Overview Of Alcohol Abuse

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Approximately a dozen studies have been conducted on the way natives process and metabolize alcohol in the body. It has genrally been found that natives process alcohol at a similar rate to other ethnic groups in the United States.

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The overall liver structures of American Indians are not unique, and their liver phenotypes are similar to those of other enthnicities, especially to those of Europeans.

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Epidemiological statistics compiled of Native American drinking patterns reveal that Natives Americans drinking is influenced by many of the same traits and factors as seen in other ethnic groups.

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High school surveys across the country reveal that highest substance abuse rates among high school Native Americans occurs in Nonreservation Indians.

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Statistics in survey literature across the United States portrays that rates of lifetime substance abuse is higher in Native American youth as compared to non-Indian youth.

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Almost every study conducted on adult Native American alcohol abuse has indicated a number of generalizations, including proof that drinking behavior has tremendous variation from one reservation to the next,fewer women drink than men, and there is more drinking among urban Indian populations than on reservations, where the number of people practicing abstinence from substances is higher.

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The tremendous variation from one reservation to the next may help to account for the stereotype that "all Indians are drunks." Studies are often small community based and the focus on one tribe or area could pull extremely high substance abuse rates where a study of another area might pull lower drinking results than the national average.

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The stereotype might also be further instilled due to the higher rate of substance abuse in urban Indian populations. These populations are more visible, and therefore it is easier to formulate generalizations of the entire population based on those most public.

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Between 1987 and 1989, compiled surveys conducted in that time frame on alcohol related deaths including suicide, alcoholism, homicide, motor vehicle crashes and other accidents have unearthed some interesting information. For homicides, motor vehicle accidents, and other accidents, mortality rates in Indian males are around 1.4 to 3.9 times higher than the US average.

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The death rates due to alcoholism in 15-year-old to 24-year-old Indian males is 13 times higher than the US average. There is a steady decline with age, but the average still remains higher. From the age range of 25-34 the death rates are 8.8 times higher, and even for the age range of 35-74, the death rate is still 3.3 to 5.4 times higher.

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This trend is similar for female Indians. Though Indian women do not die as often from alcohol-related causes, they still die more often from alcohol-related causes than the rest of the female US population in every category except for suicide in females older than 44-years-old.

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In all, the alcohol related death rates for female Indians is 1.2 to 3.5 times higher than averages in other American females.

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Alcohol-specific related deaths in Indian females, such as alcohol dependence syndrome and cirrhosis, are 31 times higher than the average in the US for females 15 to 24 years old.

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This evidence suggests that alcohol-dependent mortality and alcoholism affects a disproportionate number amount of female Indian individuals.

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In low-integration societies, as dictated by Durkheim's Social Integration Theory, there are fewer permanent groups that individuals within that society are members of and there are less mandates for a strong sense and need for conformity. The individual has more power over defining their behavior. The opposite is true in high integration societies. Social groups are more defined and there are more mandates to which social group the individual can belong to. Conformity is expected of the individual.

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For natives, this means those with a deeper sense of culture, or a more highly integrated society, alcohol abuse is less prevalent.

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Low integrated native societies have often become that way due to high pressures from mainstream society. Alcohol abuse is highest in these tribal communities.

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Studies in low integrated native Alaskan and Canadian societies indicated abnormally high fetal alcohol syndrome and heavy binge drinking in the female natives.

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There are alcohol problems throughout native populations, and though the stereotype persists that "Indians are drunks," the majority of natives do not abuse alcohol. It is that smaller percentage that abuses alcohol to devastating degrees that sets this precedent.

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In a native community in British Columbia in Alkali Lake, it was reported that 95% of the community abused alcohol. Over the course of just a few years with the implementation of community organization around principles of abstinence and group support based on the foundations of Alcoholics Anonymous programs, the community is now reportedly 95% alcohol free. This social and cultural shift towards higher integration was necessary for this community's success.

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It takes the motivation of a community to change the mind-frame of a community. Sometimes, preventative alcohol treatments are stigmatized in native communities.

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There are three levels of prevention implementation: primary, secondary and tertiary. Primary prevention classifies measures taken to stop a problem either before or while it is still developing to keep the problem from morphing into something more detrimental. This can be accomplished by motivating an entire population towards the desired change or by changing the environment of the population to one that is more protective. For native communities, this can come in the form of public education. For example, there are natives who still believe that they have no control over their alcohol consumption because it is in their blood to be a drunk. A survey conducted among the Navajo population found that 63% of the surveyed Navajos found the statement, "Indians have a biological weakness to alcohol that non-Indians do not have," to be truth. This has never been scientifically proven and the majority of natives do not abuse alcohol regularly. How can a population be motivated to implement needed changes about the

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Native reservations with policies on alcohol availability that encourage more controlled drinking have found to be 20% lower over a 15 year period of implementation.

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Secondary prevention occurs when preventative measures are taken at the earliest stages. This can come in the form of short term alcohol therapy that is more cost effective than the long term therapies that are sometimes needed in tertiary prevention for people who severely misuse alcohol. Unfortunately, there is not a lot of success with brief motivational therapy among natives today.

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Inpatient therapy is an expensive option that can be very successful, but many native treatment centers are criticized for being insufficient and understaffed in current literature.

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A low proportion of native adults are drinking when compared to the rest of the natives community as a whole. However, alcohol abuse is does exist and within most native communities, it is highly concentrated.

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There has been a lot of data collected to unearth common patterns in many native communities. There is high popularity with drinking and substance abuse in late teen natives and their drinking patterns and styles emerge and evolve throughout their late 20s all the way into their mid 40s. This range varies from abstinence to binge drinking. Problems related to alcohol increase dramatically after the age of 25.

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There have been virtually no preventative health measures and other public trials that measure effectiveness among native communities. Therefore, additional research would be necessary in order to truly unearth the effectiveness of preventative measures among native communities.

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