The study used data from the Voices of Indian Teens and Monitoring the Future projects. Lifetime substance use among AI youth was significantly higher than for non-AI youth for only marijuana and cocaine; non-AI youth had significantly higher use rates of inhalants and cigarettes. AI youth were significantly higher than non-AI youth for the 30-day use of marijuana, cocaine, stimulants, alcohol, and barbiturates. However, analysis of the geographic regions revealed different patterns of substance abuse, with AI youth significantly higher on more lifetime substance abuse items in one region and non-AI youth significantly higher in another. AI youth were significantly higher on only three substances when region was controlled. In summary, AI teens’ substance use was often not very different from that of non-AI teens. The highest rates of involvement appeared to occur in places where racial or ethnic minorities lived in circumscribed, impoverished areas such as ghettos, barrios and AI reservations. Research that explores socioeconomic status, stress and access to substances are logical next steps. Tables, note, appendix, references