INTRODUCTION

from the time of earliest contact, it has been observed that the beverage alcohol introduced by Europeans had devastating consequences on Native North Americans. High rates of devastation have persisted into the present, as Figure 1 indicates. The data displayed there show that the age-adjusted rate of alcohol-related deaths had declined among Indians since the late 1960s, but increased in the late 1980s and is 5.4 times higher than it is for all races in the United States. The category of alcohol-related deaths does not include accidents, which was the second leading cause of death among Indians and Alaska Natives in 1988 and occurred at slightly more than twice the frequency as among all races in the United States. Slightly more than 50% of accidental deaths of Indians involve motor vehicles, and at least half of these are estimated to be due to alcohol abuse. Clearly, although the long-term trend of deaths involving alcohol seems to be a convergence between Indians and non-Indians, the differences are still substantial.

There have been a variety of explanations for the high rates of alcohol-related problems among Indians, none of which necessarily excludes any of the others. Perhaps the oldest in one form or another is that Indians cannot hold their liquor because biologically they are unable to do so. This explanation continues to be the subject of empirical scientific investigation, and is based upon the assumption that there is some genetic mechanism that is a necessary cause of alcohol abuse: without such a mechanism Indians would not have the problems with alcohol that they do.