Two major continuing contributions of anthropology to the study of alcohol use are in the areas of qualitative methodologies and cross-cultural and cross-national understanding. Anthropology has already pioneered the use of observation, participant observation, focus groups, in-depth interviews, and life histories as methodologies that seek to understand alcohol use from an insider's point of view and in the broadest cultural context.
The qualitative approach is especially useful when investigators seek to understand cultures and subcultures that are different from their own. Studies that link qualitative approaches with quantitative and epidemiological studies can offer us better methods for understanding alcohol use, abuse, and possible culturally compatible treatments.
Long before the field of alcohol studies was recognized anthropologists were contributing to our understanding of alcohol use and its outcomes by observing, analyzing, and reporting drinking patterns among different peoples. There was a brief period when drinking patterns tended to be viewed by those in other disciplines as irrelevant except inasmuch as they related to sheer volume of consumption. At the beginning of the 21st century, drinking patterns have re-emerged in the consciousness of alcohol researchers. They are now being recognized as important by survey-investigators who no longer claim that only consumption matters. There is a scramble to devise quick and easy ways to count and measure drinking patterns in ways compatible with the social survey format.
A few spokespersons for critical medical anthropology have been careful to demonstrate that many alcohol-related problems do not result from specifically individual, constitutional, or personality issues but can be better understood in relation to the historical context emphasizing political economy, that is, primarily relations of power and wealth. Recurrently, around the world such problems tend to be especially prevalent among the homeless, unemployed or underemployed, migrant workers, minorities who are subject to racial and other forms of discrimination; in sum: the poor and powerless within societies, even those societies that are ostensibly open and allowing mobility. It is as if heavy drinking and drunkenness were an adaptation to systemic frustrations, providing relief from stress, opportunities to act or speak in ways that would otherwise be censured. Such an interpretation has important implications in terms of both prevention and treatment.
Perhaps a breakthrough can be achieved now that drinking patterns have been explicitly identified as crucial intervening variables between sheer consumption and the occurrence of alcohol-related problems. This came about through qualitative studies by anthropologists in which they have identified specific patterns—some behavioral and some ideational—that are associated with the harms and risks of alcohol abuse. Of special importance with reference to populations that are thought to be difficult to study, the traditional methods of participant-observation and non- or semi-directed interviewing are often streamlined to allow short-term assessments that are more congenial to the timetables and budgets of agencies concerned with public health and social welfare. Similarly, greater attention to political economy and relations of power access within social systems promise to enhance our understanding of causes, consequences, and alternatives to problem drinking and drinking problems.
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