American Indian alcoholism

American Indians have historically had extreme difficulty with the use of alcohol. At times Native Americans have made paupers of themselves to obtain alcohol. Problems continue among contemporary Indians with 12% of the deaths among American Indians and Alaska Natives being alcohol related. Use of alcohol varies by age, gender and tribe with women, and older women in particular, being least likely to be regular drinkers. Indians, particularly women, are more likely to abstain entirely from alcohol than the general US population. Frequency of use among American Indians is generally less than the general population, but the quantity consumed when it is consumed is generally greater.

A survey of death certificates over a four year period showed that deaths among Indians due to alcohol are about 4 times more common than in the general US population and are often due to traffic collisions and liver disease with homicide, suicide, and falls also contributing. Deaths due to alcohol among American Indians are more common in men and among Northern Plains Indians. Alaska Natives showed the least incidence of death. Alcohol abuse by Indians has been shown to be associated with development of disease, including sprains and muscle strains, hearing and vision problems, kidney and bladder problems, head injuries, pneumonia, tuberculosis, dental problems, liver problems and pancreatitis.

Indian youth are far more likely to experiment with alcohol than mainstream youth with 80% alcohol use reported. Low self-esteem is thought to be one cause. Active efforts are underway to build self-esteem among youth and to combat alcoholism among American Indians.

Genetic factors
While little detailed genetic research has been done, it has been shown that alcoholism tends to run in families with possible involvement of differences in alcohol metabolism and the genotype of alcohol-metabolizing enzymes.

Psychosocial factors
It has been found that incidence of alcohol abuse vary with gender, age, and tribal culture and history.

Environmental factors
Factors related to rural reservation life may be involved, including law enforcement.

In popular culture
Inappropriate focus on American Indian alcoholism can result in application of an ethnic stereotype to all American Indians.
 * In Jack London's White Fang, an American Indian trader is tricked into alcoholism by another tradesman, which eventually takes him of everything he had and he owned, including his skins (the tools of the Indian's trading) and his "dog", the main character of the book.
 * The 2002 movie Skins explores the degrees of alcoholism in Native Americans.