Table 2:

Quotes Related to Common Themes

Themes	Quotes
Drugs of Greatest Concern	Alcohol, and, well, marijuana is a staple, cocaine, prescription drugs. Nowadays, people go doctor shopping. (Location 3)
	Alcohol is often the drug of choice. Prescription medication. Whatever they can get their hands on. (Location 3)
Community Concerns	There are not enough opportunities or options in this town to keep kids from turning to drugs. (Location 1)
	I watch young people drift toward those things as coping mechanisms as substitutes for the extended Native family due to the breakdown in the family system. The social, economic, and cultural breakdown as a result end up as a thing that is passed down to the next generation. (Location 1)
	There is a lack of commitment on Tribal leadership. There are not enough community-initiated programs. (Location 2)
	Shame. A lot of people are trying to hide it so they’re not getting help. (Location 2)
	Prescription abuse – it is on the increase, and once that is cut off from the person, they go to heroin. If we see this kind of increase – and we already are losing – then most of our people are being lost. And there is a lot being lost within this young generation. I mean think about it – they don’t know how to be self-sufficient, don’t know how to kill hogs, grow gardens. In education – they are lost. I see more dependence on government and then there I the degradation of the family unit. It’s like we are becoming ghetto and it is detrimental. (Location 3)
Concerns for Adolescents	There are a lot of unsupervised youth which can lead to the opportunity to use. Parents get too comfortable or busy to pay attention. (Location 1)
	The troubles that come with substance abuse, such as legal troubles, limit the future options of the young and is devastating to the population. (Location 1)
	Young people are disrespectful and lack discipline and honor. This stems from not having guidance from adults or positive role models. (Location 2)
	There is not a system-wide conversation. Behavioral health, mental health, and the judicial department leaves education out of the conversation regarding how to address substance abuse. (Location 2)
	The problem with our youth is that they are going to model what they see at home. Drug addiction is in the homes, and there is easy money when selling, and then there is now way out. Students need to realize there are other options besides drugs – but the issues here stem from the family. (Location 3)
Opinions about Services Available	Wellbeing needs to be a priority. We wait until people come in, after they have engaged in this lifestyle, and they are in a mess, the family is in a mess, the children are in a mess. We need to be more proactive. (Location 2)
	[The programs] have the potential of being really effective if reinforced in the home. (Location 1)
	[The programs are] only as effective as the person wants them to be. The individual has to choose to change. (Location 2)
	[Programs] are not designed for young people. They lack help. Teens have no program that is designed for their age group. (Location 2)
	We need structured activities around the Drum that cleans them up. I would like to see needs addressed through culture – the talking stick and the circle. (Location 3)
	There are [programs] but our county is so large – we need more local support. I mean, our people don’t have vehicles, there is no transportation. The [programs] aren’t reaching the population they need to. (Location 3)
	There is not a community program awareness activity or project that I am aware of where I live which focuses on alcohol and drug prevention. Now, the schools in my community do have exposure to such programs through their counselors and through their health curriculum. We tend to be part of “after the fact” processes instead of preventive awareness of alcohol and substance abuse in and around where I live. (Location 3)
Effective Strategies	We need traditional [tribal] lifestyle activities, build pride in being traditional/spiritual, connecting pride with traditions, get parents out with them, gardening, traditional games, Elder involvement, learning tradition (respect for each other, respect for the things Creator gives us), culture camp for youth, arts (birch bark baskets, moccasins), they need to realize what it means to be Indian (can’t be negative, focus on the positive aspects of being Indian). (Location 2)
	Drugs and alcohol are not the problems – we are self-medicating – we must determine what the root is. Let’s grow and stop using crutches.
	Schools need to help more. Our churches need to get more involved and well-being needs to be a priority. Right now, we wait until people come in, after they have engaged in that lifestyle, and they are in a mess, the family is in a mess, the children are in a mess… so we can fix it. That isn’t working. We need to be more proactive. (Location 3)