Alcohol and Native Americans

Some Native Americans in the United States have been harmed by, or become addicted to, drinking alcohol. Among contemporary Native Americans and Alaska Natives, 11.7% of all deaths are related to alcohol. By comparison, about 5.9% of global deaths are attributable to alcohol consumption. Because of negative stereotypes and biases based on race and social class, generalizations and myths abound around the topic of Native American alcohol misuse. A survey of death certificates from 2006 to 2010 showed that deaths among Native Americans due to alcohol are about four times as common as in the general U.S. population. They are often due to traffic collisions and liver disease, with homicide, suicide, and falls also contributing. Deaths related to alcohol among Native Americans are more common in men and among Northern Plains Indians. Alaska Natives showed the lowest incidence of alcohol-related death. Alcohol misuse amongst Native Americans has been shown to be associated with development of disease, including hearing and vision problems, kidney and bladder problems, head injuries, pneumonia, tuberculosis, dental problems, liver problems, and pancreatitis. In some tribes, the rate of fetal alcohol spectrum disorder is as high as 1.5 to 2.5 per 1,000 live births, more than seven times the national average, while among Alaska Natives, the rate of fetal alcohol spectrum disorder is 5.6 per 1,000 live births. Native American and Native Alaskan youth are far more likely to experiment with alcohol at a younger age than non-Native youth. Low self-esteem and transgenerational trauma have been associated with substance use disorders among Native American teens in the U.S. and Canada. Alcohol education and prevention programs have focused on raising self-esteem, emphasizing traditional values, and recruiting Native youth to advocate for abstinence and healthy substitution. Historically, those Native American tribes who manufactured alcoholic drinks used them and other mind-altering substances in ritual settings and rarely for personal enjoyment.

Alcohol consumption, alcohol dependence, and related mortality in Italy in 2004: effects of treatment-based interventions on alcohol dependence

Gerrit Gmel

Background: The tradition of consuming alcohol has long been a part of Italian culture and is responsible for a large health burden. This burden may be reduced with effective interventions, one of the more important of which is treatment for Alcohol Dependence (AD). The aim of this article is to estimate the burden of disease in Italy attributable to alcohol consumption, heavy alcohol consumption, and AD. An additional aim of this paper is to examine the effects of increasing the coverage of treatment for AD on the alcohol-attributable burden of disease. Methods: Alcohol-attributable deaths and the effects of treatments for AD were estimated using alcohol-attributable fractions and simulations. Deaths, potential years of life lost, years lived with disability, and disability adjusted life years lost were obtained for 2004 for Italy and for the European Union from the Global Burden of Disease study. Alcohol consumption data were obtained from the Global Information System on Alcohol and Health. The prevalences of current drinkers, former drinkers, and lifetime abstainers were obtained from the GENder Alcohol and Culture International Study. The prevalence of AD was obtained from the World Mental Health Survey. Alcohol relative risks were obtained from various meta-analyses. Results: 5,320 deaths (1,530 female deaths; 3,790 male deaths) or 5.9% of all deaths (4.9% of all female deaths; 6.3% of all male deaths) of people 15 to 64 years of age were estimated to be alcohol-attributable. Of these deaths, 74.5% (61.3% for females; 79.8% for males) were attributable to heavy drinking, and 26.9% (25.6% for females; 27.5% for males) were attributable to AD. Increasing pharmacological AD treatment coverage to 40% would result in an estimated reduction of 3.3% (50 deaths/year) of all female and 7.6% (287 deaths/year) of all male alcohol-attributable deaths. Conclusions: Alcohol was responsible for a large proportion of the burden of disease in Italy in 2004. Increasing treatment coverage for AD in Italy could reduce that country's alcohol-attributable burden of disease.

Biomed Central Ltd2013

Global burden of injuries attributable to alcohol consumption in 2004: a novel way of calculating the burden of injuries attributable to alcohol consumption

Gerrit Gmel

Background: Alcohol consumption is a major risk factor for injuries; however, international data on this burden are limited. This article presents new methods to quantify the burden of injuries attributable to alcohol consumption and quantifies the number of deaths, potential years of life lost (PYLL), and disability-adjusted life years (DALYs) lost from injuries attributable to alcohol consumption for 2004. Methods: Data on drinking indicators were obtained from the Comparative Risk Assessment study. Data on mortality, PYLL, and DALYs for injuries were obtained from the World Health Organization. Alcohol-attributable fractions were calculated based on a new risk modeling methodology, which accounts for average and heavy drinking occasions. 95% confidence intervals (CIs) were calculated using a Monte Carlo simulation method. Results: In 2004, 851,900 ( 95% CI: 419,400 to 1,282,500) deaths, 19,051,000 ( 95% CI: 9,767,000 to 28,243,000) PYLL, and 21,688,000 (95% CI: 11,097,000 to 32,385,000) DALYs for people 15 years and older were due to injuries attributable to alcohol consumption. With respect to the total number of deaths, harms to others were responsible for 15.1% of alcohol-attributable injury deaths, 14.5% of alcohol-attributable injury PYLL, and 11.35% of alcohol-attributable injury DALYs. The overall burden of injuries attributable to alcohol consumption corresponds to 17.3% of all injury deaths, 16.7% of all PYLL, and 13.6% of all DALYs caused by injuries, or 1.4% of all deaths, 2.0% of all PYLL, and 1.4% of all DALYs in 2004. Conclusions: The novel methodology described in this article to calculate the burden of injuries attributable to alcohol consumption improves on previous methodology by more accurately calculating the burden of injuries attributable to one's own drinking, and for the first time, calculates the burden of injuries attributable to the alcohol consumption of others. The burden of injuries attributable to alcohol consumption is large and is entirely avoidable, and policies and strategies to reduce it are recommended.

Biomed Central Ltd2012

Alcohol consumption, alcohol dependence, and related mortality in Italy in 2004: effects of treatment-based interventions on alcohol dependence

Global burden of injuries attributable to alcohol consumption in 2004: a novel way of calculating the burden of injuries attributable to alcohol consumption

Estimating uncertainty of alcohol-attributable fractions for infectious and chronic diseases

Alcohol consumption, alcohol dependence, and related mortality in Italy in 2004: effects of treatment-based interventions on alcohol dependence

Estimating uncertainty of alcohol-attributable fractions for infectious and chronic diseases

Global burden of injuries attributable to alcohol consumption in 2004: a novel way of calculating the burden of injuries attributable to alcohol consumption