Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

5. Alcohol 83show low incidences of alcoholism or alcoholic complications. For example, theFrench have relatively high rates of alcoholism and cirrhosis.Native AmericansMany Native American tribal groups have high rates of alcohol-related problems(Westermeyer, 1986). However, attitudes toward drinking vary considerablyfrom tribe to tribe. Westermeyer noted increasing rates of alcoholism and medicalcomplications secondary to alcohol as Native American tribes have moved fromtheir rural tribal areas to cities. Those living on reservations drink less frequentlybut are more likely to binge drink and to consume more alcohol per drinking occasion(May & Gossage, 2001). A recent study that contradicted the “firewatermyth” theory that Native Americans are more sensitive to the effects of alcohol(Garcia-Andrade, Wall, & Ehlers, 1997) found that the Mission Indian men weregenerally less sensitive to alcohol effects, a physiological characteristic shown tobe associated with a greater risk for alcoholism in white populations.Alcohol-related motor vehicle fatalities are highest in the Native Americanpopulation, with a 68.1% rate compared to 44.2% for whites (NationalHighway Traffic Safety Administration, 1999). Cirrhosis is the sixth leadingcause of death in Native Americans (Stinson, Grant, & Dufour, 2001).African AmericansA 1996 report by the Group for the Advancement of Psychiatry (GAP) onalcohol abuse among African Americans found little difference in the lifetimeprevalence of alcoholism between African Americans and whites. The alcoholismprevalence for African Americans is low in the young adult group and thenincreases, in contrast to the alcoholism prevalence for whites, which starts atmoderately high levels in the young group and then decreases. Deaths fromalcohol-induced causes are about 2.5 times higher in the black population thanin the white population. Cirrhosis death rates for African American males are45.3% compared to 34.7% for whites (Caeteno & Clark, 1998b). Motor vehiclefatalities are essentially equal between blacks (45.2) and whites (44.2%)(National Highway Traffic Safety Administration, 1999).Asian AmericansAsians have the lowest rates of cirrhosis (11.5 per 100,000 males) and the lowestpercentage of motor vehicle fatalities (28.2%). A variant of aldehydedehydrogenase-2 is found in Asians (e.g., in 48% of college students of Chineseancestry and 35% of those of Korean background) (Luczak et al., 2001). Thisgenetic variant changes the way alcohol is metabolized and leads to the aversivesymptoms of headache, nausea, dizziness, and facial flushing.