@article{ref1,
title="Understanding the relationship between substance use and self-injury in American Indian youth",
journal="American journal of drug and alcohol abuse encompassing all addictive disorders",
year="2012",
author="Barlow, Allison and Tingey, Lauren and Cwik, Mary F. and Goklish, Novalene and Larzelere-Hinton, Francene and Lee, Angelita and Suttle, Rosemarie and Mullany, Britta and Walkup, John T.",
volume="38",
number="5",
pages="403-408",
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 &quot;drunk or high&quot; at the time of suicide death with data missing for 2/11 deaths; 75.7% (n = 118/156) were &quot;drunk or high&quot; 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.<p /> <p>Language: en</p>",
language="en",
issn="0095-2990",
doi="10.3109/00952990.2012.696757",
url="http://dx.doi.org/10.3109/00952990.2012.696757"
}