ABSTRACT
American Indian and Alaska Native (Al/AN) populations have the highest opioid overdose related
death rate in the United States, and the rate continues to rise. At the same time, access to
prevention, treatment, and recovery services is limited to some Indian Health Service (IHS) and
Tribal health facilities, where provider shortages, confidentiality concerns, lack of culturally centered
services, mistrust of clinicians, and insufficient fiscal resources are commonplace. AI/ANs also face
unique social and structural conditions which intersect with substance use and perpetuate the
aforementioned disparities including colonialism and racism, historical and intergenerational
trauma, poverty, unemployment, mental health concerns, etc. The Native Collective Research Effort
to Enhance Wellness (N CREW) Program proposed by the Albuquerque Area Indian Health Board,
Inc. (AAIHB), and its Albuquerque Area Southwest Tribal Epidemiology Center (AASTEC), therefore
aims to plan, develop, and implement community-led research, research capacity enhancement,
and data improvements, to respond to the opioid/drug public health emergency within our 27-Tribe
service area spanning across New Mexico, Colorado, Texas and Utah. Our overall goal is to build and
strengthen the research capacity within our tribal organization and the tribes we serve to generate
knowledge and improve outcomes related to overdose, substance use, and related factors including
mental wellbeing. Specific aims that we will pursue to achieve our overall goal during this initial
two-year program phase, center upon development and planning activities, including: 1) cultivate
research partnerships and elucidate community-prioritized research topics for future
implementation by AAIHB/AASTEC and its member tribes; 2) enhance capacity within our Tribal
Organization/Tribal Epidemiology Center, and the 27 member tribes in our service area, to conduct
locally prioritized research related to overdose, substance use, and related factors; and 3) improve
access to and the quality of Al/AN data on substance use and related health and wellbeing factors to
maximize their potential for use in local decision-making. Our primary hypothesis is that
strengthening research capacity within a tribal organization and its member tribes, and focusing
studies on tribally prioritized topics led by Native researchers and allies, will elucidate culturally
grounded, strengths-based, effective and sustainable intervention strategies that support substance
use prevention, treatment, and recovery.