As someone with Pueblo Indian ancestry who is in long-term recovery and is also a certified drug and alcohol counselor, I know all too well the devastating toll addiction has on Native American communities. According to the 2023 National Survey on Drug Use and Health (NSDUH), more than 25% of American Indian and Alaskan Natives struggle with a substance use disorder—the highest rate among all ethnic and racial groups in the United States. Yet, many treatment centers are not equipped to meet this population’s specific needs.
With 547 recognized tribes in the United States, we must do better. We are failing our Native American brothers and sisters whose unique histories, traditions, and trauma must be taken into consideration. It’s the reason why I championed a tribal recovery track at my treatment center. The impact of the track on patient care has been profound.
Culturally Sensitive Care: More than a Nice-to-Have
Addiction is a complex disease, and effective treatment requires an individualized approach. But for Native Americans, conventional substance use disorder treatment often fails to address the unique cultural and spiritual aspects that are essential for recovery—a major disservice to Native Americans in need of care.
For centuries, Native American communities have endured historical trauma, such as forced relocation and genocide. These experiences have contributed to deep mistrust toward government institutions, including healthcare systems. For some, this mistrust is a significant barrier to seeking treatment for addiction. If a treatment provider does not take the time to build trust with their Native American patients, they may disengage from the recovery process entirely.
Cultural sensitivity in addiction treatment is not only essential for building trust, but for improving treatment access, engagement, and success rates. Many factors can influence how an individual seeks and responds to treatment, including their faith, family structure, language, tribal affiliation, history of discrimination and trauma, and more. For many Native Americans, spirituality is deeply tied to their identity. A culturally competent program acknowledges this and actively integrates it into the treatment process so recovery feels meaningful and relevant.
At Laguna Treatment Center I lead an addiction treatment program tailored to Native American communities. I have always been drawn to spirituality. Part of this comes from my Pueblo Indian ancestry and more than 16 years of sobriety. This connection has deepened my appreciation for the power of culturally sensitive addiction treatment and the importance of integrating spiritual practices into recovery.
Running this program, I have seen firsthand the profound impact culturally sensitive care can have. Culturally sensitive care is more than just a nice-to-have, it is a necessity. Standard 12-step meetings, while widely accessible, may not fully address the cultural and spiritual aspects that are essential to Native American traditions. Unfortunately, culturally specific addiction treatment options are not as readily available as traditional programs, leaving many Native Americans with limited access to the support they deserve.
Native American spiritual beliefs and traditions are foundational to many individuals’ community and sense of self. Incorporating these elements into addiction treatment provides a path to recovery that aligns with patients’ lived experiences and values. Practices like morning meditation, talking circles, and sage smudging ceremonies offer a deeper sense of connection and healing.
Studies show that culturally adapting interventions can improve treatment outcomes. I see this in the way Native American patients respond when their treatment program incorporates their culture.
Our patients often express how much it means to have their traditions recognized and honored in their healing process. We recently held a powerful letter-burning ceremony, guiding patients through meditation and mindfulness, accompanied by Native chanting and a prayer to the Great Spirit. The emotional impact was profound—patients cried, opened up, and allowed themselves to be vulnerable. Moments like these reinforce why cultural sensitivity in treatment is essential; it creates a space where healing feels personal.
How Addiction Treatment Facilities Can Improve Cultural Sensitivity
To better serve Native Americans, addiction treatment centers must take intentional steps to embrace cultural sensitivity. This might look like hiring staff who understand Native traditions, providing individualized treatment plans that incorporate cultural and spiritual beliefs, and acknowledging that conventional treatment might not align with every culture.
My commitment to this work led me to complete Red Road training, a program that aligns with Native American cultural and spiritual traditions in recovery. The Red Road curriculum focuses on community, spirituality, and traditional practices to guide individuals toward healing. It has given me the tools to better support our patients in a way that respects and uplifts their heritage.
Addressing the barriers Native Americans face in accessing care requires a commitment to integrating cultural and spiritual care with modern treatment approaches. I sincerely believe that by doing so, we can create an environment where Native Americans feel seen, heard, and empowered in their recovery journey.
Gilbert Isaac
Gilbert Isaac is a certified drug and alcohol counselor at Laguna Treatment Center, an American Addiction Centers facility.
