Supplement Directors: Roland Moore, Ph.D. and Juliet Lee, Ph.D.
Like states and many counties in the US, sovereign Indian nations may decide whether and how to legalize alcohol on their lands. Of the 567 federally-recognized tribes, approximately 1/3 maintain complete prohibition of alcohol, while many more maintain partial restrictions on possession, consumption, and/or sales of alcoholic beverages. In a number of American Indian and Alaska native communities where alcohol is prohibited, residents of those communities, including the majority who do not drink at all, wonder why their reservations experience severe physical and psychological damage from alcohol-related injuries, intimate partner violence, and other kinds of harm, even when sales and/or possession of alcohol is forbidden.
It is difficult to assess how communities currently restricting all alcohol sales might improve or worsen the physical and psychological health of the individuals, families, and tribes who live there. This study investigates the range of objectives as well as locally-defined measures of current and potential harms and benefits that reservation residents believe would occur if they decide to change the alcohol control policy or leave it alone.So why do alcohol-related problems occur in places where alcohol is prohibited? Working with community and scientific partners on and near a reservation which was considering legalizing alcohol sales, we assessed the personal, social and economic impacts of alcohol availability on the reservation, and considered the potential impacts of legalization, using typical public health outcomes (such as alcohol-involved assaults and traffic collisions) as well as novel health indicators identified through qualitative inquiry with tribal members and other reservation residents.
Our overall goal is to understand how it is possible that less formal availability of alcohol might be related to more problems on Native American lands which prohibit sales and use of alcohol. This is an important theoretical step for refining a presently underdeveloped yet widely used alcohol availability theory that is based primarily upon urban research.
To achieve this goal, we formed a research group comprising alcohol researchers, a tribal non-profit development company located on a Great Plains reservation, and a non-profit owned and operated by American Indian health researchers in the region. We sought and obtained the guidance and approval of the tribe's research review board before we began the study.
Collaboratively, we conducted a mixed-method study collecting different kinds of information about how alcohol is and might be sold and consumed under past, present and future policy constraints.
We also observed, asked about, and analyzed data about the costs and benefits of each of these policy systems in and around the reservation:
What we have learned so far is that there is little published information on tribal alcohol control policies and their influence on alcohol-related problems. In the course of our collective study, we have:
What are the most helpful recommendations for policy makers?
At this point it appears that it is not possible to recommend prohibition as an unalloyed good for all American Indian tribes. When tribal areas are surrounded by readily available alcohol, when bootlegging is a profitable activity, and when tribal members may easily access alcohol just off reservation lands for consumption at home, risks for alcohol problems may increase.
More importantly, the very limited amount of research on this topic leads us to two critical recommendations. Researchers must: