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Native Americans in the United States have historically had extreme difficulty with the use of alcohol.^[1] Problems continue among contemporary Indians with 12% of the deaths among American Indians and Alaska Natives being alcohol-related. Use of alcohol varies by age, gender and tribe with women, and older women in particular, being least likely to be regular drinkers. Indians, particularly women, are more likely to abstain entirely from alcohol than the general US population. Frequency of use among American Indians is generally less than the general population, but the quantity consumed when it is consumed is generally greater.^[2]

A survey of death certificates over a four-year period showed that deaths among Indians due to alcohol are about four times as common as in the general US population and are often due to traffic collisions and liver disease with homicide, suicide, and falls also contributing. Deaths due to alcohol among American Indians are more common in men and among Northern Plains Indians. Alaska Natives showed the least incidence of death.^[3] Alcohol abuse by Native Americans has been shown to be associated with development of disease, including sprains and muscle strains, hearing and vision problems, kidney and bladder problems, head injuries, pneumonia, tuberculosis, dental problems, liver problems, and pancreatitis.^[4]

Native American youth are far more likely to experiment with alcohol than other youth with 80% alcohol use reported. Low self-esteem is thought to be one cause. Active efforts are underway to build self-esteem among youth and to combat alcoholism among American Indians.^[5]

While little detailed genetic research has been done, it has been shown that alcoholism tends to run in families with possible involvement of differences in alcohol metabolism and the genotype of alcohol-metabolizing enzymes.^[6]

Anastasia M. Shkilnyk who conducted an observational study of the Asubpeeschoseewagong First Nation of Northwestern Ontario in the late 1970s when they were demoralized by Ontario Minamata disease has observed that heavy Native American drinkers may not be physiologically dependent on alcohol, but abuse it by engaging in binge drinking, a practice associated with child neglect, violence, and impoverishment. After binges during which entire families and their friends drink until they are unconscious and their funds are exhausted, they go about their business without drinking.^[7]

It has been found that the incidence of alcohol abuse vary with gender, age, and tribal culture and history.^[8]

Factors related to rural reservation life may be involved, including law enforcement.^[9]

Inappropriate focus on Native American alcoholism can result in application of an ethnic stereotype to all American Indians.^[10]

• In Jack London's White Fang, an American Indian trader is tricked into alcoholism by another tradesman, which eventually takes him of everything he had and he owned, including his skins (the tools of the Indian's trading) and his "dog", the main character of the book.
• The 2002 movie Skins explores the degrees of alcoholism in American Indians.

• Methamphetamine and Native Americans
• Modern social statistics of Native Americans

• Krause, Traci M (Fall 1998). "A potential model of factors influencing alcoholism in American Indians". Journal of Multicultural Nursing & Health.
• Beauvais F (2002-01-14). "American Indians and Alcohol" (PDF). Alcohol Research & Health. 22 (4): 253–9.
• "Alcohol among Native Americans"
• "Fighting Alcohol and Substance Abuse among American Indian and Alaskan Native Youth. ERIC Digest."
• "How to Address Alcoholism on Indian Reservations" "Room for Debate", The New York Times May 16, 2012