“Factors Associated with Remission From Alcohol Dependence in an American Indian Community Group,” by Gilder et al. (1) is a well designed and carefully implemented study that provides valuable new information for American Indian communities but also for society at large. Perhaps the most salient finding is the relatively high rate of 6-month remission: 59% in an ethnic group whose remission rates 25 years ago ranged from 0% to 21% (2–4). Another study recently revealed a 41% 1-year full remission in 199 American Indian people with substance use disorder, confirming the salutary finding of Gilder and coworkers (1).
What has occurred over the last few decades in Native American communities to permit such a dramatic change? One factor lies in leadership: many tribal leaders have identified substance abuse as a major social and health problem (5). The fact that Gilder and coworkers could carry out such a study in Indian communities today bespeaks this critical political change. Second, many American Indian professionals and researchers have devoted their efforts to eliminating substance abuse from American Indian lives and communities (6, 7).
This fifth principle, by affirming the inextricable link between personal health and community health, calls upon the addiction treatment agency and the addiction counselor to become actively involved in the communities within which their clients reside or to which they identify.
This person-community link is being conveyed to Native communities across the country within the cultural model of the Healing Forest. When a sick tree is removed from diseased soil, treated, and returned and replanted in the same diseased soil, it gets sick again. What is called for instead is a healing of the tree AND the replacement of diseased elements in the soil with nurturing elements (Red Road to Wellbriety, in press). Personal recovery flourishes best in a climate of family health, cultural vitality, political sovereignty, and economic security. What White Bison and other Native recovery advocacy organizations are trying to do is mobilize all segments of Native communities – the tribal councils, schools, churches, service programs, and political and cultural organizations – to forge and then actualize a healing vision for the community. The goal is to create a Healing Forest that creates a synergy between personal and community wellness. Such a synergy is reflected in the words of Andy Chelsea, who as the Shuswap tribal chief at Alkali Lake, declared, “The community is the treatment center” (Abbott, 1998).