Native American Alcoholism and Treatment Failure

A colleague recently asked me for my assessment ofall of the women have left, preferring the easier life
the applicability of the "disease model" of alcoholismavailable to them with non-Native husbands, college
with regard to Native Americans. She asked not onlyeducation, or city jobs. Who can blame them for
because my adopted children are Inyupik, and fromleaving, or for the hopeless young men left behind
alcohol devastated families in northwestern Alaska, butfrom drowning their loneliness?
also because I have worked in non-traditional ways ofIn addition to personal and community factors there
combating alcohol abuse for over twenty years.are also political factors. Leadership within some Native
My answers have evolved out of the past forty yearsAmerican entities, like other ethnic or religious entities, is
of my experience, work, observations, research,sometimes jealously held by families or individuals who
discussion, and reflection.see promoting alcohol abuse as a way of maintaining
To begin with, the repeatedly discredited "diseasetheir positions and preventing rivals from threatening
model" negatively impacts everyone suffering fromtheir power. "As long as they're drunks, and their
alcohol abuse - not just Native Americans; and second,children are drunks, my children's future is secure," is
"Native American" is also a counter-productive term,how one Fairbanks Athabascan matriarch put it to me
one implying that there is only one homogeneous groupover twenty years ago, echoing her western Alaska
indigenous to North America. Nothing could be fartherYupik counterpart two decades before that. They
from the truth.were right.
To exemplify, Alaska alone, is home to three distinctlyThe unending problem, of course, is that alcohol also
different "Native" groups: Aleuts; the Yupiks andmakes all of the problems it "solves" worse; providing
Inyupiks ("Eskimos"); and over twenty different "Indian"temporary fixes which preclude long term solutions.
tribes. Within and between these entities the degree ofDepression that encourages alcohol abuse, while
alcohol use and abuse varies widely and so domaking the depression worse, is only one of a number
solutions to their alcohol related problems."of short and long term "Catch 22" features of alcohol
However, it is true that across the continent, includingmisuse.
Alaska and Canada, Native Americans do exhibit aReturning to my colleague's original question, viewing
higher percentage of alcohol abuse and dependencealcohol abuse as a "disease" makes maintaining the
than many other groups, though again, not in everystatus quo easier for everyone. It obscures the real
case. Still, given the high incidence it's tempting to wantproblems and sidetracks everyone from seeking and
alcoholism to be a disease, rather than looking forimplementing real solutions.
more complicated and less forgiving causes. However,On the other hand, if it's a choice, , then changing the
regardless of the group being considered, alcoholhabits of use and abuse becomes matters of individual,
abuse and dependence rates really are a reflection offamily, community, and political choice. Predictably,
an accumulation of contributing social, psychological,however, there aren't a lot of people anxious to sign
biological, and cultural factors.up for responsibility when being a victim is so much
Consider for a moment one such factor: that alcoholmore appealing, at least for today. After all, having a
use is frequently a matter of learned behaviors baseddisease over which I am powerless is the perfect
on community and cultural expectations. Most of usexcuse to keep on drinking. Changing, on the other
adopt alcohol use, and abuse, as patterns from ourhand, requires a sustained effort along with the
family, our community, and society at large. Whoacceptance of responsibility for one's own situation
introduced alcohol to Native Americans? Prospectors,and decisions.
whalers, soldiers, and others whose immoderateThe picture I have painted in this brief essay is, of
alcohol "use" is now reflected in many of today'scourse, a simplification - a picture that includes only
Native American's usage, and these stereotypicalsome of the major factors that contribute to the
patterns continue to be handed down from oneongoing destruction of what? Nor have I discussed the
generation to the next.individuals, communities, and tribal groups who have
Of course these learned behaviors could be changedsuccessfully navigated through alcohol's traps and
if they weren't serving a purpose, which, unfortunately,temptations and achieved a sober and satisfactory life.
they do. For example, in many cases being drunk is aMany more could, and would, with social and political
readily accepted excuse to diverge from culturalsupports that addressed the underlying needs and
norms - an excuse to act out aggressively rather thanfactors from a realistic perspective.
adhering to a passive conformity, for example.Is that apt to happen? Not as long as "treatment"
Community members hesitate to criticize someone forreinforces the hopelessness and powerlessness that
getting drunk and acting out this week when they maythat failed industry provides and depends upon. Not as
themselves want to get drunk and do the same nextlong as leaders externalize the causes they profit from
week. (Again, however, please remember that this isn'tfinancially and politically rather than addressing the real
a pattern unfamiliar to many other communities.)needs, problems, and attitudes which support continued
Drinking is also a way of achieving some temporaryalcohol dependence. Not as long as "alcoholism" is
respite from crowded living arrangements that don'tseen as a cause rather than a symptom. Not as long
allow for any privacy. Thirty years ago my neighbor onas being a victim is preferable to assuming
the upper Yukon was one of eight people occupying aresponsibility for ourselves and for our communities.
cabin roughly fifteen by twenty feet - a cabin withoutClearly, alcohol abuse is not a disease, and the
electricity, running water, or any distractions. Who couldsolutions - including real assessment of individuals and
blame him for disappearing into an alcohol inducedcommunities; the provision of active opportunities
stupor from time to time?vocationally, socially, and recreationally; and the
Alcohol also helps blot out the depression andrefutation of a passive "disease" mentality - are no
frustration that comes from a seemingly hopelessdifferent for Native Americans than they are for the
future. In many communities the most capable peoplerest of us. But it requires the courage to acknowledge
have left, pursuing educational, vocational, and socialthe mistakes of the past, to implement real change,
opportunities. Generations have seen a steady declineand to withstand the objections and sabotaging of
in leadership, stability, and ability. In some cases, nearlythose who profit from business as usual.