While the rates are much higher than those found among other American youth and while American Indian youth often start using drugs earlier than other youth, they do not constitute a special deviant group. They are much like other youth, but are probably more susceptible to drug use because of poverty; prejudice; and the lack of economic, educational, and social opportunities. American Indian culture does not encourage drug use; in fact, younger American Indians who are bicultural are less likely to be involved with drugs. Although many authors have seen the high drug use rates of Native American youth as a result of acculturation stress, data show that emotional distress, whether caused by acculturation stress or not, is not particularly related to drug involvement. Rather, drug involvement is primarily a function of peer clusters. Underlying problems such as poor family conditions and school adjustment difficulties tend to increase the chance that a Native American child will make friends with other youth who also have problems. Antidrug publicity and general social change have reduced drug use among the most susceptible youth, but other youth with a higher potential for deviance have not reduced their drug use. Prevention programs and treatment facilities for American Indian youth are needed that encourage the family, school, and community to work together. 133 references, 4 figures.