During the early part of the 19th-century, the major US federal policy towards Native American tribes was removal and resettlement. Thousands of Native Americans died on these relocation marches due to exposure, disease, and starvation. The government relocated Native Americans to land that was unsuitable for agriculture or grazing, further impoverishing these individuals. From the mid-19th-century through the mid-20th-century, the US government pursued policies that tried to force assimilation and acculturation of Native Americans into American society. This policy had profound psychological, social, economic, and physical effects on generations of Native Americans who repeatedly learned that their culture and lifeways were inferior to the broader American culture.

The disadvantages Native Americans have faced for centuries partly explains one major problem facing Native American communities: high rates of alcohol abuse disorders. Native American youth have some of the highest rates of alcohol use disorders of any other racial/ethnic group in the US. There are also high rates of fetal alcohol syndrome among Native people. As Lori notes, the lives of many Native Americans have been “scarred by the disease of alcoholism” (81), including her own. Lori’s father died because of driving while intoxicated.