Unraveling FASD in Native American Communities: History, Stereotypes, and Systemic Roots
Written by Bella Lee-Rojas
Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe a range of effects such as physical, mental, behavioral, and learning disabilities caused by alcohol consumption during pregnancy. While FASD itself is not a clinical diagnosis it encompasses more identifiable diagnoses like fetal alcohol syndrome (FAS), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects (ARBD).
Over the last few decades, research has begun to shed light on the disproportionately high FASD rates within Native American communities. A 2016 study shows that in some Indigenous American communities, FASD rates were as high as 4.1% of children aged 5–7 years old. To compare, the general average FASD rate in the US ranges from about 0.02%~0.1%. Many believe the disproportionately high rates of FASD found in Indigenous communities correlate to the issues of alcoholism and addiction many native communities face.
It is important to preface that although FASD, alcoholism, and addiction are no doubt serious problems Native American communities face, they in no way justify the stereotypes of “the drunken Indian”. Stereotyping Natives as “drunken” or “raging alcoholics” has been used throughout history as a tool of suppression. Whether to justify the unjust incarceration of Indigenous Americans or diminish and dismiss Native culture as primitive, such stereotypes are rooted in misleading narratives of colonial dominance and eugenics.
To understand the underlying reasons for higher FASD as well as addiction rates within Native Communities we must first examine the historical contexts of alcohol consumption in the Americas. Prior to European colonisation native communities in North America had little exposure to alcohol. While historians note that some tribes produced weak beers or fermented beverages, most alcohol use was reserved for ceremonial purposes rather than everyday consumption. This all changed with the arrival of European colonists who first introduced large amounts of alcohol to Indigenous American communities. Alcohol was commonly introduced to Natives as a trade commodity in exchange for their highly sought-after animal skins and other natural resources. However, colonists also saw alcohol as a tool of coercion; many European traders provided “free” alcohol during trading sessions with natives to “aid” with negotiations.
It is also important to note the cultural shift in alcohol use in Native society after European colonists' arrival. Many accounts detail common intoxication among colonists which inadvertently modeled normalized social uses of alcohol to the relatively naive native population. There is no doubt that Indigenous Americans' lack of alcohol exposure had the physical effect of a lower initial tolerance to the substance. Moreover, without previous access to large amounts of alcohol or familiarity with its recreational use Native communities lacked the social, legal, and moral guidelines to regulate alcohol consumption. While, of course, the mere introduction of alcohol by European settlers cannot be solely to blame for the issues of addiction and alcohol abuse many Native communities face today it is still a crucial part of the conjecture of historical, societal, and cultural factors leading to disproportionately high FASD rates among Indigenous peoples today.
Like most disparities, combating substance abuse and FASD begins with awareness and education. Many Indigenous values consider pregnancy sacred and deeply care about protecting future generations of Native youth. With this in mind, effective services and initiatives to combat FASD must incorporate cultural and community-based approaches that align with tribal values. FASD is of course a symptom of larger issues Native communities face. Addressing healthcare disparities like access to mental health and substance abuse support along with receiving proper school funding for learning or developmental disorder resources are all part of FASD prevention and treatment. By centering Indigenous voices and prioritizing culturally grounded solutions, we can create lasting change in the fight against FASD and its underlying historical, societal, and cultural causes.
Sources:
Centers for Disease Control and Prevention. 2025. "Fetal Alcohol Spectrum Disorders (FASDs)." Last modified March 27, 2025. https://www.cdc.gov/fasd/index.html.
National Institute on Alcohol Abuse and Alcoholism. 2025. "Prevention of Fetal Alcohol Spectrum Disorders." Last modified March 27, 2025. https://www.niaaa.nih.gov/health-professionals-communities/native-air/prevention-fetal-alcohol-spectrum-disorders?s=cultural_inclusion_sort%3ADESC.
MPR News. 2007. "Fetal Alcohol Spectrum Disorder and Native American Communities." October 17, 2007. https://www.mprnews.org/story/2007/10/17/indianfasd.
Indian Health Service. 2025. Fetal Alcohol Spectrum Disorders Among Native Americans. Last modified March 27, 2025. https://www.ihs.gov/HeadStart/documents/FetalAlcoholSpectrumDisordersAmongNativeAmericans.pdf.
Lange, Shannon, Svetlana Popova, Jayadeep Patra, and Jürgen Rehm. 2019. "Impact of Fetal Alcohol Spectrum Disorder on Families: Evaluation of Systematic Data." Journal of Family Studies 28 (3): 1–12.https://pmc.ncbi.nlm.nih.gov/articles/PMC6761887/.
