Maintaining Abstinence in a Northern Plains Tribe

Abstract

In this article, we examine how American Indian individuals with a history of alcohol dependence have been able to maintain their abstinence despite strong pressures to return to drinking. This work builds on close collaboration with individual tribal members who have resolved their problems with alcohol and community-based service providers to develop open-ended qualitative interviews. Using these, we explored how former drinkers respond to the twin challenges raised by their former drinking associates and strong feelings that emerge when alcohol is no longer an option for coping with life's difficulties. The resolution of these challenges is central to abstinence, given the strong ties between drinking and sociality in some American Indian communities (including the one where this study was conducted) and underscores the ways in which alternate relations to alcohol can be established even within a heavy drinking cultural context. Interviews were conducted with 133 individuals from a northern plains tribe who were identified in a previous epidemiological study as having a lifetime history of alcohol dependence. Inquiry into the processes involved in the meaningful constitution of abstinence for these men and women highlights the role of religion and spirituality for some, but by no means all of these individuals and, more broadly, the emergence of what Bea Medicine has characterized as "new ways of coping," which force us to expand on leading conceptualizations of coping in the literature on problems with alcohol.

Investigating the interlinkages of alcohol use and misuse, spirituality and culture – Insights from a systematic review

“…Religiosity seems to be a protective factor for alcohol use among undergraduate students (Sukhwal & Suman, 2013), but general population data show that social modelling can play an important intermediary role in this relationship (Drerup et al, 2011). Minorities appear to have a greater predisposition to alcohol use and its problems, and it seems clear that the degree of religiosity increases and has a predominant role during the treatment process in pursuit of abstinence and is also closely interlinked with cultural values in these populations (Bezdek & Spicer, 2008;Morjaria-Keval, 2006;Stone et al, 2006;Wardman & Quantz, 2005;Yu & Stiffman, 2007). However, it is not entirely clear whether there is an increase or a decrease in the level of religiosity during treatment for alcohol problems in the general adult population.…”

“…We found studies using samples of American and Canadian Indian (Bezdek & Spicer, 2008;Stone et al, 2006;Wardman & Quantz, 2005), individuals from Sikh backgrounds (Morjaria-Keval, 2006), and Indian undergraduate students (Sukhwal & Suman, 2013). Within the fi rst four studies (Bezdek & Spicer, 2008;Stone et al, 2006;Wardman & Quantz, 2005, Morjaria-Keval, 2006, the concepts of religiousness and spirituality were presented together, whereas the last study (Sukhwal & Suman, 2013) evaluated these concepts alone, but the results were similar.…”

“…Within the fi rst four studies (Bezdek & Spicer, 2008;Stone et al, 2006;Wardman & Quantz, 2005, Morjaria-Keval, 2006, the concepts of religiousness and spirituality were presented together, whereas the last study (Sukhwal & Suman, 2013) evaluated these concepts alone, but the results were similar.…”

Awakening: 'Spontaneous recovery’ from substance abuse among Aboriginal peoples in Canada

“…This model highlights the need for substance abuse treatment and intervention policy to consider culture as a determinant of health. Just as it is important to understand how recovery is maintained in Aboriginal peoples, it is equally important to understand how various individuals come to recovery in the first place (Bezdek & Spicer, 2006).…”

“…For instance, Bezdek and Spicer's (2006) study underscored the importance of adopting new social support systems within one's community, culture-based coping strategies, and renewed spiritual practices to support recovery. Mohatt et al's (2008) life histories study identified the valuable role of social support, most often through spouses as well as adult children, AA sponsors, and/or the Creator/higher spirit.…”