Book: Review/Commentary: Addictions and Native Americans

Abstract

Addictions and Native Americans, by Laurence Armand French (Westport, CT: Praeger, 2000), 192 pp., $59.95 (cloth only). Substance abuse is among the most serious public health problems facing Native Americans. Compared with the general population, rates of alcoholism among Native Americans are higher, death rates due to alcohol-related causes are eight times higher, and Native Americans as a group tend to die younger, often from alcohol and alcohol-aggravated conditions (Green, 1999, p. 233). Although the phenomenon of Native Americans' problem drinking has been studied for many decades, there is still an incomplete understanding of the etiology of the problem and a lack of effective prevention and treatment programs. Addictions and Native Americans presents a review of the current state of knowledge on the prevalence, nature, causes, and treatment of addictions (primarily alcohol abuse, with limited reference to inhalant abuse and gambling addiction) among Native Americans in the United States. The problem of substance abuse is first examined from a historical perspective and then from within its current sociocultural context. The author makes a good case for the significance of historical events in the evolution of problem drinking among Native Americans-e.g., the manner and purpose of introduction of alcohol to aboriginal groups as well as the federal policy on prohibition, which promoted a pattern of rapid intoxication. In addition, he cites such varied federal policies as forced removal to reservations and assimilation in the 19th century and termination of federal protection and responsibility in the 1950s, with relocation off reservations to cities, as contributing to the disintegration of native cultures and to their current marginality. With the loss of cultural cohesiveness, native groups could not establish or reestablish aboriginal proscriptive or prescriptive drinking norms that might have controlled drinking behaviors. While current systemic factors such as poverty and inadequate housing, diet, and health care are noted, the author, a psychologist, emphasizes psychocultural marginality as an etiological factor in the high rate of substance abuse among Native Americans. He does not discuss the alienation, despair, and hopelessness that stem from economic marginality, denial of land, hunting, and fishing rights, racism, and increasingly prevalent violence. The focus at the microlevel of analysis in this book results in a tendency to make Native Americans' problem drinking too much a special case that is explainable primarily in psychocultural terms and therefore requires primarily psychocultural solutions. Consequently insights into causation that could be gained from an examination of the association of colonialism with high rates of substance abuse in aboriginal groups worldwide are overlooked, as are studies that indicate that economic and community development have been associated with declines in substance-abuse rates. The author provides a good summary of the native culture-- centric treatment programs that have been developed to replace or augment existing substance-abuse treatment approaches found to be ineffective. …