Alcoholism, Fetal Alcohol Syndrome, and the Native American Woman

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by Britnae Purdy


We survive, and we do more than just survive. We bond, we care, we fight, we teach, we nurse, we bear, we feed, we earn, we laugh, we love, we hang in there, no matter what.

-Paula Gunn Allen

Fetal alcohol syndrome has devastating effects on all those around it. It is a disease that has the power to destroy childhoods, families, and in some cases even an entire culture. This paper aims to explore the causes and effects of alcoholism as a general ailment, and more specifically fetal alcohol syndrome, on the culture of Native American societies. It will follow a path through the introduction of alcohol to Native American tribes, prevalence of alcohol abuse in those tribes, the causes and effects of Fetal Alcohol Syndrome, and the effectiveness of intervention programs. It will also examine the unique role that Native American women have to play in the fight against alcoholism and its damaging effects on their way of life, ending with a call for Native American women to take up the fight against this disease in favor of the healthy continuation of their culture. In this paper, the terms Native American, American Indian, and Indian will be interchangeably used to refer to the aboriginal residents of the United States, excluding Alaskan and Hawaiian Natives.


Introduction of Alcohol to Native Americans

 Coming in the wake of epidemic diseases and interracial hostilities, the alcohol trade contributed to the decline of Indians in eastern North America.

-Peter C. Mancall

Alcohol has longed played a tempestuous role in the history of Native Americans, particularly coloring the interactions between white Americans and Natives. Alcohol was first introduced to Native Americans by white settlers arriving on the eastern shore, and soon became a commodity commonly traded with the Indians in return for crops. Alcohol had not been widely used previously to this introduction. Soon, however, alcohol use became prevalent among Native tribes – it was a novelty, after all. As one traveler, Jean Bossu, wrote, when he first gave brandy to an Indian who had been helping him hunt, the Indian described it as “urine of the chief of Hell,” and proceeded to “[drink] so much as to lose the use of his reason,” (Mancall 1). Bossu resented his drinking and felt entitled to play tricks on the inebriated Indian. This depicts a snapshot of what continued to happen across the United States as settlers spread west – they would entice the Indians with this “fiery” new drink, and when they became dependent on it the settlers were free to take advantage of them. As frontiersmen Jaspar Danckaerts recorded, “[settlers] all solicit the Indians as much as they can, and after begging money from them, compel them to leave their blankets, leggings…guns and hatchets, the very instruments by which they obtain their subsistence,” (Mancall 46).Researcher Peter Mancall sums it up brilliantly when he states in his book, Deadly Medicine:

There is nothing unique or necessarily genetic about drinking, even destructive drinking, in the wake of destabilizing     social and economic change. Indians drank at least in part because the world they knew was eroding around them. Whether liquor was supposed to bring power, as many believed, or to make them forget their problems, its effects were welcomed at the time. The tragic dimension of this story is not that Indians drank but that their drinking only exacerbated the crises that were besetting their communities (Mancall 8).

Of course, this misuse of alcohol is not universal among the American Indians and the early settlers. Some Indian tribes never took up alcohol in daily life, and not all settlers exploited the inebriated Native. There were even small movements to attempt to prevent frontiersmen from trading alcohol with the Indians, especially as attacks of natives against settlers became more violent and common (which, if examined logically, most likely had more to do with the white men expanding into Indian territory than it did with liquor). Unfortunately, these movements remained small, and often elicited a response along the lines of, “if [tradesmen] did not [trade alcohol], others would, and then they would have the trouble and others the profit; but if they must have the trouble, they ought to have the profit,” (Mancall 46). Eventually, it was made illegal to sell alcohol to Native Americans with the Indian Intercourse Act of 1832. This act was not reversed until 1952, long after prohibition was repealed in the U.S. Legislation still placed limits on providing Native Americans with alcohol. However, these limits simply led to the emergence of bootlegging and “drunk towns” – towns bordering Indian reservations where alcohol flows freely.

Certainly, this early use of alcohol among Native Americans set into motion a series of downfalls that continue to be seen today. In fact, though American Indians physically ingest alcohol identically as Americans of European descent, surveys show that two out of three Native American women and half of all Native American men believe that Indians have a “physical weakness for alcohol” (Mancall 1995).

Alcoholism and Alcohol Abuse in Tribal Settings

Everyone is sane until he is drunk.

