Addictions and Native Americans PDF
Preview Addictions and Native Americans
ADDICTIONS AND NATIVE AMERICANS ADDICTIONS AND NATIVE AMERICANS A LAURENCE ARMAND FRENCH LibraryofCongressCataloging-in-PublicationData French,Laurence,1941– AddictionsandNativeAmericans / LaurenceArmandFrench. p. cm. Includesbibliographicalreferencesandindex. ISBN0–275–96349–7(alk.paper) 1. IndiansofNorthAmerica—Alcoholuse. 2. IndiansofNorth America—Druguse. 3. IndiansofNorthAmerica—Gambling. I. Title. E98.L7F74 2000 362.29'12'08997—dc21 99–32094 BritishLibraryCataloguinginPublicationDataisavailable. Copyright(cid:1)2000byLaurenceArmandFrench Allrightsreserved.Noportionofthisbookmaybe reproduced,byanyprocessortechnique,withoutthe expresswrittenconsentofthepublisher. LibraryofCongressCatalogCardNumber:99–32094 ISBN:0–275–96349–7 Firstpublishedin2000 PraegerPublishers,88PostRoadWest,Westport,CT06881 AnimprintofGreenwoodPublishingGroup,Inc. www.praeger.com PrintedintheUnitedStatesofAmerica TM Thepaperusedinthisbookcomplieswiththe PermanentPaperStandardissuedbytheNational InformationStandardsOrganization(Z39.48–1984). 10 9 8 7 6 5 4 3 2 1 CONTENTS A Introduction vii Part 1 Historical Perspectives on Native American Addictions 1 The Aboriginal Worldview and Lifestyle 3 2 Aboriginal Uses of Psychoactive Agents 9 3 Federal Policies and Marginality 15 Removal 21 Allotment 24 Reorganization 25 Termination/Relocation 27 Self-Determination/NewFederalism 28 Part II The Nature of Substance Abuse among Native Americans 4 Psychocultural Factors 35 5 Studies on Substance Abuse in Indian Country 45 vi A Contents The Drunk Town Phenomenon 45 Review of Contemporary Research 50 Part III Prevention, Intervention, and Cultural Treatment 6 Understanding Culture-Specific Primary and Secondary Clinical Diagnoses 65 Introduction 65 The History of the ICD, DSM, and PTSD 68 The Neurophysiology of Addictions 73 7 Cultural Treatment Considerations 81 Introduction 81 Review of the Treatment Literature 83 The Native Response 88 8 The Federal Response: Standards and Practice Guidelines 97 IHS Guidelines 97 Federally Funded Programs 102 Part IV Indian Gaming—The New Addiction 9 Indian Gaming and U.S./Indian Policy 109 Introduction 109 The Historical Context of Gaming Control 110 The Indian Gaming Regulatory Act Controversy 115 10 Indian Gaming: Social, Political, and Clinical Issues 121 Introduction 121 A Comparison of Two Systems: The Cherokee of North Carolina and the Indians of New Mexico 124 Prevention and Treatment Issues 132 Notes 139 Bibliography 155 Index 169 INTRODUCTION A SubstanceabuserepresentsthemajorhealthproblemplaguingAmerican Indians,bothhistoricallyandtoday.Amajorfactorwastheintroduction of fortified and distilled alcohol, first by the Europeans and later the Americans, to an indigenous population whose physiology (metabolism and neural compensation) was not accustomed to this concentration of ethanol. Another factor was the introduction of alcohol outside of tra- ditional customs and folkways. While there is evidenceof substanceuse during aboriginal times, notably of fermented corn or cactus juices and psychoactive agents such as peyote and cocoa leaves, these substances were confined to prescribed rituals and were not abused. Moreover, in most instances the concentration of psychoactive agents consumed dur- ing aboriginal times was minimal compared to today’s standards. Clearly,thedeparturefromprescribedaboriginalcustomsandritualistic use of psychoactive substances, combined with the increasedpotencyof psychoactive agents introduced by Western groups, has contributed greatly to the substance abuse problem among American Indians and Native Alaskans.1 By all accounts, alcoholism is the number-one killer among American Indians.AreviewbytheprestigiousRobertWoodFoundationofcurrent data indicates that the death rate for Indians aged fifteentoforty-fouris viii A Introduction over 300 percent higher than that of the overall U.S. population.2 Since World War II, when reliable data began to be collected, alcoholism has registered as the single most serious health problem for American Indi- ans, accounting for the four leading causes of death in that group: acci- dents, cirrhosis of the liver, suicide, and