Native Collective Research Effort to Enhance Wellness (N CREW) Program: Addressing Overdose, Substance Use, Mental Health, and Pain

Overview

The Research Need

Despite the numerous strengths of Native American people, culture, and communities, and the significant innovation that communities have brought to responding to the opioid crisis, health disparities for Native American people persist in substance use outcomes. This is largely due to longstanding structural barriers to good health and the historical trauma caused by policies and practices.

HEAL, in partnership with the NIH Tribal Health Research Office, National Institute on Drug Abuse, and National Institute of Neurological Disorders and Stroke, held a Tribal Consultation in 2022 to seek input about research-related needs and research priorities for addressing opioid misuse and improving pain management, building on what was learned in a 2018 Tribal Consultation and prior listening sessions. Themes that emerged in the Tribal Consultation highlighted gaps in current substance use‒related research, particularly on topics that require Native American cultural expertise and knowledge of local community conditions, and the need to develop and enhance research capacity among Tribes and Native American Serving Organizations (T/NASOs) so they can lead locally prioritized research. T/NASO-led research is critical for ensuring that funded research produces strategies to combat the opioid crisis that reflect Native American strengths, challenges, and priorities; are culturally grounded for Native American people; and have the potential for scale-up and sustainability within Native American communities or populations. Tribal leaders also highlighted the need to invest in scientific solutions for generating culturally relevant, accurate, and timely data that characterize opioid and other substance use as well as related factors within Native American communities to inform local intervention strategies.

About the Program

The N CREW Program aims to co-construct and establish a novel way to partner with Tribes and T/NASOs to learn, understand, and meet Native American research needs, in direct response to priorities identified in Tribal Consultations and listening sessions. T/NASOs will be supported to flexibly and agilely respond to the opioid and other drug overdose crisis, in partnership with NIH and other organizations. The N CREW Program is planned as a multi-component program using a variety of funding mechanisms, which may include Other Transactions, Cooperative Agreements, Contracts and/or Grants over the course of the program.

The program is designed to invest in research and address three main goals, using a variety of Indigenous and Western scientific methodologies and approaches:

1. Increase locally prioritized research to prevent and combat opioid and other drug overdoses, including research on all factors deemed relevant or related as determined by the community (e.g., substance use, mental health, pain, resilience).

2. Develop or enhance and evaluate scalable methods, including novel organizational structures as needed, for increasing research capacity and infrastructure to support locally prioritized research.

3. Improve data related to opioid/drug overdoses and related factors (e.g., strengths-based factors and resiliencies; individual and social risks, substance use, mental health, pain), increasing data relevance, accuracy, and timeliness to maximize potential for using data in local decision-making.

Participating NIH Institutes, Centers, and Offices

• National Institute on Drug Abuse (NIDA)
• National Center for Advancing Translational Sciences (NCATS)

Resources

• HEAL Tribal Consultation Report, June 2022

View Other Research Programs in This Focus Area

• Collaborative Care for Polysubstance use in Primary Care Settings (Co-Care)
• Optimizing Care for People with Opioid Use Disorder and Mental Health Conditions
• Optimizing the Duration, Retention, and Discontinuation of Medication Treatment for Opioid Use Disorder
• Preventing Opioid Use Disorder
• Prevention of Progression to Moderate or Severe Opioid Use Disorder (STOP)
• Randomized, Double-Blind, Placebo-controlled Trial of Monthly Injectable Buprenorphine for Methamphetamine Use Disorder (MURB)
• Sleep Dysfunction as a Core Feature of Opioid Use Disorder and Recovery

For More Information, Please Contact:

Dr. Kathy Etz, NIDA