-Medieval Irish Proverb 

Physicians delineate between “alcoholism,” which is a physical dependence on alcohol in which the victim has withdrawal symptoms when alcohol use is discontinued, and “alcohol abuse,” or “risky use,” which can cause physical and mental problems but does not encompass physical dependence. According to the National Center for Biotechnology Information, 15 percent of people in America are classified as abusing alcohol, whereas 5-10 percent of males and 3-5 percent of female drinkers are alcohol dependent (Merill, Zieve 2010). In startling contrast, 75 percent of Native American men and one third of Native American women can be classified as alcoholics or alcohol abusers (Mancall 1995). These numbers are amazing, and do not even accurately reflect the far-reaching effects of alcohol abuse, such as physical problems, mental illness, community violence, unemployment, and domestic abuse.

Indians die from alcohol-related causes at a rate four times higher than the rest of United States citizens. In fact, four of the top ten causes of death among Indians are alcohol related – injuries resulting from alcohol and substance abuse (18 percent), chronic liver disease and cirrhosis (five percent), and suicide and homicide (both 3 percent). Of American Indian homicides, 90 percent are alcohol-related (violence brought about by inebriation, or inebriated victims being targeted during hate crimes). Indian youth are twice as likely to die in car accidents, 75 percent of which are alcohol-related. And Native Americans are also two times more likely to commit suicide, with 75 percent of these suicides being alcohol-related, meaning that depressive symptoms were exacerbated by continued or heavy drinking (French 2000). One of the most devastating conditions stemming from alcohol use is Fetal Alcohol Syndrome.


Fetal Alcohol Syndrome and the Native American

What must become of the infant who is conceived in gin? with the poisonous Distillations of which it is nourished, both in the womb and at the breast?

-Henry Fielding

Fetal Alcohol Syndrome (FAS) was first identified as a distinct disorder in 1973. FAS is a condition of the fetus that results from continued alcohol abuse of a woman during pregnancy. Depending on the degree of alcohol abuse, the fetus may be born devastatingly disabled. FAS can also cause stillbirth and premature labor. The most common symptoms of a child with Fetal Alcohol Syndrome include facial anomalies, heart defects, low birth weight, behavioral problems, and mental retardation. The child may also present with hearing problems, difficulty developing gross and fine motor skills, bad teeth, scoliosis, short stature, hypersensitivity or, conversely, hyposensitivity, microcephaly (small head), deformed palm patterns, poor physical coordination, and seizures (French 200). Children are often misdiagnosed as simply being “trouble-children,” or as having Attention Deficit Hyperactivity Disorder (ADHD). This is unfortunate as the disease is best managed when caught early and closely monitored.

Though drinking while pregnant is strictly advised against for all women, alcohol does not universally affect all pregnant women. Rather, two women that drink the same amount of alcohol during their pregnancies may result in babies that do not have similar degrees of FAS. As French states, “well-nourished and mentally and physically healthy women who drink moderately have only a small chance of producing an FAS birth,” (French 41-42). There are several factors that contribute to the susceptibility of women; these include a poor self-image (physically, mentally, and sexually), powerlessness and “learned helplessness,” bad relationships with men (often violent or abusive), poor physical health such as vitamin deficiencies, and a labile affect, which is a mental state embodied by swift emotional changes as well as depression, anger, guilt, shame, stigma, and dependence. Fetal Alcohol Syndrome has also been linked to Post Traumatic Stress Disorder and General Adaptation Syndrome, which refers to being in a constant state of stress. Unfortunately, these susceptibilities collide upon American Indian women, leaving them at great risk for passing Fetal Alcohol Syndrome onto their children. This is blaringly obvious when the statistics are examined. The 1991 National Institute on Alcohol Abuse and Alcoholism found that white Americans have an FAS birth rate of 0.9 for every ten thousand births, whereas Native Americans have a troubling rate of 29.9 FAS births for every ten thousand. Further breakdowns of this study can be seen in Figure 1 (French 2000.)

Ethnic Group FAS Births Per Ten Thousand Births
Asian-Americans 0.3
Hispanics 0.8
Caucasian Americans 0.9
African Americans 6.0
Native Americans 29.9

Figure 1

The FAS rates are not at all uniform across all Native American tribes, which can be seen in this comparison of three different tribes from across the United States in Figure 2 (French 2000).

