Alcohol and Drug Use in Micronesia

 

Micronesia is a vague designation for that part of Oceania that lies in the western Pacific north of the equator. [Fig 2: map]  Our concern here will be with the Federated States of Micronesia (FSM), comprising four states: Yap, Chuuk, Pohnpei and Kosrae.  We will also be reviewing data from the Republic of the Marshall Islands.  And here is Palau, another small island nation in the region and one on which Sylvia Andres has already presented.

 

The data here come from surveys that were conducted in 1997 by the Micronesian Seminar, the small NGO of which I am the director.  Let me make a short comment on the methodology.  For various cultural reasons we dispensed with the direct interview method in favor of a key informant approach.  Furthermore, we opted to survey everyone in preselected communities of between 200 and 400 people rather than to choose subjects by random selection.  The data collected represented at least five percent of the total population, and the sample pool represented the gender, age cohort, ethnicity, and general residence patterns of the nations.

 

Alcohol stands at the top of the drug list in any part Micronesia.  Following it in order of prevalence are marijuana and inhalants.  Apart from some minor cocaine use in the Marshalls (perhaps 50 users in a population of 50,000), there is no indication of use of heavy drugs.  There are indigenous drugs commonly used in different parts of Micronesia–betelnut in Yap and Palau, and kava in Pohnpei–but these are relatively benign and are outside the scope of our survey.

 

Two additional comments on the culture of drugs in the islands. First, drug use in Micronesia is additive, not substitutional.  In other words, there are relatively few users of other drugs who do not also use alcohol.  Second, throughout most of Micronesia, drugs are used by males, not females.  The gender wall, while not impenetrable, is real.

 

[Fig 3] Alcohol has been targeted for years as the major drug problem in Micronesia.  Many of the social problems, and health problems, can be traced to drinking.  The deaths shown here are directly attributed to alcohol use.  Suicide is a major problem in the islands, with rates triple those of the US.  Many of the deaths occur after a young person has been drinking.  A high percentage of all crimes occur when a person has been drinking.

 

[Fig 4] Over half the males in FSM have used alcohol in the past year.  In the Marshalls–which like Kosrae has a strong Congregational Church–just a little over a third of the males drink.  In other places male rates run about 50-70%.

 

Notice the difference between male and female rates.  The ratio is 6:1 in FSM and 7:1 in the Marshalls.  This underscores the cultural fact that drinking is a male pastime.

 

[Fig 5]  This graph shows the age spread for alcohol use by both sexes in the different areas of Micronesia. [Fig 6] Alcohol use peaks in the 30-44 age group for all places.  Note, however, that Yap’s rates remain significantly higher throughout the later years.  Its rate remains uniformly high at around 50% from age 20 to 64.

 

Onset of drinking occurs in the late teens everywhere except in Kosrae, where it begins in the early 20s.

 

Although alcohol use in FSM and the Marshalls shows no correlation with marital status, wage employment, or rural-urban residence, there is a strong correlation with education status among the young. [Fig 7]  Among the 10-19 age cohort, as the table shows, drinking is four times as common among FSM dropouts as students.  The difference is even greater, at ten to one, among Marshallese males.

 

We turn now to alcohol consumption patterns. [Fig 8]  We notice that only a small percentage of those who use alcohol are daily drinkers.  Most drink only once or twice a week or even less frequently.  There is a binge drinking pattern that shows up frequently in the data.

 

When people do drink, they drink quite a bit. [Fig 9] As the table shows, the consumption at a sitting ranges from 9 to 16 drinks.  Many people are reported as finishing two or three six-packs in an outing.  There is the story of one prodigious Yapese who is said to have finished three cases of beer, or 72 drinks, within a 24-hour period.

 

[Fig 10]  The per capita consumption over the entire population ranges from 2 ½ cases of beer in the low consumption areas of Kosrae and the Marshalls to 10 ½ cases in Yap and Chuuk.  This translates into one liter of pure alcohol yearly for Kosrae and the Marshalls, 3.4 for Pohnpei, and 4.5 for Chuuk and Yap.

 

In lieu of any clear definition of an “alcoholic,” we identified what we called problem drinkers.  Problem drinkers were those who used alcohol at a certain level frequency and quantity–they had five or more drinks at least twice a month, or had two drinks every day, or had an overnight binge at least once in the previous month.  But problem drinkers also had to have shown behavioral problems, or been referred to treatment for alcohol in the past year, or be judged by the community to be a problem drinker. [Fig 11]  By these criteria, over one-third of the males in FSM and one-sixth of the males in the Marshalls are problem drinkers.

 

[Fig 12] From this table showing the numbers of drinker and problem drinkers in Micronesia, we can see that well over half of the drinkers in FSM are problem drinkers.  The figure is slightly under half in the Marshalls.  Note that females constitute only about 7 percent of the problem drinkers.

 

Marijuana, introduced into Micronesia during the late 1960s, has grown into the second largest drug used in the islands.  Although illegal, it is grown widely.

 

[Fig 13]   Note the use of marijuana is even more gender-linked than alcohol use.  The rate for males in the FSM is 15 percent, while only one percent of the females smoke marijuana.  The corresponding rates for the Marshalls are two percent and one percent.

 

[Fig 14] As this table shows, real use begins in the late teens (except in Kosrae), it peaks in the 20s and 30s, and then drops sharply in middle age.  Kosrae alone has lifetime users.  There are indications in the survey that many young men quit on their own because they don’t like the drug’s effects on them.

 

[Fig 15] There are nearly 5,000 marijuana users in FSM, but less than a tenth of this number in the Marshalls, an island group with half the population of FSM.

 

[Fig 16] The average marijuana user in FSM smokes between one and 2 ½ joints a day, while the average Marshalls user smokes only one a week.  The table also shows that, with 3 1/4 million joints smoked last year, marijuana is a multi-million dollar business in the islands.

 

Inhalants consist mostly of gas and glue.  Often this is the first stage of drug use. [Fig 17]  No inhalant use was recorded for Kosrae and Yap, but inhalant use is hard to detect from third person sources because it is often practiced alone and so is the “hidden vice” of the young. As the table shows, use trails off during the twenties and later.

 

To summarize our findings, then:

 

*         Everywhere in Micronesia, drug use is additive rather than substitutional.  Hence, those who use marijuana or other drugs are also regular users of alcohol.

 

*         As a rule, drug use follows gender lines, with males using drugs and females generally abstaining.

 

*         The use of “hard drugs” (ie, cocaine, heroin, amphetamines and hallucinogens) is still negligible but bears watching.  There is no clientel for hard drugs in FSM at present, although an estimated 50 persons in the Marshalls use cocaine and heroin.

 

*         Inhalants (gas and glue sniffing) are a problem among young teens in Chuuk and to a much lesser degree in Pohnpei, as well as among older males in Ebeye.

 

*         Marijuana is commonly used by young males, especially by those between the ages of 15 and 44, except in the Marshalls.

 

*         Alcohol is by far the greatest drug problem in Micronesia.  In most places the great majority of young males drink, while in Kosrae and the Marshalls one-third of the males drink.  Drinking seems to have increased among older age groups.

 

*         Binge drinking is a common practice in every part of Micronesia, in keeping with island styles of consumption.  The average daily consumption of alcohol, as reported in the survey, ranges from 9 to 16 drinks a day.

 

*         There are currently over 11,000 problem drinkers in FSM, and 2,600 more in the Marshalls.  More than one-third of all FSM males over the age of 15 can be designated problem drinkers.  One out of every six males in the Marshalls are problem drinkers.

 

 

Francis X. Hezel, SJ

December 5, 1999