homicide. A fifth, more subtle causality of Indian alcoholism is fetal alcoholism, known as FAS (fetal alcohol syndrome). FAS is an especially problematic form of substance abuse, in that it tends to perpetuate a cycle whereby the compromised infantsgrowupwithahostofphysicalandpsychologicalproblemsthat greatly increase their susceptibility toward alcohol and other substance abuse. The groups with the highest rates of FAS are the Sioux tribes residing within the Indian Health Service’s (IHS) Aberdeen area (North and South Dakota, Nebraska, and Iowa). FASisalsoacommonhealthproblemamongurbanIndians,especially among these who are phenotypically Indian but are unaware of their native languages or traditional ways. Here, psychocultural marginality, aphenomenonEricEricksonnotedwhenstudyingAmericanIndiandis- organization a half-century ago, appears to play a major role in the in- tensity of FAS.3 The more alienated the Indian mother is from both her traditional culture and the dominant U.S. society, the more likely she is to be afflicted with the combination of poor mental and physical health associated with fetal alcoholism. The schism between our Western-oriented society and that of tradi- tional Indian waysisillustratedbythecompetingepistemologicalmeth- odologies.Westernsocietiesbasetheirrelativeconstructsofrealityupon a secular version of the protestant ethic, while traditional (aboriginal) North American Indian groups based their world view on the harmony ethos.4 Simply stated, the former engenders individual competition and culpability within a society, while the latter promotes cooperation and shared responsibility. It is rare for American Indians to be adequately socialized within both cultural orientations; they are forced to be pri- marily oriented to one or the other. American Indians socialized within the protestant ethic, regardless of their phenotype or blood degree, are commonly termed white Indians or, in derogatory terms, apples (red on the outside and white on the inside). American Indians adequately en- cultured (understanding both their language and customs) within their respective tribe are known as traditionalIndians,whilethosewhoarenot adequately socialized within either epistemological methodology are termed marginal Indians. Marginal Indians are those most susceptible to substance abuse.5 The book is divided into four parts: (1) Historical PerspectivesonNa- tive American Addictions; (2) The Nature of Substance Abuse among Native Americans; (3) Prevention, Intervention, andCulturalTreatment; Introduction A ix and (4) a special section on a new aspect of addiction within Indian country—Indian Gambling—the New Addiction. Part I consists of two sections: Chapter 1 explores the pre-Columbian worldview of Native Americans and their aboriginal lifestyle, while Chapter 2 looks at Euro-Americancontrol processesandtheirimpacton Indian marginality. In Part II, we review current research on the nature andextentofsubstanceabuseamongAmericanIndiansandNativeAlas- kans. Psychological factors are discussed in Chapter 3, followed by epi- demiological studies of substance abuse and related health problems in Chapter 4, while Chapter 5 addresses one of the most serious health problems facing American Indians and Alaskan Natives—fetal alcohol- ism.PartIIIaddressestreatment,intervention,andpreventionissuesfac- ing therapists treating Native Americans addictions. Chapter 6 explores primaryandsecondaryclinicaldiagnosesfromtheAmericanIndiancul- tural perspective, while Chapter 7 looks at culture-specific prevention and treatment strategies for fetal alcoholism, with special focus on the effortsmadebythethreelargesttribes:theNavajo,Cherokee,andSioux. Chapter8providescurrentfederalclinicalstandardsandpracticeguide- lines for Indian country. Thelast section,PartIV,IndianGambling—the NewAddiction,exploresthecurrentcontroversyoverIndiangaming.In Chapter 9, the link between reduced federal funding and greater tribal autonomy under the U.S./Indian policies of self-determination and “NewFederalism”isreviewedrelevanttothegamingindustryinIndian country, while Chapter 10 looks at prevention and treatment issues.
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