Exploring binge drinking and drug use among American Indians: Data from adolescent focus groups.

Participants reported substance use most commonly with ÒfamilyÓ and Òfriends,Ó Òat a house,Ó or Òaround the community.Ó Substance use was not confined to a particular time of day, and often occurred Òat school.Ó Commonly endorsed reasons fell into two main categories: Òto avoid problemsÓ or Òto reduce negative feelings,Ó versus Òto be coolÓ or Òto feel part of a group.Ó All adolescents but one thought that some youths use substances excessively as a way to harm/injure themselves (n = 25 responses). Prevention approaches included encouraging healthy relationships, teaching about consequences of use, providing alternative recreation, and changing/enforcing laws on the reservation.