Saturday, August 30, 2008

A White Earth issue across Indian Country

High rate of alcohol-related deaths came as no surprise to White Earth Band of Chippewa.

MAHNOMEN, MINN. — The numbers came as no surprise to Pat Moran, manager of a substance-abuse program on the White Earth Indian Reservation in northern Minnesota.The Centers for Disease Control and Prevention reported Thursday that almost 12 percent of deaths among American Indians and Alaska Natives are alcohol-related — more than triple the rate in the general U.S. population.The report is based on the first-ever national survey of alcohol's role in Indian mortality. The CDC found the largest number of alcohol-related deaths among Indians in the Indian Health Service's Northern Plains region, which includes North Dakota and Minnesota. There was no breakdown by state or tribe.

"Those numbers don't surprise me at all," Moran said. "We have a high rate of alcoholism on the reservation, and a majority of deaths here are related" to alcohol or other chemical abuse.The White Earth Band of Chippewa Indians (PDF) offers intervention and prevention services, diagnosis and referrals. The band also operates several outpatient and after-care sites scattered across the large reservation and an in-patient treatment center for women and their children in Mahnomen.

The White Earth program is "short-staffed and short-funded," Moran said. "We're always looking for more money to do more things."With $2 million each from the state and the Shakopee Mdewakanton Sioux Community, White Earth this summer bought a 40-acre treatment center in Bemidji, Minn., after it was closed by Episcopal Community Services. The band plans to spend a total of $8 million to reopen the center to treat American Indian teenagers with substance-abuse problems. Moran said there are other signs of progress on her reservation."I see people who are out walking who are in recovery," she said. "I'm one of them.

"In the Northern Plains, reservations often are remote, isolated and poor, the CDC report notes, and those factors may contribute to the higher alcohol-related death rate. In any case, the survey results should be "a call to action" for federal, state, local and tribal governments, said Dwayne Jarman, one of the study's authors and a CDC epidemiologist who works for the Indian Health Service.

Jarman said in an interview Thursday that states should increase alcohol excise taxes to cut demand. Policies against serving people who already are intoxicated need to be better enforced, he said, and there should be better coordination between tribal courts and health centers."We also need to look at new community-specific ways to address the problem," he said, bringing Indian cultural values more into play. Researchers analyzed death certificates from 2001 to 2005. They found that traffic accidents and alcoholic liver disease were the two leading causes of alcohol-related deaths, each accounting for about a fourth of the deaths. Homicide and suicide also were causes.There may have been more alcohol-related deaths, according to the report, because deaths attributed to such diseases as pneumonia and colon cancer were not counted, although alcoholism is considered a major risk factor in each. Men accounted for two-thirds of the alcohol-related deaths among Indians, according to the study. Almost two-thirds were younger than 50, and 7 percent were younger than 20.The study results confirm that alcoholism remains a crippling problem on reservations despite development in recent years of culturally sensitive "red road" recovery programs.

Linda Duckwitz, a licensed addiction counselor at the Spirit Lake Indian Reservation in north-central North Dakota, said the CDC statistics "are very troubling." The Spirit Lake Dakotah Nation "is doing some creative things, including equine therapy," where young addicts in treatment work with horses, she said. But the effort is hampered by a lack of state funding for treatment programs that aren't hospital-based and by permissive attitudes throughout the state toward binge drinking and alcoholism.

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