Epidemiological research consistently indicates that many American Indian and Alaska Native communities suffer disproportionately from the consequences of alcohol use (USCDC, 2008; Spicer et al., 2003).

Recent analyses by the U.S. Centers for Disease Control, for example, found that 11.7% of all deaths in American Indian and Alaska Native communities can be attributed to alcohol, with an age-adjusted rate of alcohol-attributable deaths that is twice that of the United States. Analyses of these patterns of mortality by region underscore important variation, with death rates the highest in the plains, southwest, and Alaska (USCDC, 2008). Research using diagnostic criteria in random community samples has also documented significantly higher levels of alcohol dependence for both men and women in some American Indian communities (Spicer et al., 2003).