Alcohol abuse has been the most significant ongoing health problem American Indians have experienced since the mid-seventeenth century. The social costs of Indian drinking in modern society are staggering: Deaths related to alcoholism (including cirrhosis) remain four times higher for Indians than for the general population; alcohol plays a role in perhaps 90 percent of all homicides involving Indians; inebriated Indians die while walking along roads, either hit by cars or succumbing to hypothermia; 70 percent of all treatment provided by Indian Health Service physicians is for alcohol-related disease or trauma. Alcohol abuse at times appears among Indian children by age thirteen; most seek complete intoxication. There is even one reported case of delirium tremens in a nine-year-old boy in northern New Mexico, himself the son of an alcoholic father. Maternal drinking has contributed to the growing incidence of fetal alcohol syndrome and has led also to an increased rate of other neonatal problem. So intense is the desire to become intoxicated among some Indians today, especially on reservations in the West, that they mix cleaning solvents with other fluids in order to produce what is now known as "Montana Gin," a concoction that can cause profound somatic disorders, including aspiration pneumonia and organic brain syndrome, which can lead to death. These social and clinical problems have occurred in spite of the fact that North American Indians, so far as clinicians and medical researchers can tell, are no more susceptible physiologically to abusing alcohol than other American.

The Revolutionary War and its aftermath brought ruin to the Indians of the upper Susquehanna Valley. The majority allied themselves with the British, infuriating local colonists who mostly sided with the Continental Army. General John Sullivan’s campaign of 1779 devastated the Susquehanna Indians’ towns, as well as the communities of Indians living farther north and west throughout Iroquoia. At the end of the war these Valley Indians were displaced, impoverished, and ignored; they lived at the edges of the new republic but could not enjoy the benefits of citizenship. While recent studies of the Revolutionary period have described crucial decades in the nation’s past, historians still have not examined the influence of the Anglo-American crisis on Indians in sufficient depth. Barbara Graymont’s The Iroquois in The American Revolution traces the experiences of the Six Nations but treats primarily the political and military aspects of these Indians’ lives. Anthony F. C. Wallace’s The Death and Rebirth of the Seneca, while putting the Revolutionary period into a broader historical and cultural context, focuses almost exclusively on the Senecas. But this westernmost tribe in Iroquoia managed to retain at least a portion of its land in the post-Revolutionary period, thereby distinguishing the tribe’s history from that of many Indians who were completely displaced from their territory, The Indians who inhabited the upper Susquehanna Valley, many of whom were not members of the Six Nations tribes, have received insufficient attention from scholars. Even Barry Kent‘s recent analysis, Susquehanna ’s Indians, contains little on the Revolutionary period, primarily analyzing the earlier Indian occupation of the region.