One of the greatest health issues facing the American Indians (AI) and Alaskan Natives (AN) is substance abuse with alcohol being the most abused (Marlatt, 2004). The nature/outlook of substance use and misuse among them is diverse due to the diversity of Native community. Native Americans consist of American Indians, Alaskan natives, and other Smaller Native races that forms a population of about 4.1 million people that speak more than 200 different tribal languages and live within 35 states (Marlatt, 2004). The American Indians and the Alaskan natives alone are about 2.5 million people (about 0.8% of U.S.). Currently, 63% of Native Americans live in urban areas whereas 22% reside in Federal reserved tribal land (Marlatt, 2004).