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alcohol and first nations in Canada (book review)

Social History of Alcohol and Drugs 20/2 (Spring 2006)

Richard W. Thatcher, Fighting Firewater Fictions: Moving Beyond the Disease
Model of Alcoholism in First Nations
. Toronto. University of Toronto Press,
2004. 358 pp. Paper. $35.00. isbn 0802086470. Reviewed by Greg Marquis, Uni-
versity of New Brunswick, Saint John.

Richard Thatcher is a clinical sociologist who is an experienced health and so-
cial policy advisor and researcher for Canada’s First Nations communities and
has been involved in community health surveys of dozens of reserves. These are
largely isolated, rural and poor communities inhabited by “status” Indians who
live in official “bands” recognized by the federal Department of Indian Affairs
and Northern Development. By the mid 1990s, Canada had roughly 500,000
“registered” Indians living on more than 2,000 reserves. In recent years these
communities have been experiencing a transition to self government, notably
in education and social services, but they remain heavily dependent on federal
transfer funds, and the social, economic and health indicators for reserve dwell-
ers are more problematic than those of off-reserve aboriginals.

Fighting Firewater Fictions is a complex and ambitious work that attempts to
explain the genesis and continued resiliency of the “firewater complex,” a set
of beliefs about alcohol consumption in aboriginal communities. It also argues
that the traditional disease concept of alcoholism, government policies and the
power structure of reserves help perpetuate social and medical problems related
to excessive drinking. According to Thatcher, things will not improve simply by
increased self governance. The simplistic disease concept of alcoholism, based
on abstinence as the only response, has to be re-evaluated, as do the real causal
factors behind disruptive and unhealthy drinking. Reforms will only take place
when the current passive model of reserve government, dominated by chiefs,
band councils and influential families, is replaced by community-based ap-
proaches and genuine economic development. Until then, reserve populations
will continue to suffer from risk-taking behaviours such as drinking, drug tak-
ing and gambling.

Reserve communities are associated with higher than average rates of family
violence, child abuse and neglect, suicide, arrest and incarceration. Despite of-
ficial assumptions, most problem drinkers on reserves are not alcoholics and
the rate of abstinence among First Canadians is higher than the Canadian av-
erage. The incidence of high-risk drinking is linked to gender, education and
employment: women, those with more schooling and those in the workforce are
less likely to be affected. The most visible form of problem drinking, group or
binge drinking, meets with two responses: tolerance, due to the forgiving nature
of reserve communities, or disease concept treatment (DCT) programs based
on abstinence, referral to Alcoholics Anonymous (AA) and a standardized
rehabilitation regime. Although DCT programs have adopted some cultur-
ally-appropriate aspects, such as sweat lodges, sweet grass ceremonies and the
involvement of elders, Thatcher views these as “politically correct” add-ons to
a flawed model.

The book is a good barometer of the state of the debate on alcoholism and its
treatment in North America. It discusses recent criticisms of “therapy” and the
tendency of research and service delivery to pathologize the poor and minorities.
Although the author is open to recent neurobiological evidence on addiction, he
is less comfortable with psychological or psychiatric explanations and is trou-
bled by the non-scientific influence of AA and fatalistic attitudes on reserves
that tend to blame all major problems on outside forces beyond personal or
community control. These include the decline or loss of shamanism, the need
for social cohesion in the face of colonialism, and dysfunctional personal and
family relationships caused by the residential schooling of native children prior
to the 1970s and child welfare interventions that resulted in large numbers of
children placed in foster care or adopted by non-native families.

The author offers a number of factors to explain how alcohol developed into
such a problem on reserves. These include the fact that drinking brings short-
term pleasure, that “out-of-control” drinking is learned behaviour and not the
result of genetic factors, and that group drinking reflects traditional aboriginal
ethics such as sharing scarce resources. He attributes First Nations’ tendency to
forget or excuse excessive drinking, or seek leniency in terms of legal sanction,
to the power of the disease theory, which views alcoholism as a sickness, not a
weakness or moral failing. The problem is exacerbated by the historic influence
of externally-imposed “total institutions,” the loss of traditional social controls
and periods of official prohibition that reinforced binge drinking practices. He
also attributes much out-of-control drinking behaviour and violence to male
status anxiety. The most important factor of all, however, was “the displacement
of the adult male economic role.” (161) These conditions were all created
by historic and outside forces, but the situation is reinforced by reserve band
governance, federal agencies, the culture of dependency and a crude reliance on
DCT models.

The second part of the book offers a series of strategies for reorienting al-
cohol prevention strategies in First Nations communities. The first necessary
step is developing a holistic approach to the problem that includes meaningful
economic development, community participation and expertise and individual
responsibility. Thatcher argues that because of the lack of normal career/life cy-
cle trajectories for most aboriginals, many literally do not outgrow risk-taking
behaviour such as binge drinking. Band governance itself, with its emphasis on
consuming resources and creating parallel institutions, will have to be reformed.
Programs should be measured for their effectiveness. Intensive, community-
based intervention programs for children are specifically highlighted.
This reviewer can find few faults with the book, although as an historian I
would have liked to have seen more attention to how and when problem drink-
ing became an actual, as opposed to an imaginary, problem on reserves. The
suggestion that prohibition, either under the federal Indian Act and provincial
liquor legislation or band policy, exacerbated the problem is not backed up
with research references in a book that otherwise is extremely well documented.
Finally, despite the logic of Thatcher’s reform suggestions, and recent acknowl-
edgements by native leaders that people should take greater responsibility for
their problem drinking, it is unlikely that either reserve governments or the fed-
eral government will, in the short run, enact radical reforms in areas such as self
government, service delivery and economic development.

Posted by David Fahey on August 27, 2006 at 06:12 PM in Alcoholism, Book Reviews, Canada | Permalink