The "drunken Indian" has been a subject of continuing concern in the United States from the earliest contacts between Europeans and Indians down to the present day. Popular notions about the nature of alcohol and excessive drinking, however, have changed radically over the years. During the seventeenth and eighteenth centuries it was thought that the "savage" nature of the Indians was expressed without inhibitions under the effects of alcohol. From the nineteenth century and the present, the idea that Indians are physiologically unable to handle alcohol as well as white Americans has become increasingly popular and is, indeed a belief subscribed to by many Indians themselves. On the other hand, most contemporary studies of American Indians attribute deviant behaviors such as alcohol abuse to social disorganization and the stress of acculturation. A number of deprivations, including confinement to reservations and federal wardship, are cited as causes for many Indians to feel inadequate. Alcohol, according to this view, has been the easiest and quickest way to deaden the senses and to forget the feeling of inadequacy.
———With the few exceptions, the Indians of America north of Mexico had no knowledge of alcohol prior to contact with Europeans. In consequence, the drinking behaviors observed since the nineteenth century can be traced directly to the contact situation. In the Southwest, the Akimel O'Odham (Pima), Papago (Tohono O'Odham), and River Yuma peoples did make wine from the saguaro cactus as well as from the agave and mesquite. However, the alcoholic content of these beverages was quite low — between 2 and 4 percent — and their nutritional value was significant. Agave wine, for example, was rich in sucrose and vitamins B1 and C. It was also an important source of comparatively safe liquid in areas where drinking water was scarce or contaminated. In the east, the Cherokees and Catawbas made a wine from persimmons.
———The Pimas and Papagos made large quantities of saguaro wine in July, following the harvest of the first crops. During the saguaro ceremony all adults drank copiously, believing that, as humans saturated themselves with the wine, so the earth would be saturated with rain. Informal and secular use of alcohol appears to have been relatively infrequent so that, prior to the coming of the Europeans, none of the tribes of America (north of Rio Grande) had well developed "drinking ethic" to prepare them for the advent of beverages with high alcohol content.
———It is difficult for the contemporary reader to fully appreciate the drinking practices in the United States during the nineteenth century. We are apt to compare descriptions of early drinking by Indians on frontiersmen with the more familiar drinking habits of the urbanized, largely middle-class society of the late twentieth century. The consumption of alcohol in nineteenth century America, however, was unlike anything twentieth century Americans are likely to experience in their own lives. Between 1790 and 1840, Americans drank more alcoholic beverages — nearly half a pint of hard liquor per adult male each day — than at any other time in our history. The most popular beverages were cider and whiskey. Water was usually of poor quality, milk was scarce and unsafe, and coffee, tea, and wine were imported and expensive.
———When the frontier moved west of the Appalachians, settlers were cut off from the East and were forced to develop their own markets. Land transportations were too expensive for the bountiful corn crops to be hauled over the mountains. Whiskey was widely produced because it was easily preserved and traded, and it soon became the medium of exchange on the frontier.
———During the colonial period there were already two distinct styles of drinking distilled spirits. Many Americans took small amounts of alcohol daily, either alone or with the family at home. "Drams" were taken upon rising, with meals, during midday breaks, and at bedtime. Ingesting frequent small doses develops a tolerance to the effects of alcohol, and this style of drinking did not generally lead to intoxication. The other style of drinking was the communal binge, a form of public drinking to intoxication, and practically any gathering of three or more men provided an occasion for drinking vast quantities of liquor.
———Although consumption declined for the nation as a whole during the later half of the nineteenth century, binge drinking spread to the western frontier and became an integral part of the periodic gambling, fighting, and whoring sprees engaged in by trappers, miners, soldiers, and cowboys. Thus, western Indians had as tutors some of the heaviest drinkers in the nation at the time of their disruptive contacts with Anglo-Americans. And Anglo-Americans, for a variety of reasons, encouraged this style of drinking among the western Indians. Fur companies, for example, preferred to pay trappers, white as well as Indian, with liquor rather than money so that they would drink up their profits and be forced to trap the next year. Not only did the Indians learn the binge style of drinking from observing those who introduced liquor to them, they also found the white man's notion that a man is not responsible for actions committed while intoxicated consonant with their own notions of possession by supernatural agents. Supernatural power was obtained in dreams or induced trance states that resembled the intoxicated state. Over the years the nation became increasingly urbanized, and drinking styles changed radically after national prohibition. Drinking on Indian reservations, however, continued largely unchanged due to their relative isolation from the larger society.
