Early socio-cultural theories posited that Native American alcohol use and abuse was a result of loss of traditional community lands, cultures and ties coupled with the stress of acculturation; however, there has been little direct evidence to support such theories [8]. More recent theories have presented data to support an association between alcohol dependence and such factors as personal and historical trauma (see [9-10]), early age of onset of drinking [11] as well as lack of contingency between access to basic life reinforcers (employment, housing, education and health care) and sobriety [12].
