Alcohol remains one of the most pressing public health concerns in many American Indian and Alaska Native communities (USCDC, 2008). As sovereign nations, American Indian and Alaska Native tribes have the ability to pass a wide range of laws to control alcohol (May, 1992), which may be an important component of more comprehensive prevention planning. This Knowledge Asset focuses on evidence about the potential impact of these policies.
American Indian and Alaska Native communities can use a wide variety of policies to control problems associated with alcohol use. To date, research has focused on efforts to control the supply of alcohol in tribal jurisdictions through the prohibition of sales and/or possession of alcohol. Evaluations of the impact of these policy changes on alcohol-related consequences are mixed, however, with studies in the continental U.S. suggesting that efforts to bypass restrictions on access to alcohol may be associated with increased morbidity and mortality (Gallaher et al., 1992), while others, conducted in Alaska, indicate dramatic reductions in alcohol-related consequences that can be attributed directly to tighter control over alcohol supply (Chiu, Perez, and Parker, 1997). A major reason for the different outcomes of such policy interventions may have to do with the availability of alcohol in nearby non-tribal jurisdictions in the continental U.S. (Wood and Gruenewald, 2006). Future tribal policies in less isolated tribal communities in the continental U.S. would likely benefit from increased resources for enforcement of alcohol control and explicit coordination with non-tribal jurisdictions in developing a more comprehensive set of policy solutions to this continued public health problem in American Indian and Alaska Native tribes.