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Research Summary

Unhealthy Drinking and Comorbidity in American Indians

To identify drinking patterns and comorbidities correlated with alcohol dependence among American Indians (AIs), researchers examined data from a stratified random-sample survey of 3084 Southwest and Northern Plains AIs who lived on or within 20 miles of their reservations at baseline. A gold-standard interview defined substance dependence and other DSM-IV diagnoses.

  • Of the 1287 (42%) subjects who drank alcohol in the past 12 months, 15% had alcohol dependence (20% of men and 11% of women).
  • Among men, a threshold of >=12 drinks on a day in the past year was 89% sensitive for alcohol dependence.
  • Among women, a threshold of >=5 drinks on a day in the past year was 98% sensitive for alcohol dependence.
  • In adjusted analyses, increasing drinking amounts and frequency were associated with alcohol and drug use disorders (in both men and women), and alcohol-related conditions and traumatic injuries (in women only).


According to this study, high frequency, and particularly high quantity, of drinking was strongly associated with alcohol dependence among reservation-based American Indians. These findings bolster the imperative for alcohol screening among all reservation-based American Indians seeking care for physical or mental health problems. Fortunately, these patients will screen positive on the revised screening item recommended by the National Institute on Alcohol Abuse and Alcoholism (Have you had 5 or more drinks on an occasion in the past year?).

Peter D. Friedmann, MD, MPH


O’Connell J, Novins DK, Beals J, et al. The relationship between patterns of alcohol use and mental and physical health disorders in two American Indian populations. Addiction. 2006;101(1):69–83.