As of 2016, there were only a little more than 111,000 Native Alaskans residing in Alaska, accounting for just 15 percent of the state’s population. The number of Native Alaskans has been dwindling for many years, and recent trends in alcohol use is threatening an already vulnerable population. Indigenous advocacy groups, as well as the state government, are doing what they can to introduce rehab programs into rural Alaska, but their determination to avoid a slow genocide is tinged with desperation.
The Long and Difficult History
Native Americans have had “a long and difficult history with alcohol,” says USA Today, dating back to when European colonists plied them with alcohol to weaken them during negotiations and hostilities. As much as 12 percent of the deaths suffered by Native Americans and Alaska Natives are related to alcohol, which is more than three times the rate of the general American population. That figure comes from a 2008 report published by the Centers for Disease Control and Prevention, which also noted that the two leading causes of alcohol-related deaths among Indigenous Americans were traffic fatalities and alcoholic liver disease; each cause of death is responsible for more than one-quarter of the 1,514 recorded alcohol-related deaths over the four-year period of study.
In general, Native Americans, including those in Alaska, have much higher death rates among most of the leading causes of death than the general American population does. In addition to alcohol-related causes of death, natives have significantly higher rates of drug abuse, diabetes, cardiovascular disease, and suicide, all of which contribute to above-average alcohol use.
NBC News mentioned that it is possible the CDC study did not get the full scale of alcohol-related deaths among Native American populations. Researchers did not count deaths related to certain conditions for which alcohol abuse is believed to be a contributory factor, like colon cancer, tuberculosis, or pneumonia. The CDC study did find that alcohol consumption and abuse tended to be higher on reservations that are remote and destitute, where locals do not have much knowledge about the dangers of problematic drinking, job prospects are low, and healthcare and emergency services have a very limited reach.
The CDC suggests “culturally appropriate clinical interventions” to cut down on the excessive drinking. This might take the form of closer partnership between tribal healthcare centers and tribal courts, the latter of which are responsible for dealing with alcohol-related crimes.
Life and Death in Rural Alaska
For many Native Alaskans, alcoholism has been a long-running public health threat, affecting day-to-day life across generations. Some tribes have taken to promoting alcohol-free events as a way of encouraging more members to cut back on their drinking. It is also a case of survival; statistically, Native Alaskans are three times more likely to commit suicide than non-native Alaskans, according to the Ron Perkins, the former executive director of the nonprofit Alaska Injury Prevention Center. In 2007, Perkins told The New York Times that “rural Alaska has some of the highest rates in the world for suicide,” the causes of which are linked to undetected and untreated mental illness (like depression) and substance use disorder. Contributing factors include economic stress and cultural taboos. Most families are reluctant to discuss suicide and mental health, leaving individuals to feel like they have no one to talk to about their problems.
Additionally, more and more Native Alaskan residents are leaving their villages and reservations to find jobs in urban areas, leaving families (and their culture, according to some) behind. This adds to the existential fear that the Indigenous Alaskan way of life is dying out, with future generations unlikely to continue the traditions. It is a fear echoed by the section manager for prevention and early intervention for Alaska’s division of behavioral health, who told The New York Times that Native Alaskans are losing their roots while struggling to support their families. As a result, many are falling on drug and “particularly alcohol” abuse to self-medicate their depression. Among young men, “there’s such a feeling of hopelessness.” Unsurprisingly, substance abuse accounted for almost 75 percent of the suicides among Alaskan natives.
Life in the Last Frontier
Even for non-native Alaskans, drinking runs deep in the state’s way of life, so for a population as vulnerable as tribal residents, the problem becomes magnified. In 2015, the Daily News-Miner wrote that Alaska is among the national leaders in per capita alcohol consumption, and with high rates of drinking come some serious consequences, such as high rates of violent crime, domestic violence, sexual abuse, and suicide, all of which have been linked to the dangerously high rate of drinking in the state. Alaska’s remote geographic location has contributed to the “Last Frontier mythology,” where fur-trading, gold mining, logging, oil, and fishing contributed to the modern Alaska economy, but, in many cases, are no longer viable. Drinking – and drinking heavily – has been a part of that image, especially among men who keep isolation and boredom at bay by engaging in risky behavior, like substance abuse.
