American Indian youth who use alcohol or marijuana in the past 30 days are more likely to use peyote, whether for spiritual or recreational purposes, though the link is stronger for recreational use. Youth who report higher religiosity and stronger cultural identity are more likely to use peyote spiritually but not recreationally. Grade, sex, and religious affiliation did not predict either type of peyote use. The findings come from a secondary analysis of survey data from 3,861 American Indian youth and suggest that prevention and treatment models should distinguish spiritual from recreational hallucinogen use in this population.
American Indian (AI) and non-AI youth living on or near reservations show largely similar rates of using substances often grouped as 'other' (inhalants, MDMA, hallucinogens, prescription opioids, over-the-counter cold medicines), though some regional and sex-based differences emerge. In two regions, AI youth had higher odds of using any 'other' substance than non-AI youth, while in the Southeast and Northwest they were less likely to use prescription opioids and over-the-counter cold medicines, respectively. Males in the Southwest were more likely than females to use inhalants, hallucinogens, and tranquilizers. The Southern Plains region reported the highest prevalence of 'other' substance use overall. These patterns can guide targeted prevention and intervention.