Comorbidity of Alcohol Abuse and Dependence with Medical Conditions in 2 American Indian Reservation Communities

Abstract

In this community-based study of rural AIs, diverse medical conditions were associated with alcohol abuse and dependence. Further research should examine, and confirm, the nature, extent, and tribal variation of the medical consequences of alcohol abuse and dependence in these unique populations.

Disability Associated With Alcohol Abuse and Dependence

“…Despite the fact that speech impairments are traditionally associated with acute alcohol intoxication we were able to find only three studies describing specific speech impairments in AUD (Hollien et al, 2001; Pisoni and Martin, 1989; Pisoni et al, 1991). Chronic and excessive alcohol consumption were found to have some ototoxic effects in several studies (Bellé et al, 2007; Niedzielska et al, 2001; Ribeiro et al, 2007; Shore et al, 2006; Verma et al, 2006), though they were inconclusive. Also several experimental studies showed some visual impairment in alcohol abusers and addicts, namely, color vision impairment and deterioration of visuospatial perception (Kapitany et al, 1993; Mergler et al, 1988; Shore et al, 2006; Skripnichenko, 1987; Vanlith and Henkes, 1979).…”

Racial and Ethnic Differences in Substance Abuse Treatment Initiation and Engagement

“…The fact that we were able to test for these differences using encounter data from publicly funded services is important given that the majority of substance abuse treatment in this country is publicly funded (Levit et al 2008). We were also able to assess treatment processes among Native Americans, who have higher rates of substance abuse disorders and disproportionately suffer some of the consequences of substance abuse, but are often overlooked in studies due to limited sample size (Booth et al 1992; Compton et al 2007; Hasin et al 2007; Shore et al 2006). …”

“…Among the aims of the 2006 IOM report, Improving the Quality of Health Care for Mental and Substance-Use Conditions , is that high quality care for substance use disorders should be equitable and should not vary based on individuals’ personal characteristics, such as race/ethnicity (Horgan, and Garnick 2005; Institute of Medicine 2006). Equitable quality of treatment is particularly relevant for substance use disorders given that racial/ethnic minorities suffer more severe consequences from substance use/abuse than Whites, including higher incarceration rates, higher alcohol-related problems, and higher drug overdose mortality (Galea et al 2003; Iguchi et al 2005; Schmidt et al 2007; Shore et al 2006). However, differences among racial/ethnic groups in the quality of treatment for substance use disorders have not been extensively studied (Schmidt, Greenfield, and Mulia 2006).…”

Research Partnerships between Academic Institutions and American Indian and Alaska Native Tribes and Organizations: Effective Strategies and Lessons Learned in a Multisite CTN Study

“…Approximately 104,000 AIANs living in rural areas of the Indian Health Service Aberdeen Area in North and South Dakota, Nebraska, and Iowa are faced with daily struggles of poverty, limited access to health care, and minimal educational and employment opportunities. The role that alcohol and drug abuse plays in the health disparities, including suicide, among AIANs in the Aberdeen Area is well-documented [11,12, 13]. Focus groups were conducted and ASI and client intake data were gathered from AIAN clients at the partnered sites.…”