———Today we are told that Indians and Alaska Natives die from "alcoholism" at almost five times the overall rate for the nation. Such statistics not only give cause for concern but also shape how the problem of Indian drinking is perceived. Moreover, the manner in which the data on Indian drinking is presented reflects our assumptions about the nature of alcohol as well as our image of the American Indian and of ourselves as a people. Because many believe that homicide, suicide, and accidents are strongly associated with alcohol, deaths from these "related" causes are often lumped together with deaths directly the result of drinking, such as alcoholic cirrhosis. But whether this image and our concern are directly related to an objective assessment of the Indians' use of alcohol or to more subtle involvements between whites and Indians is difficult to say.
———The population of most Indian tribes are so small that the relatively small number of occurrences of deaths from alcoholic cirrhosis or suicide will vary widely from year to year. The need to avoid bias caused by these fluctuations and to use population denominators of sufficient size to obtain statistically meaningful results leads most investigators to aggregate data for "all Indians" or Indians of a particular administrative region and to compare them to national averages. These practices, however, obscure the interethnic relations among the many Indian groups. Obscured also are the considerable differences in mortality rates among regions of the nation as well as rural and urban non-Indian populations.
———Today the southern states along with those of the Rocky Mountain West have relatively high rates of death from what have come to be thought of as alcohol-related causes, a circumstance often attributed to our frontier heritage. During the 1980s, for example, the average annual age-adjusted mortality rate from "selected alcohol-related causes" for twenty-one northern states was forty-five deaths per 100,000 population. By contrast the eight mountain states averaged sixty-six deaths, a rate nearly 50 percent higher.
———In general, urban areas have lower mortality rates from alcohol-related causes than do rural areas, and regional differences are even greater in rural areas because of the persistence of older cultural factors as well as certain environmental variables. When rural areas of the northern and southern mountain region are compared, the northern tier has considerably lower mortality rates than the southern. For example, 1987 and 1988 the rural population of the northern mountain states had an annual death rate from alcoholic cirrhosis of 11.6 per 100,000 population — slightly above the national average of 10.6 — compared to the southern states of Arizona and New Mexico with an average rate of 25 and Nevada with 43.8
———Western Indians live almost entirely in rural areas and may be expected to have death rates from alcohol related causes more in line with those of the rural populations of the states in which they live. This is in fact the case for the Navajo tribe, which is the largest single tribe in the nation. When death rates for cirrhosis, suicide, homicide, and accidents among rural Navajos and Anglos in Arizona are compared, they were found to be virtually the same with the exception of deaths from accidents. There is also evidence to suggest that the proportions of these deaths due to alcohol abuse are virtually the same in the two groups. The higher rate of deaths due to accidents is due to environmental differences rather than to a higher proportion of alcohol related accidents.
———Tribal differences continue to be large, however, and the situation found among the Navajos cannot be generalized to all tribes. The Pueblos of New Mexico, for example, seem to have lower rates of alcohol related deaths than do rural Anglo, while the tribes of the northern plains appear to have rates higher than those of their non-Indian neighbors.
———Statistical data on drinking patterns often fail to reflect the distinctive nature of Indian society. The Indian style of binge drinking would be considered alcoholic by most measures used in studies of the subject. Withdrawal symptoms, generally thought to be a certain sign of physiological addiction, were reported by over 50 percent of drinkers in one study of 67 Navajo men and 45 women conducted from 1966 through 1990. Yet most of these drinkers became abstinent by the time they were thirty-five or forty years of age, a circumstance one would not expect if they had been addicted to alcohol. It seems likely that much of the explanation involves the characteristic style of drinking that takes place in Indian communities. The reservation style of drinking among the Navajos, for example, fosters sudden withdrawal. After ingesting large amounts of alcohol at one time, drinkers may frequently pass out to find their supply exhausted. Especially on reservations, there are no easily available supplies to help a drinker taper off. In towns bordering the reservation, drinkers may get arrested or wake up after drinking with no money. Social and legal prohibitions against drinking, the absence of a ready supply, and the fact that Indians who drink in public or in bars in off-reservation border towns are often arrested all foster sudden withdrawals and, in consequence, a high incidence of hallucinatory experiences.
———Alcohol use and abuse is a heterogeneous phenomenon both among and within various tribes, and no global explanation, either racial or social, appears to account for it. As the number of Indian deaths from infectious diseases has decreased over the past thirty years, the Indian Health Service and Indian communities themselves are turning their attention more to the chronic disorders associated with aging as well as to such social pathologies as alcohol abuse. It is to be hoped that this will lead to a better understanding of the phenomenon and ultimately to more effective prevention and treatment programs.

JERROLD E. LEVY
University of Arizona