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Invited Commentary
Substance Use and Addiction
February 21, 2020

Alcohol-Induced Deaths Among American Indian and Alaska Native Individuals—“Drinking Was What I and Others Just Did”

Author Affiliations
  • 1Centers for American Indian and Alaska Native Health, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, Aurora
JAMA Netw Open. 2020;3(2):e1921391. doi:10.1001/jamanetworkopen.2019.21391

“Alcohol was a way of life for me, my family, my friends, my community. I used to think being Indian was about drinking. That I couldn’t stop because I was Indian… and if I did, I would no longer be Indian. The bad things about being a drunk were all around me—liver disease, domestic violence, car accidents, suicide, PTSD [posttraumatic stress disorder]. But I never really thought about dying. Drinking was what I and others just did.”

The article by Spillane et al1 awakened my memory of this reflection, shared by an Alaska Native patient in a tribal residential treatment program with which I work. His words acknowledged the widespread consumption of alcohol in many of these communities, its interface with personal identity, the acceptance of alcoholism as an inevitable part of life, and the denial of its harmful consequences, apparent as they may be. Tribes have made remarkable progress in reducing the stigma surrounding addiction in their communities and in developing prevention as well as treatment programs. There are bright lights of success in curbing the nature, extent, and consequences of alcohol use and dependence. Yet, as the trends described by Spillane et al1 underscore, alcohol-induced mortality in general continues to rise and heralds many battles still to be fought in Native communities.

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