Columns 2013

War On Alcohol a failure – big surprise!

Anyone involved in the ongoing alcohol war in Bush Alaska is not at all surprised by recent findings that the alcohol war is about as successful as the drug war.  The problem is that no one seems to be able to come up with a better solution that won’t take a long time for results to show.

Sometimes the problem of alcoholism is simply addiction itself. A person is born with a proclivity towards addictive substances and all the best parenting, schooling and counseling in the world can’t cure that. All you can ever do is control it, a daily struggle.

But often, alcohol abuse is symptomatic of deeper problems over and above the basic addiction. In Alaska, accepting this seems to be the greatest obstacle to overcome before we can sensibly and logically address alcohol created problems.

I was in health care when grants for alcohol treatment programs first started flowing from the state and federal government. At the time, the thinking was that if we could just bring enough “cures” into our communities through everything from AA meetings to inpatient treatment programs, we could make headway against a problem that was clearly destroying families and cultures. We were wrong. Treating the abuse itself should be the last, not the first step taken. The first step taken should be to address the tangled mess of issues that create an atmosphere in which alcohol becomes an attractive alternative to a sober life.

I can understand the appeal of controlling the flow of alcohol into a village. It seems to be intuitively a simple and direct response to the problems that alcohol causes. Simply stop the flow and you stop the problem. But the problem is not simply alcohol. And people who want to drink will be more creative than we can possibly imagine in getting their hands on their preferred substance. Alcohol continues to be abused at about the same rate as it was when all those grants started flowing more than three decades ago.

Aside from what it would cost to explore the myriad issues that tangle together to wreak havoc on Bush Alaska’s quality of life, there is the issue of defining what those problems are, how they interconnect and what, if anything, can be done to resolve them. It’s the kind of complicated problem that does not lend itself to simple slogans (“Just Say No”), simple legal controls (wet? damp? dry?), or 30 day treatment programs.

While I can’t speak to the dynamics in urban Alaska that create such high levels of substance abuse, I can certainly speak to the difficulties of village life. Young people, geographically isolated, are inundated through the explosion of TV and Internet accessibility to a world that seems so much more desirable than the one they inhabit. Elders watch young people getting drunk, using drugs, spending all day in front of a TV or computer or game box and wonder how to get them more involved in their culture. Many of these Elders spent most of their adult lives raising these children while drunk. The respect they think should automatically accrue to them based on reaching the age to be called an Elder rings hollow to the young people who remember the alcoholics who raised them. Sobering up at 60 doesn’t forgive the lifetime of problems you left behind.

Alaska is cold and dark a lot of the year. Our villages are limited in their participation in a moneyed economy. There are few jobs available. Cultures that have lasted millennia teeter on the edge of extinction, along with their languages, because that X Box is simply more attractive than the future outside the front door. Shot through all of this are the devastating threads of generational family dysfunction as child abuse, spousal abuse and alcohol abuse continue to be the norm in all too many Alaskan families.

The problem is complex. Its solution is a long term effort that does not provide the instant gratification of simply banning alcohol from a community. Unfortunately, Americans are not famous for having the patience this problem requires. So I imagine we will continue to ban alcohol in some communities and continue to wonder why the simple fix doesn’t work.

The answer is that the problem is too complex for our current attention span.