Arielle Cruz
Alcohol abuse among Native Americans has been linked to a multitude of factors, including historical trauma, violence, mental health issues, and the influence of European colonists. Native Americans have a higher prevalence of alcohol use disorders, with 9.7% reporting an alcohol use disorder in the previous year, compared to 6.1% of whites. The rates of substance abuse among Native Americans are generally much higher than in the general US population, with 10% having a substance use disorder and 7.1% having an alcohol use disorder. Native Americans are also more susceptible to alcohol-related illnesses and accidents, with a higher risk of alcohol-attributed deaths and fetal alcohol syndrome. Historical trauma, such as family separation, violence, and mental health problems, has been identified as a contributing factor to substance abuse. Furthermore, the introduction of distilled spirits and wine by European colonists, as well as current social and cultural factors, have played a role in the high prevalence of alcohol abuse among Native Americans.
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What You'll Learn
Historical trauma and its impact on mental health
Native Americans have the highest rates of substance use disorders, including alcohol, marijuana, cocaine, inhalant, hallucinogen, and methamphetamine abuse, compared to other ethnic groups in the United States. They are also more likely to need treatment for alcohol or drug use, with 13% requiring substance use treatment, but only 3.5% receiving it. This disparity is due to factors such as transportation issues, poverty, and a lack of appropriate treatment options in their communities.
Historical trauma, driven by colonization, has been identified as a significant factor contributing to the high rates of substance misuse among Native Americans. This trauma includes the introduction of distilled spirits and wine by European colonists, the loss of population, land, and culture, as well as historical injustices such as massacres, incarcerations, suppression, and the operation of American Indian boarding schools by the US government. The intergenerational transmission of this trauma results in symptoms such as depression, substance dependence, diabetes, dysfunctional parenting, and unemployment.
Maria Yellow Horse Brave Heart argues that historical trauma leads to pathological coping strategies, such as substance misuse, to deal with low self-esteem, loss of cultural identity, history of abuse, and self-medication for feelings of hopelessness. Treating historical trauma in conjunction with alcohol use disorder has been found to be more effective than substance use treatment without addressing the underlying trauma.
The impact of historical trauma on mental health is evident in the high rates of post-traumatic stress disorder (PTSD), addiction, and suicide among Native Americans. Native Americans experience discrimination and harassment, with 23% reporting discrimination in medical encounters, contributing to a lack of trust in research and the government. This hesitancy to seek healthcare, along with limited access to substance abuse services, further exacerbates the mental health challenges within this community.
To effectively address Native American mental health, it is crucial for mental health professionals to embrace cultural humility and understand the effects of historical and ongoing mistreatment on this community. Clinicians should be aware of the cultural and spiritual practices of their patients' tribes and remain mindful of the power dynamics and cultural differences that exist. By incorporating historical trauma into their clinical work, professionals can better respond to the unique needs of Native American individuals.
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The influence of European colonists
European colonists introduced large quantities of distilled spirits and wine to Native Americans, and this sudden availability of alcohol had a significant impact. Native Americans had little time to develop social, legal, or moral guidelines to regulate alcohol use, and early traders quickly established a demand for alcohol by using it as a medium of trade. Alcohol was exchanged for highly sought-after animal skins and other resources, and traders also provided free alcohol during trading sessions, giving them an advantage in negotiations.
The behaviour of White frontiersmen, who drank heavily and acted unacceptably while drunk, also influenced Native Americans' responses to alcohol. Alcohol became a tool of "diplomacy" in official dealings between authorities and natives, and by the early 1700s, it had become an important trade item and an essential element in treaty negotiations, political transactions, and Native American gift-giving rituals.
The introduction of alcohol by European colonists has been described as a form of cultural genocide, undermining social integrity, promoting violence, and contributing to the belief that Native Americans were culturally inferior. The high prevalence of alcohol use and its consequences among Native Americans may be attributed, in part, to the influence of these early colonists.
In addition to the historical influence of European colonists, current social and cultural factors also contribute to alcohol abuse among Native Americans. Psychosocial stressors, such as family structure, physical and sexual abuse, and educational disruptions, play a significant role in alcohol use among Native adolescents. Native American youth are socialised into the culture of alcohol at an early age, and this pattern of testing alcohol limits can persist into early adulthood.
