As an extension of the broader statewide needs assessment report, this study specifically focused on urban American Indian and Alaska Natives (AIAN) experiencing homelessness to access to substance use treatment. The USC research team collaborated with partners from AIAN community-based organizations to conduct interviews with AIAN individuals experiencing homelessness in Los Angeles, Oakland, San Francisco, Sacramento, and San Diego. The results and recommendations are available in this comprehensive community report.

USC was tasked with evaluating the efforts of five Tribal medication assisted treatment (MAT) programs in California. These five programs, which serve American Indian and Alaska Natives (AIAN), are using Tribal MAT funding to increase accessibility and use of MAT services with the larger goal of reducing opioid overdose deaths. The scope of work for each program is unique based on what type of services each program could offer. This report outlines the progress of these five programs.

A collaborative research team comprised of American Indian and Alaska Native researchers, urban Indian agency partners, Tribal entities, and students and staff from the University of Southern California (USC) conducted research from March – November 2018 with Tribal and urban populations throughout the state of California culminating in Addressing the Opioid Crisis in American Indian & Alaska Native Communities in California: A Statewide Needs Assessment. This report recognizes the need to address the opioid overdose crisis in AIAN communities in California and aims to identify gaps in prevention, treatment, and recovery services (including medication-assisted treatment, or MAT) targeted to these communities.

American Indian and Alaska Native (AIAN) communities have higher rates of substance use than other racial and ethnic groups. Substance use disorder (SUD) is tied to the increased risk of experiencing homelessness. National policies have also led to the disproportionate rates of homelessness among AIAN communities. However, specific experiences related to the occurrence of SUD and homelessness among AIAN in California, as well as seeking and accessing SUD treatment, are not well understood. This study explored potential SUD risk and resilience factors for AIANs experiencing homelessness and their experiences when seeking services for SUD.