Tribe FAS Births Per One Thousand
Navajo 1.6
Pueblo Indians 2.2
Southwestern Plains Indians 10.7

Figure 2

It is no coincidence that the Southwestern Plains Indians are widely believed to be the group most affected by westward expansion and mistreatment under the early anti-Indian government and its resultant “treatises.” French describes these different rates when he states that,

These differential rates appear to follow the cultural trauma concept, which applies to tribes most impacted by harsh U.S. policies, cultural genocide. While most tribes were subjected to carrying degrees of cultural genocide, the Plains Indians and Apache experienced the most intense punitive efforts. They were also the last American Indian groups to be aggressively pursued by the U.S. military (French 84-85).

High rates of Fetal Alcohol Syndrome would be devastating for any community, but are even more so within Native American Tribes, which already suffer from discriminatory laws, small territories (in the case of reservations), poor education, and diminishing cultural pride and cohesiveness. Unfortunately, alcohol abuse is very likely to create a cycle of problems, which is one reason why these abuse rates have not decreased considerably over the years. Imagine this scenario: a child is born with Fetal Alcohol Syndrome onto a reservation. She attends a reservation school, low on qualified teachers and high on moral judgment. Her peers have grown up in a society where alcohol is prevalent and easy to obtain – one study examining the differences between drinking patterns in white and American Indian adolescents found that American Indians abused alcohol at rates 50 to 100 percent higher than the white students (French 2000). Prevalent drinking in her community has contributed to high rates of domestic abuse – six out of every ten Native American women will be victims of domestic abuse in their lifetime (Miller, Chuchryk 1996). When she becomes pregnant, most likely at a young age, she embodies the model most susceptible to birthing an FAS baby. Neither she nor her child will be in a position to contribute positively to her society.


Native American Women – Marginalized Victims 

As Native women, we are faced with very difficult and painful choices, but, nonetheless, we are challenged to change, create, and embrace “traditions” consistent with contemporary and international human rights standards.

            -Emma LaRocque

Native American women have a unique and powerful position in overcoming this detrimental infliction. As the Cherokee saying goes, “A nation is not conquered until the hearts of its women are on the ground.” The hearts of the Native American women are still beating strongly in their chests. Women play an integral role in continuing the culture of their societies. The atmosphere in which they raise their children sets a background that will follow the child through their life. If a mother demonstrates that they respect their culture, their children will grow up to honor their unique culture as well. Creating a pride in oneself is the first step in overcoming socially and physically debilitating ailments, and this pride must stem from a supportive community culture.

As devastating as alcohol is on the Native American community in whole, it is even more so on Native American women. As Emma LaRocque states:

The tentacles of colonization are not extant today, but may also be multiplying and encircling Native peoples in ever-tighter grips of landlessness and marginalization, hence, of anger, anomie, and violence, in which women are the most obvious victim (Miller, Cuchryk 11-12).

Women die from cirrhosis at a greater rate than alcoholic men do, partially due to susceptibilities such as genetics, diet, and hepatitis C, all of which are more likely to be harmful in women. 60 percent of Native American women will be victims of domestic abuse in their lifetimes, contributing to a steady state of stress that makes them more susceptible to body-image issues and Post-Traumatic Stress Disorder, both of which exacerbate and are exacerbated by Fetal Alcohol Syndrome. The rate of suicide among Native American women is seven times higher than that of white American women, and the age at which they commit suicide is on average 15 years lower. Overall, Native American women live a total of 10-12 fewer years than their white counterparts (Miller, Chuchryk 1996). Jobs on reservations are scarce, and when they are open tend to go straight to men. Women are then confined to the household – unemployed, poor, undereducated, often abused and surrounded by negative stereotypes, women are more likely to surrender to the bottle for temporary respite.

A Mixed Bag: Alcohol Prevention and Treatment Programs 

If Native American cultures are to be preserved, two things must happen: attempts these therapeutic environments at cultural genocide must end, and culture specific treatment models must drive the healing process. 

-Laurence French 

 Alarmingly, programs designed to help alcohol-addicted Native Americans are few and far between. Though 70 percent of the services provided by Indian Health Services are to treated alcohol-related problems, only one percent of their budget is allotted towards drug and alcohol abuse treatments (French 2000). Traditional Western services such as Alcoholics Anonymous do not cross the culture border easily – unless adapted to fit Native American values and traditions, they will be less than effective (for a contrast between Western and Native Alcoholics Anonymous programs, see Figure 3, adapted from French 2000). Some Western-style non-profit programs are run by churches; on the surface they appear to offer much-needed services, but are religiously-based and attempt to steer participants away from their traditional beliefs, such as Narconon, which employs a Scientology-based program (French 2000). Scientology is a religion that denies the legitimacy of mental illness – clearly illustrating that programs with ulterior missionary motives will only instill a sense of guilt and cultural confliction within the patients. As French states, “It is imperative that treatment programs proposed for Native Americans be reviewed critically for both their tribal-centric application and for more subtle forms of cultural genocide disguised as clinical treatment,” (French 83). The most effective programs are those designed and run by Native Americans themselves; unfortunately, tribal programs can be less stable than government-funded ones due to internal tribal politics (French 87).

