A few years ago the senior author of this chapter was invited to attend several evening meetings of American Indian parents, community leaders, and alcohol and other drug (AOD) use specialists held at a community center on a nearby reservation. The meetings were initiated in response to an alarming increase in AOD-related problems occurring among many of the community's youth. Over the course of these meetings, parents and community leaders offered many suggestions for dealing with the problems; these suggestions often led to lengthy and sometimes heated debates. As one can imagine, there was considerable anger expressed at those who provided AODs to young people and at the physical and psychological damage created by the youth while in their intoxicated states. For many residents, though, defining the problem and its solution was straightforward: the young people had a problem with their self-esteem, and AOD abuse would decline if they felt better about themselves. The belief that most youth, especially' those of ethnic minority background, engage in AOD use because of problems with their self esteem is a common one in many communities across the country including many American Indian communities.