Death by Drink: Indian Country’s Curse

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1/22/15

The Center for Disease Control released a study on January 6 about U.S. deaths from alcohol poisoning based on two years of death certificate data, 2010 to 2012. It contains some expected results and some not so expected.

The result that most surprised the CDC was that the majority of people who poison themselves with alcohol are not teenagers. Of the six people per day who died from excessive alcohol, only 5.1 percent were between the ages of 15 and 24. Those under lawful drinking age (21) were only 2 percent.

Most persons who depart this life on a drinking binge are white males, because there are more whites and most binge drinkers are male. Men aged 45 to 54 accounted for 25.6 deaths per one million of the population. By comparison, the age-adjusted rate for American Indians and Alaska Natives was 49.1 deaths per million, the highest of any ethnicity.

State alcohol poisoning rates ranged from 5.3 per million in Alabama to 46.5 per million in Alaska. The only two states that came in over 30 per million contain major Indian country, Alaska and New Mexico.

Somewhat surprising is that most alcohol poisoning deaths came to persons with no history of alcohol dependence. Those who die are binge drinkers—not necessarily alcoholics. Of our numbers, the CDC study commented:

The high alcohol poisoning death rate among American Indians/Alaska Natives … is consistent with the high binge drinking intensity that has been reported by binge drinkers in this population. A recent study found that American Indians/Alaska Natives were seven times more likely to die from alcohol poisoning than whites, reflecting both the higher intensity of binge drinking among binge drinkers in this population and other factors, such as geographic isolation and reduced access to medical care.

The authors admitted that the study is limited by a general underreporting of alcohol poisoning deaths and by only counting deaths where alcohol poisoning was the primary cause rather than a contributing cause. There is also a long history of failure to record tribal status on official documents, a failure that gets more common with distance from Native homelands.

This report would be incomplete without noting the definition of “binge drinking” used by the CDC – For women, four or more drinks on one occasion, for men, five. Most adults who report binge drinking consumed eight or more drinks at a time.

Anybody who has had enough to “pass out” has rolled the alcohol poisoning dice. Since you can’t help yourself while unconscious, you will die or not depending on how much alcohol is in your digestive system but not yet absorbed. Those of us who have been with somebody who passed out, whether we were completely sober or not, could either take responsibility or let the dice roll.

Alcohol poisoning deaths are preventable by fairly obvious means. Telling people they should not drink at all is both obvious and futile. If you have reason to think you can talk a drunk into a life of sobriety, go for it. But it would be wise to have a backup plan.

Eat when you drink to slow the alcohol down. Don’t drink alone. Don’t leave an unconscious drunk to “sleep it off” unless you don’t care whether they wake up. We prevent these deaths by watching out for ourselves and watching out for each other. Or not.

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