American Indian/Alaskan Native Binge Drinking: Reviewing Treatment and Developing Collaborative Methodologies to Measure Outcomes

Abstract

Purpose: The AI/AN population has a proportionally high rate of binge drinking that accounts for significant morbidity and mortality. 1 This maladaptive behavior is the result of generations of psychosocial trauma and the subsequent loss of languages, traditions, family and hope, isolation, limited positive role models, and racism. The principle aim of this project was to review how tribal beliefs and practices are integrated into current treatment strategies and propose specific methodologies to measure outcomes demonstrating a reduction in binge drinking among the AI/AN population. Methods: Experts in addiction psychiatry, public health, education, and AI/AN leaders and healers reviewed various tribal beliefs and practices as well as current treatment strategies including, but not limited to, somatic therapeutic modalities such as psychopharmacology as well as behavioral therapy and Alcoholics Anonymous (AA) or 12- Step Facilitation (TSF) therapy. Results: Several key elements for developing research methodologies to measure treatment outcomes founded in Indigenous cultural ways of knowing were examined. Notably, three were identified: recognize culture as treatment, overcome Western interpretations of research, and apply culturally appropriate research methodologies. Conclusions: It is time to recognize that there is more than the dominant Western worldview to approach research; Indigenous knowledge and worldview are another and must be foundational in research with American Indians and Alaskan Natives. It is such a relationship that recognizes culture as the strength it is, and that can contribute to reconciling America’s research response to binge drinking among American Indians and Alaskan Natives.