Many Native American tribal groups have high rates of alcohol-related problems (Westermeyer, 1986). However, attitudes toward drinking vary considerably from tribe to tribe. Westermeyer noted increasing rates of alcoholism and medical complications secondary to alcohol as Native American tribes have moved from their rural tribal areas to cities. Those living on reservations drink less frequently but are more likely to binge drink and to consume more alcohol per drinking occasion (May & Gossage, 2001). A recent study that contradicted the "firewater myth" theory that Native Americans are more sensitive to the effects of alcohol (Garcia-Andrade, Wall, &Ehlers, 1997) found that the Mission Indian men were generally less sensitive to alcohol effects, a physiological characteristic shown to be associated with a greater risk for alcoholism in white populations.
Alcohol-related motor vehicle fatalities are highest in the Native American population, with a 68.1% rate compared to 44.2% for whites (National Highway Traffic Safety Administration, 1999). Cirrhosis is the sixth leading cause of death in Native Americans (Stinson, Grant, & Dufour, 2001).
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