Explanations for increased drinking in some Native American communities have often focused on the hypothesis that disruption of their traditional cultures was associated with psychological states of anomie, depression, and/or anxiety which in turn led to increased use of alcohol and alcohol-related problems (see Brave Heart, 2003; Kunitz and Levy, 1994; Levy and Kunitz, 1974; Whitbeck et al., 2004). However, a relatively low prevalence of anxiety and affective disorders combined with a high prevalence of substance use disorders has been reported in SWC Indians (Gilder et al., 2004). Higher rates of substance use disorders and equal or lower rates of “other psychiatric illness” have also been reported in four other studies of Native Americans (Howard et al., 1996; Kasprow and Rosenheck, 1998; Walker et al., 1994).
