The Myth & Reality of Native American Drinking Patterns

Problem-drinking is a human problem which crosses many cultural and all racial boundaries. Special care must be taken to avoid assuming that the drinking dynamics of the southwest Indian people are necessarily different from, or the same as, the general U.S. population or other Native American tribes. Rebach (1988) warned that the literature on substance abuse among minorities is often limited, imprecise, and incorrectly generalized. It is also important to realize that there are significant environmental, social, and cultural differences among tribes, and that there is no standard Native American response to alcohol (Watts & Lewis, 1988).

Within the Gallup area, problem-drinking, and the alcohol related problems of increased disease, poor nutrition, violence, and automobile accidents, is the leading cause of mortality (May, 1992). Alcohol-related deaths among all U.S. tribes nationally account for a disproportionate 16.7% of all Native American deaths. This can be compared with 7.7% alcohol-related deaths in the overall U.S. population. In spite of this statistic, however, May (1992) pointed out that fewer Navajos, for exampe, actually drink (52%) than do members of the general U.S. population (67%). (Note: this is a Navajo specific statistic and may, or may not, be typical of other tribes.) Of six studies in the literature, May also cited three studies which indicated that the average Native American consumer drinks less than the average U.S. non-native consumer. He found one study which showed that Native Americans consume the same amount of alcohol as non-natives, and two studies which found that Native Americans have a slightly higher drinking level. May did not make a distinction between tribal groups in this assessment. It is also important to recognize that the majority of Native American drinkers, like most non-native people, enjoy alcohol socially without problems (Mail, 1992). Gregory (1992) also stated that although alcohol-related problems are indeed serious, the prevalence of Native American drinking is commonly exaggerated. Mail also reported that many Native American communities have reduced this trend significantly. As an illustration, unlike at most popular U.S. events, the majority of Navajo meetings, ceremonies, dances, rodeos, and public events are alcohol free.

In spite of this improvement, a disproportionate percentage of Native Americans who do consume alcohol still experience drinking related problems. Although statistics are often skewed by the extremely high rates of some smaller, urban-surrounded tribes, May believed the Southwest Native American population experiences a 18.4% mortality from alcohol-related deaths. This can be compared to a 7.7% of the overall U.S. population. He attributed the higher mortality ratios (in spite of the apparently near-similar drinking prevalence percentage) to a combination of social and cultural factors magnified by the environmental situation of extreme poverty, poor nutrition, and the long distance and low availability of medical attention. For example, a large percentage of alcohol related deaths in the Navajo environment are due to cold weather exposure. In comparison, for example, several rural, non-native counties in the Southwest have almost identical alcohol-related death/injury statistics (May, 1992).

May (1992) also pointed out that Native American substance abuse, magnified by the limited economic and environmental-logistical context, places a disproportionate strain on the already limited reservation-based medical, social, and criminal systems. For example, a mildly injured Navajo problem-drinker is more likely to become a mortality statistic because his or her accident occurred many hours from a hospital. Additionally, if this person does manage to get treatment, the hospital may be ill-equipped and understaffed.

It is a common idea among both non-Native American and Native American people that "Indians" have both a genetic metabolism and cultural heritage which pre-disposes them to substance-use-disorders (Levy, 1992; May, 1992). Milam & Ketcham (1983), for example, stated that a significant percentage of Native Americans lack the metabolic, hormonal, and neurological factors which permits the smooth metabolization of alcohol. In strong objection, however, May (1992) and others (Beauvais, 1992; Dorpat, 1992; Fleming, 1992; Gregory, 1992; Heath, 1992; Peters, 1992; Wolf, 1992) argued that, although there are some unique and specific differences, in general, Native Americans react to alcohol much like other people.

In an attempt to lessen the importance of racial predisposition towards alcohol abuse, May listed five studies which show that Native Americans metabolize alcohol as (or even more) rapidly than non-native people (Bennion & Li, 1976; Farris & Jones, 1978; Reed, Kalant, Griffins, Kapur, & Rankin, 1976; Schaefer, 1981; Zeiner, Perrez, & Cowden, 1976). Additionally, two biopsy studies concluded that the livers of Native Americans and Western Europeans were similar in both structure and phenotype (Bennion & Li, 1976; Rex, Bosion, Smialek & Li, 1985). May and others (Bennion & Li, 1976; Leiber, 1972) found only one study which indicted that Native Americans might have a slower alcohol-processing metabolism but they all believed this study was significantly flawed (Fenna, Mix, Schaefer, & Gilbert, 1971).

Wolf (1992) observed that Alaskan Natives are much more likely to experience "black-out" periods of unconsciousness during periods of heavy drinking than the average U.S. non-native population. May (1992) maintained, however, that the ethnic differences between people are not as significant as the differences of individual metabolism, diet, body weight, drinking history, state of health, speed of consumption, intention, context, and history of head trauma. Because many Alaskan Natives suffer disporportionally from these conditions, the relationship between blackouts and genetics again remains unclear.

Mail (1989) suggested that American Natives, along with many other suppressed peoples, suffer disproportionately from both "acculturation" and "deculturation" stresses (e.g., the combined demands to integrate with the dominant culture and the loss and devaluation of their own historical traditions and economic standing). In such cases, alcohol appears to help cope with feelings of inadequacy during periods of rapid personal, cultural or social trauma (Rotman, 1969; Savard, 1968; Topper, 1974). Other researchers stated that 200-500 years of physical suppression, domination, depopulation, and relocation of Native American populations have produced a generalized cultural trauma which would naturally lead many into excessive-drinking (Ackerman, 1971; Berreman, 1964). This situation becomes additionally magnified by environmental stresses such as limited resources, barren land, and harsh weather. These stressors can tumble even further out of control when additionally fanned by the resulting negative-feedback cycle of anger, rebellion, family breakdown, hopelessness, and substance abuse (Norick, 1970). It is likely that this chronic trauma eventually will impact the neurotransmitters (as postulated in the RDS model).

