ILLNESS, as Susan Sontag has written is not a metaphor: “The most truthful way of regarding illness—and the healthiest way of being ill—is one most putrified of, most resistant to, metaphoric thinking.” Like cancer and tuberculosis (and, increasingly, AIDS), alcoholism has long sustained a rich and obfuscating mythology that incorporates any number of puritanical variants on “the rake’s progress” as well as equally persistent and romantic correlations between alcohol and art. Within its pantheon of myths and metaphors, none has been more enduring than the crude caricature of the “drunken Indian.” Although perhaps less openly acknowledged than it once was in this era of politically correct skittishness, it is an image of the Indian that is deeply entrenched in the popular psyche as that of the Noble Red Man and encapsulates within it a widespread perception of modern Native Americans as fundamentally pathetic and helpless figures, defeated by a white man’’s world in which they cannot expect to cope. That said, it is impossible to evade the fact that even in the midst of vigorous political and cultural revival the grim reality of native alcoholism remains a common denomination of poverty, ill health, and social pathology, continuing to wreck a degree of human devastation upon Indian communities that can only be compared to the ravages of smallpox in centuries past.
In 1855, the Commissioner of Indian Affairs, George Manypenny, lamented, “The appetite of the Indian for ardent spirits seems to be entirely uncontrollable, and at all periods of our intercourse with him the evil effects and injurious consequences arising from the indulgence of the habit are unmistakably seen. It has been the greatest barrier to his improvement in the past, and will continue to be in the future, if some means cannot be adopted to inhibit its use.”
Almost a century and a half later, alcoholism still presents a landscape of epidemic, seemingly intractable addiction that ravages the personal health of Indians, undermines the stability of entire communities, and frustrates tribal development. In 1977, The Final Report of the American Indian Policy Review Commission declared alcohol abuse to be “the most severe and widespread health problem among Indians today.” Eight years later, a comprehensive study by the Indian Health Service reported that “after a century and a half of prohibition, few Indians have used alcohol in any context except that of rapid consumption, or ’drinking to get drunk.’ Social drinking practices may eventually become a possibility for many Indians, but few have used alcohol in this manner up to the present.”
The cumulative effect of alcoholism on Indians is simply staggering. According to the Indian Health Service, Indians are three and a half times more likely than other Americans to die from cirrhosis of the liver, a benchmark of addiction. They are also four times more likely to die from accidents, and three times more likely to die from homicide and suicide, in all of which alcohol is usually present. Between 5 percent and 25 percent of Indian babies may be born mentally and physically damaged by Fetal Alcohol Syndrome, compared to less than one-fifth of 1 percent in the general population. Alcohol is also at least a contributing factor in many, perhaps most, Indian deaths from pneumonia, heart disease, cerebrovascular disease, diabetes, and cancer, and it ultimately accounts for perhaps as much as 70 percent of all the treatment provided by the Indian Health Service’s hospitals and clinics. Indians are twelve times more likely than other Americans to be arrested for alcohol related offenses, and most Indians who are in prison are there because of a crime committed under the influence of alcohol. Alcohol also takes an immeasurable toll in chronic disability, lost earning capacity, unemployment, emotional pain, family disruption, and child abuse; the Red Road Approach, a treatment program that works with Indian children, has estimated that as many as 95 percent of girls and 33 percent of boys raised in alcoholic homes may have been sexually molested by the age of nine.