ALCOHOL-USE AMONG AMERICAN-INDIAN ADOLESCENTS - THE ROLE OF CULTURE IN PATHOLOGICAL DRINKING

Over the last 20 years, the field of substance use among American Indi an adolescents has come to be dominated by survey approaches that are unable to answer important questions about how the use of alcohol and drugs is conceptualized and meaningfully integrated in the lives of In dian teens. Without a model of adolescent alcohol use that incorporate s culture, the field misapprehends the social and cultural grounding o f both normal and pathological drinking, and cannot accurately differe ntiate between normal and pathological drinking. Traditionally, the fi eld has relied upon either a biological model or a distress model, thu s locating pathology in the biochemistry of ethanol ingestion or in ps ychopathological distress. However, findings from an ethnographic inve stigation of alcohol use among American Indian adolescents suggest tha t the criteria for distinguishing pathological drinking lie, instead, in the developmental and gender-specific expectations that derive from cultural values. Specifically, at a Northern Plains site, teen drinki ng is judged by whether drinking has begun to interfere with developme ntal tasks relating to the cultural values of courage, modesty, humor, generosity and family honor. We conclude with suggestions for clinici ans and researchers that offer the potential to facilitate the incorpo ration of culture into research and practice in the field of American Indian adolescent alcohol use.