To the Editor: Dr Costello and colleagues1 studied the association of income supplements from casino revenues with adult psychiatric and substance use disorders in the Eastern Band of Cherokee Indians (EBCI) community. The authors concluded that “ . . . there are environmental interventions that can have long-term benefits, even after the intervention is over.” Commensurate with the study's findings, the authors mentioned the possibility of income supplements being provided to poor families as an intervention to reduce delinquent behaviors, including drug problems. As important as increased income is to people living in poverty, there are some important contextual points to the Cherokee experience that need to be raised to better inform any such intervention efforts.
Bullock A, Bradley VL. Family Income Supplements and Development of Psychiatric and Substance Use Disorders Among an American Indian Population. JAMA. 2010;304(9):962-963. doi:10.1001/jama.2010.1240