Seward City News wonders if there is something in the culture of Alaska itself that plays a role in the bleak public health outlook. Figures from the Centers for Disease Control point out that the state had the national highest rate of fatal incidents involving firearms (23.4 deaths per 100,000 citizens, as opposed to 11.1 deaths per 100,000 citizens across the country). As many as 80% of the firearm fatalities “were from intentional self-inflicted injuries.” On the whole, Alaska averages 136 suicide deaths every year, meaning that in this state of 741,894 people, 10 people take their own lives every month. Among Native Alaskans, the outlook is far more grim; males aged 15-24 die at a rate of 141.6 reported suicides per 100,000 people, which is the highest rate of suicide across all demographics in the country. These are “crisis level” numbers, says the Huffington Post, where tribes become so overwhelmed with the grief of losing their members that the traditional process of grieving is replaced by more self-destructive behavior, like substance abuse.
A Theme of Tragedy
Why Alaska? Some have blamed it on the long, dark winters of the Arctic Circle, where “darkness and depression descend,” in the words of The New York Times. In 1992, the American Journal of Psychiatry noted that almost one in 10 Alaskans suffers from seasonal affective disorder, a form of clinical depression that is triggered by the changing of particular seasons. Some Alaskans, notes the Times, cope with the use of bright-light therapy (artificial lights that dim and brighten to simulate natural sunlight patterns); others move away; and yet others turn to drugs and alcohol.
Some blame Alaska’s struggles on the state’s remoteness. The state’s most rural communities, where many native tribes have their reservations (such as the Yup'ik and Inupiat to the north and west) do not have highways; the only access in or out is by aircraft or snowmobile, and only during good weather. This makes medical care hard to come by in the best of times; specialized care, like mental health counseling and substance abuse treatment, is all but impossible for many.
The isolation and barren landscape make for a perfect storm of what the Seward Times calls “a recurring theme of tragedy in the Last Frontier.” At 571,951 square miles, Alaska is the largest state in the US, but with less than 750,000 residents, it is also one of the least populated states in the country. When problems develop, they develop in isolation and silence, especially among rural communities.
A 2006 report published in the American Indian and Alaska Native Mental Health Research journal noted that indigenous Alaskans have experienced an increase in alcohol availability from bars and liquor stores outside of tribal areas, but a lack of easily accessible and culturally responsive treatment programs. Survey respondents report regular binging, followed by loss of consciousness, domestic violence, suicide, legal problems, and “feelings of intergenerational grief.” The researchers wrote that the Native Alaskans they talked to called for rehabilitation approaches that combine family with tribal customs and values.
Native Alaskans and Homelessness
In December 2016, The Guardian wrote of another problem facing rural and low-income Alaskans (many of whom are indigenous). The combination of high rates of alcoholism and homelessness means that when the frigid winters come, many of the state’s homeless population don’t survive. The temperature drops to -14 degrees Celsius in a place like New Stuyahok, a Yupik village by the Nushagak River in western Alaska.
In Anchorage, it doesn’t get much warmer, but police find bodies “with grim predictability,” in cars or in the makeshift camps that are in the city’s parks. They are usually surrounded by empty bottles of alcohol, and have likely not received adequate treatment for the physical or mental conditions that afflicted them, including years of alcohol abuse. Police and homeless advocates note that “the dead are disproportionately Alaska Natives,” many of whom left their reservations and their families to try and find work in a bigger city. But being separated from their culture takes its toll, and a number of natives struggle to make the transition work. It becomes too expensive and too difficult to move back home, so they find themselves on the frozen streets. Native Alaskans account for 20 percent of the general population, but 50 percent of the people who seek refuge in shelters.
Alaska Natives abuse alcohol at a consistently higher rate than all ethnic groups in the US, mirroring those of all the Native American tribes in the lower 48 states. Shelters in Anchorage do not allow individuals to drink once inside, compelling some people to take their chances in the cold. Some homeless people intentionally drink to the point of being dangerously drunk, with the idea that a shelter will (reluctantly) give them a place to stay for the night. Police in Anchorage told The Guardian that they often see people with two or three times the legal blood alcohol content out on the streets, hoping against hope that they get picked up before they freeze to death.
Life in Alaska exists on the fringe, concludes the Seward Times. The unparalleled natural beauty prevails in the face of brutal winters, a gutted economy, and many native tribes now living in the shadow of an industrialized nation that has robbed them of their land, their culture, and their pride. For a large number of Native Alaskans, the only companion they have is the alcohol they and their ancestors have been plied with for generations. While researchers and advocates have called for treatment programs that will make use of the rich tribal history of the indigenous regions, consistent and effective interventions are still a generation away. Until then, the long dark facing Native Alaskans may continue.