Methamphetamine Use, Post-Traumatic Stress, and Substance Use Consequences Among American Indians with a Substance Use Problem

Objective: This manuscript explores the relationship between methamphetamine as the primary drug of choice, symptoms of posttraumatic stress disorder (PTSD), and adverse consequences of alcohol/drug use in a sample of American Indian (AI) people who self-identified as having a current substance use problem. Method: Using a Community-Based Participatory Research framework, we conducted a cross-sectional survey with 198 AI tribal members experiencing addiction. In the analyses, substance use-related adverse consequences in the lifetime and past 30 days served as outcome variables. Results: Using Bayesian models, we found greater consequences for people who reported methamphetamine as their primary drug of choice as compared to those who reported other primary drugs. Moreover, PTSD symptoms were associated with increased substance use consequences across a variety of domains, regardless of primary drug used. Appreciable interaction effects were detected between methamphetamine as the primary drug of choice and PTSD symptoms for lifetime interpersonal, intrapersonal, impulse control, social responsibility, and kinship loss consequences. While methamphetamine use was associated with greater lifetime interpersonal consequences, the association between PTSD symptoms and consequences was weaker among those who used methamphetamine as their primary drug. Conclusion: Tribal members who report methamphetamine as their primary drug and those who have higher PTSD scores experience significant substance use consequences. Interventions that address stimulant use and traumatic stress are needed to improve health outcomes in this population.