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Alcohol / Drug Abuse
Among American Indians

Most of the literature regarding American Indians primarily addresses alcohol.  However, drugs other than alcohol also present problems in American Indian communities.

For example, inhalants are frequently abused by American Indian youths, especially by young adolescents before they gain access to alcohol.  Use of marijuana is highly variable across different American Indian groups, but it appears to be higher among American Indian youths than among non-Indian youths.  Heroin use is low among American Indian people and cocaine use is similar for American Indians and non-Indians.

A consequence of alcohol being the preferred drug is that alcohol abuse represents a major problem for many American Indian communities.  For example, as a group, American Indians and Alaska natives experience high rates of diseases of the heart, cancer, diabetes, and injuries or death as a result of accidents (Indian Health Service (IHS), 1991; May, 1995).  An important observation is that alcohol abuse plays a significant role in these problems.  Alcohol is a major factor in five of the 10 leading causes of mortality for American Indians (IHS, 1992).  Morbidity data also indicate that alcohol abuse is a major factor contributing to health problems among this population.

In addition to tribal differences, American Indians differ greatly by degree of American Indian ancestry; this is important because American Indians are the only ethnic group in the United States that is legally defined by degree quantum, with 25 percent American Indian blood being the most commonly accepted minimum threshold for tribal membership.

More evidence of the problem is seen in the percentage of all American Indian deaths that involved alcohol.  For 1986, 1988, motor vehicle crashes, other accidents, suicide, homicide, and alcoholism caused a total of 5,781 American Indian deaths.

However, Ferguson (1968) described the subgroups of recreational and anxiety drinkers that are also common among most American Indian communities.  The recreational drinker is typically a young man who drinks with friends (predominantly men, but also in mixed groups) on weekends and for parties, special occasion, and other social events.  As with other groups of young people, drinking and intoxication are important for social cohesion and are generally highly valued.  Recreational drinking among American Indian groups of many tribes may be different from some other groups in the United States only in matters of degree and cultural meaning.  American Indians recreational drinking is more rapid and more forced, and the “bouts” are extended over long nights, weekends, and for other lengthy periods.  High blood alcohol concentrations are commonly found in American Indians who practice this style of drinking.

Anxiety drinkers are mostly unemployed, live in border towns and skid row areas, and are not usually associated with the mainstream society of their tribe or of Western society.

These two patterns, the recreational and anxiety drinking represent the types of alcohol-abusing or alcohol problem generating styles that account for most of the problems related to alcohol in American Indian communities.

Alcohol, marijuana, and inhalants are the three drugs most commonly abused by American Indian youths.  American Indian youths generally report they use alcohol as frequently as or more frequently than other youths in the United States.  For example, by the 12^th grade, lifetime prevalence of alcohol use is quite high: 96 percent for American Indian men, and 92 percent for women (Oetting & Beauvais, 1989). 

By 12th grade, 80 percent of American Indian youths are current drinkers, but variation exists from reservation to reservation (May, 1982).  Severity measures show that American Indian youths who drink are more likely to report having been drunk and to have “blacked out”.