This guide introduces concerns and problems resulting from the use and abuse of alcohol and drugs among American Indian youth and addresses intergenerational substance abuse effects. Alcohol abuse among American Indians and Alaska Natives is the most visible effect of their cultural disruption and disorganization. Alcoholism among Native Americans has reached epidemic proportions, and death rates associated with alcohol have tripled since the 1960s. While the Indian Health Service provides services to reservation American Indians, delivery of health care and prevention services for urban Indians and Alaska Natives is more problematic. At least eight theories attempt to explain Indian drinking behavior. Alcohol education must recognize that (1) most of the adult American Indian population was raised in alcoholic settings, and (2) this population exhibits the characteristic behaviors of adult children of alcoholics (ACOAs). Therapy for ACOAs includes the resolution of delayed grief. Alcohol abuse prevention strategies for Indian youth should involve factual information, exercises aimed at changing attitudes, training in problem-solving skills and interpersonal communication skills, and positive social networks. This guide contains questions for discussion, tables of death rates by age and cause, lists of characteristics and needs of Native American at-risk students, hints for helping at-risk students, a summary of Washington laws concerning drug and alcohol use by minors, a bibliography of 20 related documents in the ERIC database, and directories of domestic violence services and alcoholism treatment services in Washington and the Portland area. (SV)