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Alcohol-related deaths and illnesses
Alcohol abuse is a serious social problem in many Native American communities. Compared to the general population, Native Americans are more susceptible to alcoholism and related diseases and deaths. From 2006 to 2010, alcohol-attributed deaths accounted for 11.7% of all Native American deaths, more than twice the rate of the general US population. Native Americans experience four times as much alcohol-related mortality, three times as much alcohol-related illness, and increased rates of alcohol-related accidental deaths, suicides, and homicides. The median alcohol-attributed death rate for Native Americans (60.6 per 100,000) was twice as high as the rate for any other racial or ethnic group.
Native Americans have higher rates of alcohol use, frequency of use, and destructive drinking patterns. Binge drinking and alcohol use disorder occur among Native Americans at relatively high rates. A study of a Great Lakes reservation community examined the social, cultural, and psychological aspects of alcohol problems, finding that men drank to alleviate feelings of powerlessness stemming from the loss of their traditional social role as providers. Another study found that 80% of Native Americans use alcohol during their youth, with poor self-esteem believed to be the main cause of alcohol abuse among younger Native Americans.
Alcohol-related illnesses and deaths among Native Americans are often due to traffic collisions and liver disease, with suicide, homicide, and falls also contributing. Motor vehicle accidents account for 27.5% of alcohol-attributable deaths, while alcoholic liver disease accounts for 25.2%. Native Americans are three times more likely to die from alcohol-related illnesses or accidents compared to the general population, and alcohol-related fatal car accidents are three times more prevalent among Native Americans than in other ethnicities.
Historical trauma and multi-generational trauma have been identified as significant factors contributing to substance misuse in Native American communities. Native Americans are more likely to experience family separation by the state, and other traumatic experiences such as violence, loss of cultural identity, and feelings of hopelessness. Treating historical trauma in tandem with alcohol use disorder has been found to be more effective than substance use treatment without addressing historical trauma.
Native American babies are at a significantly higher risk of developing Fetal Alcohol Spectrum Disorder (FAS) compared to the general population. Between 1981 and 1991, the risk of developing FAS was 31 per 10,000 among Native Americans, compared to just 2.1 per 10,000 in the overall US population. Native Americans also experience higher rates of suicide, with alcohol found to be a factor in 69% of all suicides between 1980 and 1998.
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Domestic violence and family separation
Native Americans have the highest rates of alcohol, marijuana, cocaine, inhalant, and hallucinogen use disorders compared to other ethnic groups. They are also more likely to report drug abuse in the past month or year than any other ethnic group. The Substance Abuse and Mental Health Services Administration reports that 13% of Native Americans need substance use treatment, but only 3.5% receive it.
Native Americans have a long history of trauma and loss, violence, and other adverse experiences, which have contributed to the high rates of substance abuse in their communities. Historical trauma, including violence, sexual assault, and discrimination, has been identified as a significant factor in substance misuse. Native Americans also face high levels of unemployment and a lack of health insurance, which can contribute to substance abuse.
Family separation has also played a significant role in the trauma experienced by Native Americans. In the mid-19th century, many tribes were forcibly removed from their lands and given inadequate supplies to survive the move, resulting in numerous deaths. Additionally, from the late 19th century onwards, many Native American children were forcibly removed from their parents and sent to government-run boarding schools, where they were not allowed to speak their native language and often suffered physical and emotional abuse.
The introduction of alcohol by European colonists is another crucial factor in the high prevalence of alcohol abuse among Native Americans. Before colonization, the native population had little access to distilled spirits and wine, and alcohol was primarily used for ceremonial purposes. However, colonists made large amounts of alcohol available to Native Americans, using it as a medium of trade and to gain an advantage in negotiations. This sudden availability of alcohol left little time for the development of social, legal, or moral guidelines to regulate its use.
The high rates of substance abuse among Native Americans have had significant impacts on their families and communities. Substance abuse has been identified as a risk factor for domestic violence and child abuse and neglect. Native American women who have experienced childhood abuse are more likely to suffer from physical and sexual assault in adulthood. Additionally, Native American children who grow up in households with substance abuse are at an increased risk of developing substance use disorders themselves, perpetuating a cycle of trauma and abuse.
