction, overdose, sexual health, and cultural factors.

Results: In total, N = 501 surveys were completed by unique persons who had used illicit substances in their lifetime. A large proportion had injected drugs in the past six months or greater than six months ago (19.6% and 31.7%, respectively). There were N = 210 persons who reported having used illicit substances by at least one route of administration within the last six months. We estimated that there were 419 (95% confidence interval = 277, 562) adults who had recently used an illicit substance in the county where the study occurred.

Conclusions: This study demonstrates that population estimation methodologies can be integrated with community-based participatory research approaches to quantify the size of populations of people who use drugs. Future work should be conducted to understand the degree to which population-level needs evolve over time and in response to local initiatives.

Keywords: Addiction; Indigenous peoples; Overdose; People who use drugs; Population Estimation.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This research was reviewed and approved by the Institutional Review Boards at the Johns Hopkins Bloomberg School of Public Health (Protocol #00020074) and the collaborating Tribal Nation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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References

    1. Schuler MS, Schell TL, Wong EC. Racial/ethnic differences in prescription opioid misuse and heroin use among a National sample, 1999–2018. Drug Alcohol Depend. 2021;221:108588. - PMC - PubMed
    1. Friedman JR, Hansen H. Evaluation of increases in drug overdose mortality rates in the US by race and ethnicity before and during the COVID-19 pandemic. JAMA Psychiatry. 2022;79(4):379–81. - PMC - PubMed
    1. Qeadan F, Madden EF, Mensah NA, et al. Epidemiological trends in opioid-only and opioid/polysubstance-related death rates among American Indian/Alaska native populations from 1999 to 2019: a retrospective longitudinal ecological study. BMJ Open. 2022;12(5):e053686. - PMC - PubMed
    1. Kariisa M, Davis NL, Kumar S, et al. Vital signs: drug overdose deaths, by selected sociodemographic and social determinants of health characteristics– 25 States and the district of Columbia, 2019–2020. MMWR Morb Mortal Wkly Rep. 2022;71(29):940–7. - PMC - PubMed
    1. Arias E, T.-V. B., Kochanek KD, Ahmad FB. (2022). Provisional Life Expectancy Estimates for 2021. Retrieved from https://www.cdc.gov/nchs/data/vsrr/vsrr023.pdf