Published August 13, 2026 at 8:55 AM MDT

A new National Institutes of Health-funded clinical trial found that a virtual prevention program combining evidence-based interventions with traditional Indigenous practices can reduce substance use and anxiety among American Indian and Alaska Native emerging adults.

The program, called Traditions and Connections for Urban Native Americans, or “TACUNA,” was designed to address substance use while strengthening cultural connections. American Indian and Alaska Native communities face disproportionately high rates of drug overdose deaths, cannabis use, and psychological distress. At the same time, researchers emphasize that cultural traditions, family and community relationships, and Indigenous knowledge are important strengths that can support health and well-being.

“Supportive social environments and community engagement are an important component of substance use prevention,” said Dr. Nora Volkow, director of NIH’s National Institute on Drug Abuse. “Yet few interventions have been designed specifically for American Indian and Alaska Native people living in urban areas who may feel disconnected from their tribal communities.”

Researchers recruited 541 American Indian and Alaska Native adults between the ages of 18 and 25 and randomly assigned them to either TACUNA or standard care. The programs were led by American Indian and Alaska Native facilitators. Participants were surveyed at three-, six- and 12-month intervals after the intervention about substance use, mental health, cultural connection, and peer influences.

Participants in both groups reported using cannabis less frequently and experiencing fewer negative consequences related to alcohol and cannabis use. However, participants in the TACUNA group reported additional reductions in both the frequency and amount of alcohol they consumed, as well as the amount of cannabis they used. They also reported greater reductions in anxiety symptoms and spent less time around peers who used cannabis or heroin.

Originally designed for in-person sessions, TACUNA was moved online during the COVID-19 pandemic. Researchers were encouraged that the virtual format still produced significant effects, suggesting the program could be more accessible to people living in urban areas or those who may have limited connections to tribal communities.

The findings suggest that culturally grounded, accessible prevention programs such as TACUNA may offer a new and effective approach to reducing substance use while supporting mental health and cultural connection among American Indian and Alaska Native young adults.

“This trial suggests that the multidimensional, cost-effective approach of TACUNA could be a powerful tool for reducing drug use and addiction within this population,” Volkow said.