Addressing Prenatal Alcohol and Other Drug Exposure in Tribal Communities: Key Takeaways From an Environmental Scan

Tribal child welfare and allied service programs are critical partners in preventing and addressing prenatal alcohol and other substance exposures (PAE/PSE) in tribal communities so families can heal.

This brief presents opportunities for programs to forge a new path forward on this issue through innovative and effective tribal practices. It is based on an environmental scan that examined the scope of PAE/PSE in tribal communities, as well as current practices and resources for identifying it and caring for affected children and families. The scan included a literature review and interviews with experts.

Highlighted strategies that may aid prevention and intervention include—

• Community outreach and education about the potential effects of substance use on fetal development
• Culturally grounded wraparound services that address root causes of substance use, including racial marginalization and poverty
• Training to orient programs toward family preservation and away from child removal as a first-step response
• Tribally led assessment processes to recognize prenatal substance exposures and provide early intervention
• Research investments to improve understanding of the prevalence of PAE/PSE in tribal communities, the lived experiences of families who are affected by it, and the evidence base for culturally based interventions