Alcohol and drug misuse prevention programs for American Indians: needs and opportunities.

General statistics have indicated that the problem of alcohol and drug misuse among American Indians has been in need of attention for years. A specific and critical examination of mortality and morbidity statistics yields a number of valuable insights to the ways of addressing the problem. The current status in many communities dictates intervention at three levels. First, high mortality and morbidity rates must be reduced through creative and innovative intervention with the social and physical environment. Alcohol legalization and other issues are discussed as distinct possibilities. Second, educational programs are needed to elevate the knowledge of American Indian communities about alcohol and drug misuse. Education should be specifically oriented to improving ability to deal with early developmental problems that might lead to misuse. Third, American Indian rehabilitation programs need to be upgraded and improved by gaining more resources and by using them more effectively. Increased use of both traditional tribal strengths and modern treatment modalities is promising. Rehabilitation programs may be even more important in the future if mortality reduction programs such as those described are successful.