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

14. Substance Abuse in Minority Populations 333Health Service in the 1980s. Primary case settings may be important for detectingsubstance use (Shore, Manson, & Buchwald, 2002).Illicit drug use among Native Americans is less clear, because the dataavailable are poor. Furthermore, the use of hallucinogens has an important rolein some Native American religious rituals. The heterogeneity of Native Americancultures is plainly evident and further discourages simplistic discussions ofIndian culture. The “firewater” myth states that alcohol introduced to NativeAmericans by white settlers produced exaggerated biological effects in such persons.Garcia-Andrade, Wall, and Ehlers (1997), however, found less subjectiveintoxication among nonalcoholic Mission Indian men with greater NativeAmerican heritage. The same researchers implicate alcohol expectancy andmetabolism rates as possible differential effects among members of this tribe(Garcia-Andrade et al., 1997; Wall, Garcia-Andrade, Thomasson, Cole, &Ehlers, 1996).Native Americans share a belief in the unity and sacredness of all nature.Individual or ethnic groups may be more or less familiar with their own culture.Confrontational approaches, successful in many Anglo programs, cause NativeAmericans to shy away. Risk factors for alcohol and drug use in Native Americansparallel many of the same issues of other disenfranchised groups. Attemptsat assimilation of Native American culture, in the context of isolation frommainstream opportunities, have contributed to further cultural stress. Therecent increase in Indian-owned casinos has offered monetary opportunities,but also the possibilities of increased gambling and substance abuse. The breakdownof Native American culture, a factor that allowed alcohol to take a foothold,has been reversing in recent years. Self-determination and a return to traditionalspiritual and healing beliefs have helped springboard alternativeindigenous models of alcohol and drug recovery.REFERENCESAbram, K. M., Teplin, L. A., & McClelland, G. M. (2003). Comorbidity of severe psychiatricdisorders and substance use disorders among women in jail. Am J Psychiatry,160(5), 1007–1010.Adimora, A. A., Schoenbach, V. J., Martinson, F. E., Donaldson, K. H., Fullilove, R. E.,& Aral, S. O. (2001). Social context of sexual relationships among rural AfricanAmericans. Sex Transm Dis, 28(2), 69–76.Agar, M., & Reisinger, H. S. (2002). A heroin epidemic at the intersection of histories:The 1960s epidemic among African Americans in Baltimore. Medical Anthropol,21(2), 115–156.Ahluwalia, J., Harris, K. J., Catley, D., Okuyemi, K. S., & Mayo, M. S. (2002).Sustained-release bupropion for smoking cessation in African Americans: A randomizedcontrolled trail. JAMA, 288(4), 468–474.