Abstract
OBJECTIVES: This 20-year surveillance project tracks the trends in substance abuse among American Indian students and examines the observed patterns to discover implications for prevention and treatment. The current phase of this work includes data on drug use among Indian school dropouts. METHODS: Anonymous drug use surveys are administered annually to a nationally representative sample of 7th- to 12th-grade Indian youths residing on or near reservations. An adjustment for dropouts is made to provide estimates for the entire age cohort. RESULTS: Indian youth continue to show very high rates of drug use compared with their non-Indian peers. The trends in rates during the last 20 years parallel those of non-Indian youth. While overall drug use may be decreasing, about 20% of Indian adolescents continue to be heavily involved with drugs, a proportion that has not changed since 1980. Adjustment for school dropouts increases the estimate for the entire age cohort. CONCLUSIONS: Indian youth, particularly school dropouts, remain at high risk for drug use. The similarity to trends for non-Indians indicates that prevention strategies effective with other youth can be effective with this population.

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