Assessment for Drug Abuse, Understanding the Impact of Culture and Gender, comment

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Assessment for Drug Abuse, Understanding the Impact of Culture and Gender -Thursday August 23/2007

I am a Nurse Practitioner yearly I do Locums in Alaska (locum is like a traveling nurse who works a clinic while the normal practitioner is on vacation)
I realize the high prevalence of alcoholism in these Alaskan small tribes. Everyone drinks including some of the children. Drugs are also a problem and I am beginning to see Meth. Most of the drugs are brought in by fishermen (I work on the Aleutian Islands) I have medications and support products to help these people (not detox, but) with treating a life threatening problem like alcohol intoxication, dehydration, or pancreatitis and liver failure. To change the habits now in the culture of these people will not be possible. Alcohol is part of their life. The Native Hospital will help them detox but they almost always come back to the islands and become drunk again. Money is given to all natives monthly and alcohol is purchased. All of the islands I have been on have a bar that provides credit until the checks come in.
The tribe tries to help everyone to have some sort of a job if they want it. Even the worse drunk can get a menial job to make a few extra dollars. The tribe tries to help all of its members to keep some pride.
Since everyone is related in some way on some of these small islands it is important that any care given to people who have alcohol problems (even though everyone knows) needs to be kept a secret.

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