Document Type



Purpose The purpose of this study is to: 1) investigate and examine the Indian Health Service (IHS) and Bureau of Indian Affairs (BIA) programs providing services to American Indians and Alaska Natives (AI/ANs) whom have alcohol and drug problems; 2) focus upon information and budget systems concerning the monitoring of services provided and funds expended; and 3) research the scope of the alcohol and drug problems, financial costs, and human costs among AI/ANs. Methods For operational purposes, this study was split into two major components. The first component involved the examination of current IHS and BIA program information systems with regard to the collection of alcohol and substance abuse (ASA) data. This component culminated with the development and field testing of a prototype, community-based information system to collect data associated with the services being provided by IHS, BIA, and tribal programs. The second component was labeled as the Cost Analysis Component. This component involves description of the scope of the problem of ASA including an economic cost-of-illness analysis to estimate the economic costs of alcohol and drug use and abuse for the AI/AN sub-population and comparisons with the all race data for the base year 1985. Results Some study findings include: 1) the economic burden in 1985 was $900 million nation-wide for Indian communities; 2) both BIA and IHS program information systems were not meeting the requirements of P.L. 99-750; 3) a mechanism like the alcohol and drug community-based information systems prototype should be implemented to assist tribal action committees and communities to make informed decisions; and 4) IHS, BIA, tribal and urban programs have not sufficiently evaluated ASA treatment and prevention programs. Conclusion Although alcoholism, drug abuse, and mental health can be statistically separated, in reality they co-exist, and that future research should include all 3 categories.

Publication Date



Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857.