Sixth, because we did not assess for any other forms of past or current psychopathology, any issues stemming from comorbid psychiatric disorders cannot be parsed out. This is relevant because comorbid conditions may influence the course of the progression, consequences, the seeking, and receipt of different forms of treatment, and the resolution of alcohol problems (Robin et al., 1998; Westermeyer, Eames, & Nugent, 1998; Westermeyer & Neider, 1994). Moreover, knowledge of comorbid conditions appears to be important in understanding and developing appropriate treatment plans with American Indian/Alaska Natives (Westermeyer, 2001). For many tribal communities, drinking may start at a young age (Grobsmith, 1989; May & Moran, 1995), and involve more heavy episodic drinking than is generally found across U.S. national samples (Beals et al., 2003).
Causes of Alcohol Addiction in Native Americans
Continually feeling stressed over challenging life events can exacerbate the impact of those stressors on the body and mind, outweigh coping resources and potentially make the use of substances a more appealing option 31,35,54,55. Often indicative of great levels of despair and hopelessness, is the occurrence of suicidal thoughts and attempts, which are risk factors for SUD as well as potential results of substance use 44,56. For instance, comorbid drug use, alcohol dependence, and psychiatric disorders exacerbate each other 57.
THE TREATMENTCHALLENGE
However, officials reported that, in practice, if people were merely intoxicated, officers used the charge to place an intoxicated person in protective custody for up to 8 hours without further criminal proceedings. For preliminary thematic analysis (Boyatzis, 1998), two of the authors who are experienced qualitative data analysts reviewed the interview notes and manually coded any reference made by any interview respondent about impacts of alcohol and availability on the reservation. The analysts then organized these impacts into domains that cross-cut interviews, and sorted the domains into tabular form. All project Sober living house team members reviewed and discussed the table, resulting in modifications and further analyses (Glaser, 1965). A preliminary version of the table was presented in poster form at a research meeting sponsored by the Tribal research review board. For more detailed discussion, and to include verbatim responses in this report, we referred back to the interview transcript, which also allowed the analysts to recontextualize the data within interviews.
Substance Use Among American Indian Youths on Reservations Compared With a National Sample of US Adolescents
- One Southwest woman recalled a period of time when the tribal chairman, council members, and health department were committed to reducing alcohol consumption and improving healthy behaviors among tribal members.
- Though some First Nations tribes did produce fermented beverages prior to the arrival of European settlers, they were produced mainly for ceremonial purposes and were most likely significantly weaker than alcoholic beverages today.
- Men were very likely (about 75 percent) to have been alcohol dependent at one time in their adult years and to have stopped after an average of 15 years of heavy drinking.
- Proportionally, recreational drinkers are the largest group of Indian alcohol abusers (about two-thirds of all heavy drinkers according to May 1996) and thus account for the largest number of alcohol-related problems in Indian communities.
- As first responders and case workers handling car crashes, suicides, and other traumatic events, many Tribal safety officers and health and social service providers were themselves traumatized, but respondents reported limited resources to support these staff members.
- The following sections describe some of those factors, including genetics, social and cultural influences, and personal attitudes toward alcohol.
As a rough estimate of impacts, however, Tribal service costs may offer a means to quickly assess the impact of changes in alcohol availability. This qualitative study aimed to identify locally meaningful ways to assess the impact of alcohol availability on the lands of a sovereign Tribal nation where alcohol was banned. This was important for conceptualizing the potential impacts to the Tribe and reservation residents of changing the conditions of alcohol availability. Availability may change due to conditions internal to the community—such as changing the legal status of alcohol on Tribal lands—or external to the community—such as changes in the supply of alcohol outside but near to Tribal lands. Few studies have assessed the impacts of internal changes (May, 1975), and to our knowledge there have been no impact analyses following external changes. Impacts of alcohol availability have typically been assessed using measures developed by non-Indigenous scientists, based in non-Indigenous scientific paradigms.
Patterns of Alcohol Use
According to state government records for 2010, four stores sold a total of nearly five million cans of beer for gross revenues of approximately $3 million. These sales come almost exclusively from Pine Ridge as alcoholic products are continually smuggled onto the dry reservation. School staff read directions prior to survey administration indicating that students could decline to participate or leave blank any questions they did not wish to answer, and these instructions were repeated in the online survey. Staff were instructed to remain in an area of the room where they could not observe students’ responses. Approximately 3 weeks before the scheduled survey, letters were sent to parents of enrolled students in grades 7 and higher describing the survey and providing instructions for opting their child out of the survey. This information was also posted on other local media sites, where parents were likely to see it.
Table 3. Number of Treatment Experiences and Alcohol-related Incarcerations.
In addition to the above themes, the literature has identified other variables within some communities as influential in substance abuse among Indian youth (Winfree and Griffiths, 1985). Of particular importance is the influence of norms in the home as a predisposing factor to association with abusing peer groups (see Oetting and Beauvais, 1989; Beauvais, 1992). There are a number of commonly held stereotypes with regard to alcohol use and abuse among American Indians (May 1994a, 1994b). One of the most pervasive of these is that Indians metabolize alcohol more slowly or differently than other ethnic groups.
Consistent with prior research in non-AIAN samples, poverty, acculturation, and personality disorders 95,96,97,98 appear to be risk factors for addiction in AIAN individuals as well 33,43,50. Multiple risk factors contribute to the higher prevalence of these addictions, with many of these factors arguably tracing back to the historical trauma experienced by AIANs. Previous research has established historical trauma as directly linked to poor health outcomes and increased substance use 20,21,22,26,27,28,29,99.
There is also great need for longitudinal studies to confidently establish risk and protective factors, as many of the available studies are cross-sectional where the direction of causality is not clear. Future studies should examine the role of education among AIANs and the associations to the onset and development of SUD. There is a need to address and alcoholism statistics understand the traumatic experiences between AIAN older and younger generations and its impact to the rates of SUD problems.
If participants traveled 50 to 100 miles roundtrip to participate, they were provided an additional $20 to help with travel expenses; if they traveled over 100 miles, they were given $40. This section collects any data citations, data availability statements, or supplementary materials included in this article. Alcohol use disorder, known as alcohol addiction, is diagnosed by a medical professional using a set of criteria from the Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition. When a person meets 2 or more of the criteria in a 12-month period, they may qualify as having an AUD.