May (1992) and Reed (1985) both warned that although alcohol consumption, metabolism, and the negative consequences of alcohol dependence and alcohol abuse can differ among ethnic (tribal), social, and environmental groups, there is often a great variation within the same group. May and others, concluded that the etiological complex which contributes the most to abuse lies within the social, culture, and environmental realm (including subcultures) of their communities, and the social structures of the surrounding regions (Bach & Borstein, 1981; Bennion & Li, 1976; Dozier, 1966; Kunitz & Levy, 1994).

A historical perspective is also helpful. The heavy use of alcohol among Southwest tribes was often encouraged and manipulated by the U.S. Army, was intentionally perpetuated by many missionaries and traders, and is still actively and aggressively encouraged by the liquor industry (Levy & Kunitz, 1975). As an example, several New Mexico legislators implied that they would not vote for an increase in liquor tax (which would have been applied to better treatment programs), or vote for restrictions on liquor advertisements, because the liquor industry was their primary source of election contributions and represented a substantial part of the state's economy (personal communication). The alcohol industry is a significant and integral part of today's U.S. society, especially in reservation border-towns.

Differences in Drinking Dynamics

Some behavioral aspects of average Southwest consumers differ from those of average non-native drinkers. For example, many Navajo problem-drinkers tend to "binge drink" (or drink rapidly) in contrast to the more typical urban problem-drinker's tendency to drink steadily throughout the day (Heath, 1983). Binge drinking is common among social groups who are temporarily removed from more stable, domestic situations. The rapid, excessive-drinking habits of some college students and soldiers illustrate this phenomenon.

It was also found that the EEG baselines of most Navajo's suffering from drinking problems were not alpha deficient, contrary to the literature suggesting a predisposing EEG signature for alcohol dependency among European populations (Kelley, 1992). It is unknown whether the mean EEG baselines of non-drinking Navajo people tend to be different from the non-native U.S. population norms.

The often traumatic dissonance between the Navajo cultural and the dominant, non-native U.S. culture significantly contributes to the disproportionate ratio of drinking problems to the amount of alcohol actually consumed, to the low number of Navajo problem-drinkers who seek treatment, and to the lack of treatment success among those Navajo people who do enter treatment (Christmas, 1978). Anthropologists have identified some social and cultural factors which may pre-dispose the Navajo society to this pattern. MacAndre and Edgerton (1969) suggested that societies often "get" the type of behavior which they allow. Some of these identified, possibly pre-disposing, Navajo social characteristics are as follows: (a) a nomadic-warrior individuality placed within a now-sedentary matrilineal society which increases male-role frustration and the quest for personal independence (Waddel & Everette, 1975); (b) a history of psychoactive plant usage (peyote and other herbs) to induce spiritual power, dreaming, visions, and spiritual contact; (c) the lack of recent historical self-determination, and externally imposed control (Hurlburt, Gade, & Fuqua, 1983); (d) peer conditioning from childhood to consume both rapidly, excessively, and extensively when drinking; (e) aberrant role models from early, non-native contact; (f) higher rates of tough-mindedness, introversion, and emotionality than non-native U.S norms as scored on the Eysenck Personality Inventory corrected for cultural differences (Hurlburt, Gade, & Fuqua); (g) little, or no, "stake" in either the dominant society or the outcome of their drinking problems (Levy & Kunitz, 1975).

Because most treatment programs for Native Americans are largely based upon the values and strategies of the dominant urban culture, both the rates of treatment participation and successful treatment outcomes for Native Americans are even lower than the reported rates for non-Native Americans (Kivlahan, 1985). The current treatment programs typically involves "disease model" education, general behavioral and employment counseling, psychotherapy, the Christian-oriented twelve-step-program, limited medial attention, and various forms of family support.

In designing a more effective treatment strategy for most Navajo people, several anthropologists suggested that programs must utilize traditional Navajo cultural techniques, traditional settings, and traditional self-empowerment programs (French, 1989; Kavlahan, 1985; Westermeyer, 1988). Many Navajo substance abuse specialists concur that a strong hybrid program of both select traditional and psycho/social practices will be a significant improvement over the current "failed" model.

Studies at the Na'nizhoozhi Center suggest that the majority of "chronic" problem-drinking men and women fall into what they call a "negative-warrior-tough-mindedness" category: a emotional crises-oriented trap characterized by callousness, isolation, and self-destruction which ironically becomes an effective survival mechanism. They suggest that an intense regime of traditional practices, flavored with the best modern coping and empowerment skills, may turn this "negative" survival adaptation back into what they call "positive warrior-tough-mindedness"; a self-sufficient state of inner-empowerment based on positive traditional (yet modern in their application) beliefs; e.g. "against all odds, I walk in beauty'".

Besides addressing the client's specific environmental and psychological concerns in a culturally appropriate way, it is possible that many traditional Navajo medicine and Native American Church procedures (such as sweat lodge, "blessing-way", herb-usage, and a wide range of often intense ceremonies) will produce significant psychophysiological, stress-relieving benefits. Currently, active participation in the Native American Church is considered to be more effective than the standard 12-step treatment or medical treatment protocol (Hill, 1990; Pascarosa, 1976). Christian support, for Christian-oriented Navajos, has also proven significant.

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Last modified: May 24, 2005