Bezdek Majorie, Spicer Paul
American Indian and Alaska Native Programs, Department of Psychiatry, School of Medicine, University of Colorado at Denver and Health Sciences Center, USA.
Med Anthropol Q. 2006 Jun;20(2):160-81. doi: 10.1525/maq.2006.20.2.160.
In this article, we examine how American Indian individuals with a history of alcohol dependence have been able to maintain their abstinence despite strong pressures to return to drinking. This work builds on close collaboration with individual tribal members who have resolved their problems with alcohol and community-based service providers to develop open-ended qualitative interviews. Using these, we explored how former drinkers respond to the twin challenges raised by their former drinking associates and strong feelings that emerge when alcohol is no longer an option for coping with life's difficulties. The resolution of these challenges is central to abstinence, given the strong ties between drinking and sociality in some American Indian communities (including the one where this study was conducted) and underscores the ways in which alternate relations to alcohol can be established even within a heavy drinking cultural context. Interviews were conducted with 133 individuals from a northern plains tribe who were identified in a previous epidemiological study as having a lifetime history of alcohol dependence. Inquiry into the processes involved in the meaningful constitution of abstinence for these men and women highlights the role of religion and spirituality for some, but by no means all of these individuals and, more broadly, the emergence of what Bea Medicine has characterized as "new ways of coping," which force us to expand on leading conceptualizations of coping in the literature on problems with alcohol.
在本文中，我们研究了有酒精依赖史的美国印第安人如何能够在重返饮酒的强大压力下保持戒酒状态。这项工作建立在与已解决酒精问题的个别部落成员以及社区服务提供者密切合作的基础上，开展开放式定性访谈。通过这些访谈，我们探讨了曾经饮酒者如何应对来自其以前饮酒伙伴提出的双重挑战，以及当酒精不再是应对生活困难的选择时所产生的强烈情感。鉴于在一些美国印第安社区（包括本研究开展的社区）饮酒与社交之间的紧密联系，应对这些挑战对于戒酒至关重要，这也凸显了即使在酗酒文化背景下，也能建立与酒精不同关系的方式。我们对来自北部平原部落的133人进行了访谈，这些人在之前的一项流行病学研究中被确定有终生酒精依赖史。对这些男女戒酒有意义构成过程的探究，凸显了宗教和灵性对部分（但绝非所有）这些人的作用，更广泛地说，凸显了贝亚·梅迪辛所描述的“新的应对方式”的出现，这迫使我们在关于酒精问题的文献中对应对的主要概念进行拓展。
