Addictions and Native Americans

191 Pages·2000·1.082 MB·English

by  Laurence Armand French

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
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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.