The National Institutes of Health (NIH) has launched a program to support Native American communities in spearheading public health research to address overdose, substance use, pain, and related factors such as mental health and wellness. Despite the inherent strengths of tribal communities, and driven in part by social determinants of health, Native American communities face unique health disparities related to the opioid crisis. For example, overdose death rates have been highest among American Indians and Alaska Natives in recent years. Research prioritized by Native communities is essential to strengthen effective, culturally-informed public health interventions and promote positive health outcomes.
“Elevating Native American knowledge, expertise and unique strengths in research is essential to creating sustainable solutions that can effectively advance public health and health equity. As we seek to best respond to the overdose crisis across the country, it is important to recognize that Native American communities have the best perspectives to develop prevention and treatment interventions that are aligned with their traditions and needs. This program fosters research led by and for Native American communities.”
Nora D. Volkow, M.D., Director, NIH's National Institute on Drug Abuse (NIDA)
Depending on funding, the Native Collective Research Effort to Enhance Wellness (N CREW) program, which will total approximately $268 million over seven years, will support research projects led directly by organizations that serve tribes and Native American communities. The program was established in direct response to priorities identified by tribes and Native American communities.
Many tribal nations have developed and continue to develop innovative approaches and systems of care for members of their communities with substance use and pain disorders. At NIH tribal consultations in 2018 and 2022, tribal leaders classified the opioid overdose crisis as one of their top priorities and called for research and support for the response. They shared that Native communities need to lead the science and highlighted the need for research capacity building, useful real-time data, and approaches that rely on Native knowledge and community strengths to meet Native needs.
The N CREW program focuses on:
Support research prioritized by Indigenous communities, including research that enhances and integrates Indigenous knowledge and culture. Strengthen capacity for research led by tribes and Native American advocacy organizations by developing and providing novel, accessible, and culturally-based technical assistance and training, resources, and tools. Improve access to and quality of data on substance use, pain, and related factors, and maximize the potential for using these data in local decision-making.
“Native American communities have been treating pain within their communities for centuries, and this program will advance that knowledge and support research that builds on cultural strengths and priorities,” said Walter Koroshetz, M.D., director of NIH's National Institute of Neurological Disorders and Stroke (NINDS). “These projects will further our shared understanding of key programs and initiatives that can effectively improve chronic pain management for Native American and other communities.”
The first phase of the program will support projects that plan, develop, and test community-led research and/or data improvement projects to address substance use and pain. During this phase, NIH will also support the development of a Native Research Resource Network to provide comprehensive training, resources, and real-time support to N CREW participants.
The second phase of the program, scheduled to begin in fall 2026, will build on the work conducted in the program's initial phases and further capacity-building efforts and conduct community-led research and data improvement projects. As the program evolves, additional activities that support the overarching goals of the N CREW program may also be identified.
The N CREW program is led by NIDA, NINDS, and the National Center for Advancing Translational Sciences (NCATS) at NIH, with participation from numerous other NIH institutes, centers, and offices. The N CREW program is funded through the NIH Helping to End Addiction Long-term Initiative (or NIH HEAL Initiative), which is jointly administered by NIDA and NINDS. For purposes of the N CREW program, Native American includes American Indian, Alaska Native, and Native Hawaiian. Projects are awarded on an ongoing basis and are published on a public list.
This new program is part of the Biden/Harris Administration’s efforts to advance the Unity Agenda and HHS Overdose Prevention Strategy.
If you or someone you know is suffering or in crisis, help is available: call or text 988 or chat at 988lifeline.org. To learn how to get help for a mental health or substance use condition, visit FindSupport.gov. When you're ready to find a treatment facility or provider, go directly to FindTreatment.gov or call 800-662-HELP (4357).
Helping to End Addiction Long-term® and NIH HEAL Initiative® are registered service marks of the Department of Health and Human Services.
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NIH/National Institute on Drug Abuse
