{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T03:49:17Z","timestamp":1782272957763,"version":"3.54.5"},"reference-count":14,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract<\/jats:title>\n \n Background and aims<\/jats:title>\n Early use of methamphetamine and heroin are associated with severe consequences. American Indian (AI) youth are often portrayed as the highest risk ethnic group in the United States for early use of methamphetamine and heroin, but little empirical evidence supports this. We aimed to examine odds of lifetime methamphetamine and heroin use among the largest representative sample of reservation\u2010area Indigenous youth in the United States, comparing males and females as well as mono\u2010ethnic AI (AI\u2010mono) youth with mono\u2010ethnic non\u2010AI (NAI\u2010mono), multiethnic AI (AI\u2010multi) and multiethnic non\u2010AI (NAI\u2010multi) youth pre\u2010 and post\u2010COVID\u201019 pandemic.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Annual cross\u2010sectional epidemiological surveys were conducted from 2016 to 2024, and comparisons were made between successive cross\u2010sectional samples.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n 176 schools on or near AI reservations in the contiguous United States were sampled.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n \n The sample consisted of 28.6% NAI\u2010mono, 38.0%, AI\u2010mono, 24.4% AI\u2010multi and 8.8% NAI\u2010multi youth (\n n<\/jats:italic>\n \u2009=\u200950\u2009779; mean age\u2009=\u200914.77; 50.5% male).\n <\/jats:p>\n <\/jats:sec>\n \n Measurements<\/jats:title>\n Lifetime use of methamphetamine and heroin were assessed via survey items regarding ever having used these substances.<\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n \n Overall, 2.4% of participants reported lifetime methamphetamine use, and 1.8% reported lifetime heroin use. Prevalence of lifetime methamphetamine use was statistically significantly lower post\u2010COVID\u201019 [pre\u2010COVID\u201019\u2009=\u20093.5%, post\u2010COVID\u201019\u2009=\u20091.1%; odds ratio (OR)\u2009=\u20094.13, 95% confidence interval (CI) = 2.72\u20136.27,\n P<\/jats:italic>\n \u2009<\u20090.001]. Regression models revealed pre\u2010COVID\u201019, males were 1.43 times (\n P<\/jats:italic>\n \u2009<\u20090.001) more likely than females to have used methamphetamine and 1.56 times (\n P<\/jats:italic>\n \u2009<\u20090.001) more likely to have used heroin. NAI\u2010mono youth were statistically significantly less likely to have used methamphetamine compared with AI\u2010mono youth (OR\u2009=\u20090.74,\n P<\/jats:italic>\n \u2009=\u20090.02); however, AI\u2010multi youth were statistically significantly more likely to have used methamphetamine (OR\u2009=\u20091.38,\n P<\/jats:italic>\n \u2009=\u20090.01) and heroin (OR\u2009=\u20091.84,\n P<\/jats:italic>\n \u2009<\u20090.001) compared with AI\u2010mono youth pre\u2010pandemic. Post\u2010COVID\u201019, males were 1.77 times (\n P<\/jats:italic>\n \u2009<\u20090.001) more likely to have used heroin than females, and AI\u2010multi youth were significantly more likely to have used methamphetamine compared with AI\u2010mono (OR\u2009=\u20092.34,\n P<\/jats:italic>\n \u2009<\u20090.001) and NAI\u2010mono (OR\u2009=\u20092.50,\n P<\/jats:italic>\n \u2009<\u20090.001) youth as well as heroin compared with AI\u2010mono (OR\u2009=\u20091.52,\n P<\/jats:italic>\n \u2009=\u20090.03).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Among United States reservation\u2010area Indigenous youth, use of methamphetamine and heroin was lower after the COVID\u201019 pandemic than before it; however, multi\u2010ethnic American Indian youth are statistically significantly more likely to have used methamphetamine and heroin than mono\u2010ethnic American Indian youth and mono\u2010ethnic non\u2010American Indian youth. Male youth are also at greater risk for lifetime use, supporting the need for targeted interventions for male and multiethnic American Indian youth.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/add.70386","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T01:20:48Z","timestamp":1773624048000},"page":"1927-1933","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence differences in lifetime methamphetamine and heroin use among American Indian reservation youth from 2015 to 2024"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-7290","authenticated-orcid":false,"given":"Jessica L.","family":"Morse","sequence":"first","affiliation":[{"name":"Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1606-6157","authenticated-orcid":false,"given":"Bethany A.","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Psychology and Tri\u2010Ethnic Center for Prevention Research Colorado State University Fort Collins CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4891-2303","authenticated-orcid":false,"given":"Noah N.","family":"Emery","sequence":"additional","affiliation":[{"name":"Department of Psychology and Tri\u2010Ethnic Center for Prevention Research Colorado State University Fort Collins CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan A.","family":"Crabtree","sequence":"additional","affiliation":[{"name":"Department of Psychology and Tri\u2010Ethnic Center for Prevention Research Colorado State University Fort Collins CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall C.","family":"Swaim","sequence":"additional","affiliation":[{"name":"Department of Psychology and Tri\u2010Ethnic Center for Prevention Research Colorado State University Fort Collins CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Prince","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd16.180108"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/15248380221126184"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.08.009"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108921"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073110518782950"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.31764"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2022.03.123"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.0382"},{"issue":"6","key":"e_1_2_10_10_1","first-page":"644","article-title":"Disentangling the links between risk factors and adolescent substance use","volume":"25","author":"Leban L","year":"2020","journal-title":"J Subst Abuse"},{"key":"e_1_2_10_11_1","unstructured":"HeinzeG PlonerM DunklerD SouthworthH.Firth's bias reduced logistic regression. 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