Characteristics of Problem Drinking in an Urban South American Indigenous Population

Abstract

This 2002 Medcen Foundation-funded study explored characteristics of problem drinking among 211 urban Venezuelan Native Americans of Arawak origin. Prevalence of problem drinking using Alcohol Use Disorders Identification Tests was 88.5% among men and 17.3% among women. Periodic binge drinking was marked by loss of control, failure to meet obligations, and alcohol-related trauma. Focus group participants noted that previous occasional binge drinking by men has been replaced by frequent male and female heavy weekend drinking, violence, and death. Limitations and implications are discussed. Awareness of high levels of problem drinking and desire for assistance present compelling mandates for community intervention efforts.

RÉSUMÉ

Caractéristiques des problèmes d’abus d’alcool au sein d’une population urbaine indigène d’Amérique du Sud

Cette étude financée par la fondation Medcen en analyse les caractéristiques des problèmes d’abus d’alcool parmi 221 Amérindiens du Venezuela d’origine Arawak. Le questionnaire AUDIT (Alcohol Use Disorders Identification Test) montre une prévalence des cas d’abus d’alcool chez 88.5% des hommes et 17.3% des femmes. L’abus occasionnel d’alcool peut provoquer une perte de contrôle, conduire au non respect d’engagements, et être à l’origine de divers traumatismes. Les participants au panel de discussion ont remarqué une évolution de la consommation d’alcool: si elle prenait autrefois la forme de beuveries occasionnelles entre hommes, elle est désormais plus fréquente et a lieu le week-end, impliquant hommes et femmes et générant violences et parfois des morts. Les limites et les implications de l’étude sont abordées dans cet article. La prise de conscience de la gravité des problèmes d’abus d’alcool ainsi qu’une demande réelle de soutien et d’assistance sont autant de raisons justifiant l’intervention de la communauté.

Mots clés: abus d’alcool, Amérindiens, AUDIT, alcool, indigènes, Amérique Latine

RESUMEN

Características del Uso Indebido de Alcohol en una Población Urbana Indígena de Sur América

En la fundación Medcen apoyó un estudio que exploró las características del uso indebido de alcohol en 211 personas indígenas urbanas de orígen Arawak en Venezuela. La prevalencia del uso indebido del alcohol detectado por el cuestionario AUDIT fue un 88.5% entre los hombres y un 17.3% entre las mujeres. El uso excesivo periódico del alcohol se caracterizó por una pérdida de control, la inhabilidad de cumplir con sus obligaciones y lesiones traumáticas. Los participantes de grupos focales notaron que un patrón de consumo excesivo ocasional entre los hombres había sido remplazado por un consumo excesivo durante muchos fines de semana tanto entre los hombres como entre las mujeres, trayendo a cabo violencia y hasta muertes. El artículo discute las limitaciones e implicaciones de estos hallazgos. Dados los altos niveles de consumo indebido de alcohol y el deseo de los participantes de conseguir ayuda, se encuentra una fuerte demanda para intervenciones comunitarias.

Palabras claves: Abuso de alcohol, consumo excesivo de alcohol, indígenas de las Américas, AUDIT, indígena, América Latina

Keywords :

• problem drinking
• Native American
• AUDIT
• alcohol
• indigenous
• Latin America

THE AUTHORS

J Paul Seale, M.D., is Professor and Director of Research in the Department of Family Medicine at Mercer University School of Medicine and the Medical Center of Central Georgia. He currently directs two projects related to alcohol and drug screening and brief intervention and has spent more than 10 years developing prevention and treatment resources for indigenous communities with alcohol problems.

Sylvia Shellenberger, Ph.D., is psychologist at the Medical Center of Central Georgia and professor of Family Medicine at Mercer University School of Medicine in Macon, Georgia. She was awarded a Fulbright senior scholarship for teaching and research in Argentina in 2002 and the Florence Kaslow International Award from the American Psychological Association in 2005. She directs the training efforts for federal grant projects designed to increase screening and brief intervention rates in emergency rooms and by physicians for substance use.

Dr. Nelia Sanchez de Perez is full professor in the Department of Public Health at the University of Zulia in Venezuela. Her doctorate is in Medical Sciences in Public Health.

Robert L. Vogel, Ph.D., received a B.A. in mathematics from Hanover College and a Ph.D. in Biostatistics from Rollins School of Public Health, Emory University. He is currently Professor of Biostatistics at the Jiann-Ping Hsu College of Public Health, Georgia Southern University where he teaches Experimental Design, Longitudinal Data Analysis, Survey Methodology, and Analysis and Imputation Techniques for Missing Data. His personal interests include long distance bicycling and collecting rare books.

Elibeth Villalobos holds a Bachelor of Social Work degree from the University of Zulia. She is a member of the ASOUNI, a grassroots community development foundation, which serves as an advocate for community health efforts in the urban Arawak area where this study was conducted. She is also a member of the local Arawak community, actively working to improve the lives of those who live there.

Dr. Fred S. Girton is Professor and Chairman of the Department of Family Medicine at Mercer University School of Medicine and Chief of Family Medicine at the Medical Center of Central Georgia, Macon, Georgia. He is a board certified Family Physician who is actively seeing patients with his main interest in allergy immunology and vaccines. He teaches first year immunology to Mercer University medical students and is a frequent speaker for the Georgia State immunization program (EPIC). His hobbies include jogging, photography, and travel.

Dana M. Seale received a Bachelor of Science degree from the University of Texas in Austin. She is a motivational interviewer at the Medical Center of Central Georgia as part of Georgia BASICS, a statewide Screening, Brief Intervention and Referral to Treatment (SBIRT) project. As writer, speaker, and the mother of four amazing children, she has spent the last 30 years of her life helping to coordinate international service projects in developing countries.

Dr. Ike S Okosun is an associate professor of Epidemiology in the Institute of Public Health Georgia State University. He holds Ph.D. in epidemiology from the University of Pittsburgh Graduate School Of Public Health. His research focuses on the epidemiology of alcohol and substance abuse in populations of Africans in Diaspora.

Notes

1 “Heavy drinking” is an unscientific, bounded (culture, place, time, criteria used, etc.) pseudonosology, which is often used in the literature without adequate theoretical and/or empirical underpinnings, being associated with posited cause and effect outcomes while being supported by “principles of faith” and consensus. Editor's note.