Community member perspectives on adapting the cascade of care for opioid use disorder for a tribal nation in the United States

Aanji'bide Community Action Board

Research output: Contribution to journalArticlepeer-review


Background and Aims: The Opioid Use Disorder (OUD) Cascade of Care is a public health model that has been used to measure population-level OUD risk, treatment engagement, retention, service and outcome indicators. However, no studies have examined its relevance for American Indian and Alaska Native (AI/AN) communities. Thus, we aimed to understand (1) the utility of existing stages and (2) the relative ‘fit’ of the OUD Cascade of Care from a tribal perspective. Design, Setting, Participants and Measurements: Qualitative analysis of in-depth interviews with 20 individuals who were knowledgeable regarding the treatment of OUD in an Anishinaabe tribal setting in Minnesota, USA. Community member roles included clinicians, peer support specialists and cultural practitioners, among others. Thematic analysis was used to analyze the data. Findings: Participants identified the key transition points of prevention, assessment, inpatient/outpatient pathways and recovery as relevant to their community. They re-imagined an Aanji'bide (Changing our Paths) model of opioid recovery and change that was non-linear; included developmental stage and individual pathways; and demonstrated resilience through connection to culture/spirituality, community and others. Conclusions: Community members living/working in a rural tribal nation in Minnesota, USA identified non-linearity and cultural connection as key elements to include in an Anishinaabe-centered model of opioid recovery and change.

Original languageEnglish (US)
Pages (from-to)1540-1548
Number of pages9
Issue number8
StatePublished - Aug 2023

Bibliographical note

Funding Information:
We have no known conflicts of interest to disclose. Our work was funded by grants R61DA049386 and R33DA049386 from the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of NIDA or the NIH.

Publisher Copyright:
© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.


  • Aanji-bimaadizi
  • American Indian and Alaska Native
  • Cascade of Care
  • addiction treatment
  • community-based participatory research
  • culture
  • opioid use disorder
  • qualitative research

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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