title: Exploring binge drinking and drug use among American Indians: data from adolescent focus groups.
abstract: BACKGROUND
  Risk factors for binge substance use and non-suicidal self-injury (NSSI) are similar, suggesting the importance of exploring how binge substance use and self-injury interrelate.
  
  
  OBJECTIVE
  To gain insight from a sample of American Indian (AI) adolescents regarding how binge drinking and drug use function in their lives, including as overlapping forms of self-injury, and to identify community-based ideas for dual prevention strategies.
  
  
  METHODS
  A total of N = 58 White Mountain Apache (Apache) adolescents participated in ten mixed gender (n = 33 males, 55.9%) focus group discussions. Results were interpreted and categorized by Apache researchers and compared to Nock's behavioral model of NSSI.
  
  
  RESULTS
  Participants reported substance use most commonly with "family" and "friends," "at a house," or "around the community." Substance use was not confined to a particular time of day, and often occurred "at school." Commonly endorsed reasons fell into two main categories: "to avoid problems" or "to reduce negative feelings," versus "to be cool" or "to feel part of a group." All adolescents but one thought that some youths use substances excessively as a way to harm/injure themselves (n = 25 responses). Prevention approaches included encouraging healthy relationships, teaching about consequences of use, providing alternative recreation, and changing/enforcing laws on the reservation.
  
  
  CONCLUSIONS
  Tribal-specific data support the idea that binge substance use sometimes functions as a form of self-injury. Home/school environments are critical prevention settings, in addition to improved law enforcement and increased recreation.
  
  
  CONCLUSIONS
  Understanding possible shared root causes and functions of binge substance use and self-injury may advance integrated prevention approaches.
authors.affiliation: Center for American Indian Health, Johns Hopkins School of Public Health , Baltimore, MD 21205, USA. ltingey@jhsph.edu
authors.forename: Lauren
authors.initials: L
authors.lastname: Tingey
authors.forename: Mary
authors.initials: M
authors.lastname: Cwik
authors.forename: Novalene
authors.initials: N
authors.lastname: Goklish
authors.forename: Melanie
authors.initials: M
authors.lastname: Alchesay
authors.forename: Angelita
authors.initials: A
authors.lastname: Lee
authors.forename: Rachel
authors.initials: R
authors.lastname: Strom
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Suttle
authors.forename: John
authors.initials: J
authors.lastname: Walkup
authors.forename: Allison
authors.initials: A
authors.lastname: Barlow
mesh_terms: D000293:Adolescent; D063425:Binge Drinking / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D002648:Child; D005260:Female; D017144:Focus Groups; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008960:Models, Psychological; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D055815:Young Adult