Belief in the myth of an American Indian/Alaska Native biological vulnerability to alcohol problems among reservation‐dwelling participants with a substance use problem

Abstract

Belief in the myth of an American Indian/Alaska Native (AIAN) specific biological vulnerability (BV) to alcohol problems is associated with worse alcohol outcomes among AIAN college students who drink, despite also being associated with greater attempts to reduce drinking. This study examined the association of belief in a BV with alcohol use among reservation-dwelling AI adults with a substance use problem. Methods: Participants (n=141) who drank alcohol in the past 90 days were selected from a larger AI sample who self-identified as having a substance use problem. Moderated-mediation analyses examined whether belief in a BV was positively associated with alcohol use and substance use consequences, as well as whether self-efficacy and craving mediated the association of belief in a BV with alcohol use. Results: Among participants who reported using alcohol but not hard drugs (e.g., methamphetamine, opioids), greater belief in a BV was associated with greater drinking days, which in turn was associated with greater consequences. Among participants who used alcohol only, belief in a BV was also significantly associated with greater craving, and in turn with greater drinking days. Among those who used both alcohol and hard drugs, greater belief in a BV was associated with fewer drinking days, but was not significantly associated with consequences. No association was found between belief in a BV and self-efficacy to avoid alcohol or drug use. Conclusions: Among those who use only alcohol, belief in a BV may contribute to greater drinking days and consequences through its association with greater craving. This study provides further evidence of the potential harm of internalizing the belief that being AIAN contributes to risk for alcohol problems, a notion that lacks scientific evidence despite decades of research. The findings highlight the importance of combating societal myths regarding AIAN peoples and the internalization of these stereotypes.