To address these issues, culturally sensitive treatment programs that incorporate native beliefs and approaches are needed. Organizations like the Native American Connections aim to provide affordable and accessible substance use and mental health treatment for Native Americans, recognizing the unique historical and cultural factors contributing to their communities' struggles with substance abuse and family separation.
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Youth alcohol abuse and early mental health problems
Alcohol abuse among Native Americans has its roots in the historical trauma inflicted by European colonists. Before colonisation, tribes produced weak alcoholic beverages, but these were used ceremonially or ritually. When European traders arrived, they introduced distilled spirits and wine, using them as a medium of trade for animal skins and other resources. This sudden availability of alcohol gave tribes little time to develop social, legal, or moral guidelines to regulate its use.
The introduction of alcohol by Europeans is a significant factor in the high prevalence of alcohol abuse among Native Americans today. Native Americans experience much higher rates of substance abuse compared to other ethnic groups in the US. Data from 2018 shows that 10% of Native Americans have a substance use disorder, with 7.1% having an alcohol use disorder. This is a higher rate than any other ethnic group.
Native American youth are particularly vulnerable to alcohol abuse and its associated mental health problems. A 2012 study found that 52.8% of Native American 8th graders and 67.5% of 12th graders had experimented with alcohol, compared to 13.8% and 41.1% of non-Native students. Psychosocial stressors, such as family structure, abuse, and education, play a significant role in alcohol use among Native American adolescents. Belief in the firewater myths also leads to greater intensity and frequency of alcohol use among Native American youth.
Substance abuse and addiction are major concerns among young Native Americans. The 2018 NSDUH survey revealed that nearly 1 in 5 Native American young adults (aged 18-25) have a substance use disorder, with 10% of those related to alcohol. Approximately 4 in 10 Native American adolescents (aged 12-17) have a lifetime prevalence of illicit drug use. Native American adolescents have the highest rates of tobacco, marijuana, and prescription drug use.
The high rates of substance abuse among Native American youth are linked to mental health issues and suicide. Native Americans are at an increased risk of mental illness and suicide, with alcohol consumption a factor in 69% of Native American suicides between 1980 and 1998. Native Americans have one of the highest rates of fetal alcohol syndrome, with a prevalence of 31 per 10,000 births between 1981 and 1991.
Addressing the historical trauma and cultural factors influencing alcohol abuse is crucial for effective prevention and treatment among Native Americans. Efforts such as alcohol education, youth mentoring, cultural heritage projects, and substance abuse prevention programs are being implemented to tackle this complex issue.
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Frequently asked questions
Historical and social factors have contributed to the problem of alcohol abuse among Native Americans. European colonists introduced large amounts of distilled spirits and wine to Native Americans, who had previously only consumed weak brews during ceremonies. This sudden availability of alcohol, combined with its use as a medium of trade, quickly established a demand and normalised heavy drinking. Other factors include historical trauma, violence, high levels of unemployment, discrimination, and lack of health insurance.
Alcohol misuse has caused emotional turmoil, physical health problems, and economic burdens within Native American communities. It has contributed to high rates of domestic violence, with 39% of Native women reporting intimate partner violence. Alcohol consumption has also been linked to targeted hate crimes and a higher risk of death by accident, violence, or alcohol poisoning.
Native Americans have higher rates of alcohol use disorders compared to other racial groups, with 10.7% vs 7.6% reported in one study. They are also more likely to report drug and alcohol abuse in the past month or year than any other ethnic group. Native Americans have the highest rates of alcohol, marijuana, cocaine, inhalant, and hallucinogen use disorders.
Native American youth have disproportionately high rates of lifetime and past-month alcohol use, and they are more likely to initiate use at a younger age. They experience high rates of trauma, loss, violence, and other adverse childhood experiences, which, combined with early alcohol use, increases their susceptibility to future substance use disorders.
Gene-environment interaction studies have suggested that certain genetic variants may increase the risk for alcohol consumption among Native Americans. For example, a genome scan of California Indians identified a region on chromosome 4q22.1 that may influence alcohol dependence. Another study found a link between a functional polymorphism in the MAOA gene and alcoholism, especially when combined with childhood sexual abuse.