American Indian AA Values Traditional AA Values
Cooperation Competition
Sharing Ownership
Humble Presentation Outgoing
Honor Elders Honor Self
Happiness Success
Silence Verbalism
Tradition Innovation
Learning from Elders Formal Education
Mysticism Empiricism
Smallness Bigness
Natural Medicine Synthetic Drugs

Figure 3

Power for the Future – The Role Native Women Must Play 

If we wish to act on history rather than be acted on, we can ill afford to stay silent or stay content in the shadows of our male contemporaries.

            -Emma LaRocque

A woman is the only one who can prevent FAS in her own child – that is obvious. But women have a unique position to spread education among their communities and to protect the Native American way of life.  The most effective form of intervention program would be one run by strong, educated (both formally and traditionally) American Indian women, and the effort to prevent FAS must begin early in adolescence, before young girls are likely to begin drinking and engaging in sexual activities. It is imperative that these girls are approached by women that they can both relate to and look up to as strong role models – something that is severely lacking in the Native American community. They must be educated with no judgment, as some of them may have varying degrees of FAS themselves or may be growing up in homes with cases of alcoholism in them. And finally, these programs must be based around the traditional Native American harmony ethos practice, not geared towards Christianity. This is a crucial component – adolescents must unlearn the feeling of shame in being “traditionally Indian” that centuries of white oppression has instilled.

Besides being crucial in formal prevention and treatment programs, women must also take advantage of the roles they play in their children’s lives – their position allows them to instill a pride of culture in their children. As Betty Bastien puts it, “A Native woman gives her child unconditional love as she receives it from Mother Earth. She teaches her child a reverence of and a profound respect for all creation, for all creation participates in a manner that perpetuates and strengthens life,” (Miller, Chuchryk 1996). If a child is taught a deep respect for their unique tribal culture, they will be less likely to physically damage the most important vessel of that culture – their own bodies. The individual may not play a strong role in the tribe, but each individual connects to a web of culture that will be passed down even as the generations pass by. Likewise, a culture with a renewed sense of interconnectedness is less likely to condone self-destructive and identity-corroding behavior such as alcoholism. They will promote the safety and health of their women, who physically reproduce their culture. Adolescents will not feel neglected or abused by their surroundings, and will not to turn to alcohol as a soothing device. Bastien explains it further in her essay, “Voices Through Time”:

 One’s sense of tribal identity allows for a perception of reality; and a strong sense of tribal identity brings alive, with vitality and inspiration, the expectations, desires, and purpose of life for Indian people…It is time to acknowledge the importance of Indian women as a source of strength in maintaining the continuity of traditions through difficult times. Indian women, because of the strength of our vision, have forged a reality that interprets the experiences of our children, in turn giving them strength to maintain the vision and pass it on to their own children (Miller, Chuchryk 1996).

And so, Native American women cannot afford to step down. The road will be tough – funding is limited, and the grips of malaise and substance abuse are strong and expanding. But in order to preserve a secure and increasingly positive way of life for their children, Native women, with strong support from the general community, must become educators and advocates for the health of their women and children.



French, Laurence. Addictions and Native Americans . Westport, Conn.: Praeger, 2000. Print.

Mancall, Peter C.. Deadly medicine: Indians and alcohol in early America. Ithaca: Cornell University Press, 1995. Print.

Merrill, David, and David Zieve. “Alcoholism and alcohol abuse – PubMed Health.” National Center for Biotechnology Information. N.p., n.d. Web. 21 Apr. 2011. <>.

Miller, Christine, and Patricia Marie Chuchryk. Women of the first nations: power, wisdom, and strength. Winnipeg, Man.: University of Manitoba Press, 1996. Print.

Vorvick, Linda, and David Zieve. “Fetal alcohol syndrome – PubMed Health.” National Center for Biotechnology Information. N.p., n.d. Web. 21 Apr. 2011. <

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