The National Institutes of Health (NIH) has launched a program to support Native American communities in conducting public health research to address overdose, substance use, and pain, including related factors such as mental health and well-being. 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 in recent years have been highest among American Indians and Alaska Natives. Research prioritized by Native American communities is essential to improve effective, culturally anchored public health interventions and promote positive health outcomes.
“Advancing Native knowledge, expertise, and inherent strengths in research is critical to developing sustainable solutions that can effectively advance public health and health equity,” said Nora D. Volkow, MD, director of the NIH’s National Institute on Drug Abuse (NIDA). “As we look for ways to best respond to the overdose crisis across the country, it is critical to recognize that Native American communities have the best prospects for developing prevention and treatment interventions that meet their traditions and needs. This program will enable research led by Native American communities for Native American communities.”
The Native Collective Research Effort to Enhance Wellness (N CREW) program, subject to the availability of funds, totals approximately $268 million over seven years and will support research projects led directly by tribes and organizations that serve Native American communities. It was created 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 community members with substance use and pain disorders. During NIH tribal consultations in 2018 and 2022, tribal leaders ranked the opioid overdose crisis as one of their highest priority issues and called for research and support to respond. They shared that Indigenous communities must lead the science and emphasized the need for building research capacity, useful real-time data, and approaches based on Indigenous knowledge and community strengths to meet the needs of Indigenous people.
The N CREW program focuses on:
- Supporting research prioritized by Indigenous communities, including research to promote and integrate Indigenous knowledge and culture
- Improve capacity for tribal and Native American support organization-led research by developing and delivering novel, accessible, and culturally informed technical assistance and training, resources, and tools.
- Improve access to and quality of data on substance use, pain and related factors to maximize the potential of these data for local decision-making.
“Native American communities have been treating pain in their communities for centuries, and this program will leverage that knowledge to support research that builds on cultural strengths and priorities,” said Walter Koroshetz, Ph.D., director of the NIH’s National Institute of Neurological Disorders and Stroke (NINDS). “These projects will expand our shared understanding of important programs and initiatives that can effectively improve chronic pain care for Native American communities and other communities.”
The first phase of the program will support projects to plan, develop, and pilot community-focused research and/or data enhancement projects addressing 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, expected to begin in fall 2026, will build on the work done in the initial phase of the program to advance capacity building efforts and implement community-focused research and/or data enhancement projects. As the program progresses, additional activities may also be identified that support the overall goals of the N CREW program.
The N CREW program is led by NIDA, NINDS, and the NIH’s National Center for Advancing Translational Sciences (NCATS), 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 managed by NIDA and NINDS. For purposes of the N CREW program, Native Americans include American Indians, Alaska Natives, and Native Hawaiians. Projects are awarded on a rolling basis and publicly listed.
This new program is part of work to advance the Biden/Harris administration’s unity agenda and HHS’s overdose prevention strategy.
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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