Chronic liver disease in Aboriginal North Americans

A structured literature review was performed to detail the frequency and etiology of chronic liver disease (CLD) in Aboriginal North Americans. CLD affects Aboriginal North Americans disproportionately and is now one of the most common causes of death. Alcoholic liver disease is the leading etiology of CLD, but viral hepatitis, particularly hepatitis C, is an important and growing cause of CLD. High rates of autoimmune hepatitis and primary biliary cirrhosis (PBC) are reported in regions of coastal British Columbia and southeastern Alaska. Non-alcoholic liver disease is a common, but understudied, cause of CLD. Future research should monitor the incidence and etiology of CLD and should be geographically inclusive. In addition, more research is needed on the treatment of hepatitis C virus (HCV) infection and non-alcoholic fatty liver disease (NAFLD) in this population.

Life-course observations of alcohol use among Navajo Indians: natural history or careers?

In this article, I describe changes in patterns of alcohol use and abuse among Navajo Indians from the mid-1960s to the late 1990s. The prevalence of alcohol dependence continues to be higher than in the general U.S. population, but remission is also common, as it was in the 1960s and previously. Men have substantially higher rates of alcohol dependence than women. The former engage in heavy drinking largely in response to the heavy drinking of those around them. The latter drink excessively largely as a response to psychiatric disorders, depression, and abuse by a partner or husband. As increasing numbers of people have moved to reservation and border towns, a youth culture has developed in which alcohol use is initiated by teenagers with their peers rather than, as in the past, with older kinsmen. Alcohol use has thus been freed from the constraints imposed by both isolation and family obligations.

Toward a political-economy of alcoholism: the missing link in the anthropology of drinking

This paper addresses a shortcoming in the existing anthropological and related social science literature on alcohol use and abuse, namely the general inattention to global political-economic forces that have in the past and continue to reshape social relations and drinking practices cross-culturally. Following a critical review of the dominant approaches adopted in the varying explanations of heavy drinking and alcoholism, several alternative concepts are presented and developed in order to lay the ground for the emergence of a political-economy of alcoholism. The paper urges transcendence of the existing narrow boundaries of inquiry and perspective characteristic of most anthropological study of drinking and drinking problems.

The ethnic variable and problem drinking in a select sample of southwestern two-year multicultural college students

Five hundred and ninety-two Anglo, Mexican American, and American Indian students from nine selected 2-year colleges in the Southwest were given a self-administered questionnaire with items related to problem drinking (dependent variable) and various social psychological and demographic information (independent variables). Analyses included discriminant analysis, chi square, and eta. While ethnicity per se contributed little to the discrimination of problem from nonproblem drinkers, several other variables provided an overall correct classification (discrimination) rate of 79.73%. There variables were, in order of discriminating power: neighborhood people drink, veteran status, live life differently, close friend with drinking proble, drink because acquaintances drink, and age. It is hypothesized that the psychological principle of individual differences, and the significance of some other study variables, may haver overshadowed any ethnic effect. Measurement problems in this area are discussed as well as some potential research directions.

Alcohol and Drug Use and Abuse among Indian-Americans: A Review of Issues and Sources

There is much concern that alcohol and drug abuse are among the top problems in the United States generally, and also a “high priority” health and social problem among Indians. For that reason, there have been numerous programs of education, prevention, and treatment directed toward and developed in Indian communities. Nevertheless, many personnel at both national and local levels and in both rural and urban areas lack adequate acquaintance with pertinent conceptual issues and sources on alcohol and drug use and abuse among Indians specifically. The purpose of this article is to help remedy that lack by reviewing the range of literature and presenting an overview of some of the major perspectives which should inform any approach to Indian alcohol and drug use and abuse.

Clinical guidelines for the cross-cultural treatment of chemical dependency

Clinicians should be skilled in work with their ethnic peers before attempting cross-cultural treatment. Acquiring cross-cultural sensitivity involves regression to childlike openness for new values, attitudes, and behaviors. Members of the ethnic group can orient the clinician by discussion, suggested readings, and invitations to their homes and ritual events. Work should begin slowly, with regular consultation from ethnic peers of the patient. Special transference issues involve parent-child transactions and the "Messianic countertransference." Clinicians must maintain their primary commitment to the patient and to the patient's social resources, rather than to an institution not responsible to the patient population.