High rate of alcohol deaths in Indian Country

I find the high rate of alcoholism on the reservations most often correlates with the fact that there is nothing to do on the reservations but drink. Many reservations are very desolate and isolated from nearby communites combined with high unemployment and a real lack of motivation in most tribal communities to actually push away from federal dependence this is the end result.

I work in an IHS and I find most of our cases in the ER are alcohol related. The saddest thing to see is when "kids" to young to even legally drink are brought in for DT's or being sent to rehab. Most kids here have watched generations of family abuse alcohol and fall into that pattern themselves. Even though ours is a "dry" reservation, there are communities minutes away where alcohol is sold.

i have seen this among non-indians families and extended families and communities where abuse of alcohol and drugs are not frowned on but even considered a right of passage
the babies born to these mothers are often handicapped with MR and physical disabilities
very sad

Don't these people have a genetic tendency for alcoholism and diabetes? I've been thinking about this since I've recently taken care of several Indians from our local reservation who had serious alcohol related conditions at a relatively young ages. They also had diabetes. There is definitely a metabolic component to this that, combined with the availability of refined carbohydrates wrecks havoc on the Native American people disproportionately.