What is the prevalence of current alcohol dependence and how is it measured for Indigenous people in Australia, New Zealand, Canada and the United States of America? A systematic review

Journal article

Weatherall, Teagan J., Conigrave, Katherine M., Conigrave, James H. and Lee, K. S. Kylie. (2020). What is the prevalence of current alcohol dependence and how is it measured for Indigenous people in Australia, New Zealand, Canada and the United States of America? A systematic review. Addiction Science and Clinical Practice. 15(1), p. Article 32. https://doi.org/10.1186/s13722-020-00205-7
AuthorsWeatherall, Teagan J., Conigrave, Katherine M., Conigrave, James H. and Lee, K. S. Kylie
Abstract

Background
Alcohol affects Indigenous communities globally that have been colonised. These effects are physical, psychological, financial and cultural. This systematic review aims to describe the prevalence of current (12-month) alcohol dependence in Indigenous Peoples in Australia, New Zealand, Canada and the United States of America, to identify how it is measured, and if tools have been validated in Indigenous communities. Such information can help inform estimates of likely treatment need.

Methods
A systematic search of the literature was completed in six electronic databases for reports on current alcohol dependence (moderate to severe alcohol use disorder) published between 1 January 1989–9 July 2020. The following data were extracted: (1) the Indigenous population studied; country, (2) prevalence of dependence, (3) tools used to screen, assess or diagnose current dependence, (4) tools that have been validated in Indigenous populations to screen, assess or diagnose dependence, and (5) quality of the study, assessed using the Appraisal Tool for Cross-Sectional Studies.

Results
A total of 11 studies met eligibility criteria. Eight were cross-sectional surveys, one cohort study, and two were validation studies. Nine studies reported on the prevalence of current (12-month) alcohol dependence, and the range varied widely (3.8–33.3% [all participants], 3–32.8% [males only], 1.3–7.6% [females only]). Eight different tools were used and none were Indigenous-specific. Two tools have been validated in Indigenous (Native American) populations.

Conclusion
Few studies report on prevalence of current alcohol dependence in community or household samples of Indigenous populations in these four countries. Prevalence varies according to sampling method and site (for example, specific community versus national). Prior work has generally not used tools validated in Indigenous contexts. Collaborations with local Indigenous people may help in the development of culturally appropriate ways of measuring alcohol dependence, incorporating local customs and values. Tools used need to be validated in Indigenous communities, or Indigenous-specific tools developed, validated and used. Prevalence findings can inform health promotion and treatment needs, including funding for primary health care and specialist treatment services.

KeywordsIndigenous; Australia; New Zealand; Canada; United States of America; alcohol; dependence; prevalence; screening; assessment
Year2020
JournalAddiction Science and Clinical Practice
Journal citation15 (1), p. Article 32
PublisherBioMed Central
ISSN1940-0632
Digital Object Identifier (DOI)https://doi.org/10.1186/s13722-020-00205-7
PubMed ID32943111
Scopus EID2-s2.0-85091193170
PubMed Central IDPMC7499847
Open accessPublished as ‘gold’ (paid) open access
Page range1-11
FunderNational Health and Medical Research Council (NHMRC)
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online17 Sep 2020
Publication process dates
Accepted09 Sep 2020
Deposited05 Jul 2023
Grant ID1117198
1087192
1117582
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