For some topics, particularly in public health, summaries are dangerous because they may create the idea that a single or simple solution exists. This topic is one where a summary can create a false expectation of simplicity. There is no simple or easy solution to the problem of alcohol abuse in any community, especially reservation and bordertown communities in the western United States. The solution is complex, it must be comprehensive, and it will take a great deal of effort over time to reduce alcohol and substance abuse in any individual community. Indian communities must develop a comprehensive, consistent, and clearly defined alcohol preventionfintervention policy. Such a policy must utilize a systematic, public health approach that considers the physical, mental, and social well being of each and every individual within the region. It must address all types of problematic alcohol consumption, from sporadic alcohol consumption (light and heavy) to regular alcohol abuse and chronic alcoholism, for the problems found in Indian and bordertown communities arise from a variety of different drinking patterns. Presented in this paper are a large number of policy and prevention options that have been used successfully in human societies in various parts of the world and in the United States The intent of the paper is to present and describe the variety of options for addressing alcohol problems that have been found to be of value in the control and reduction of alcohol abuse and related problems. The three broad categories of approach are: controlling the supply of alcoholic beverages through statute and regulation; shaping drinking practices directly; and reducing the physical and social environmental risks. Indian tribal councils and Native communities can, if they so desire, consider, debate, and enact any or all of these measures The important issue is that they should be aware of these ideas for prevention and consider them carefully. If the preventive measures described here can be applied systematically and reasonably within the social and culturalALCOHOL POLICY CONSIDERATIONS 7 health consequences could probably be de-emphasized on many reservations.The answer to this dilemma for health educators and public health officials may lie in point two. Health education and public attention might focus directly on the many options of public policy and prevention techniques that have been debated, implemented, and evaluated elsewhere in the nation and world. Thus, the whole focus of health education among tribal populations and tribal leaders could be expanded and redirected. Health education on what is possible would make for a more positive and proactive focus.Before any major redirection of debate and policy considerations will be possible or is likely to be productive, the other two points or issues must also be considered. Point three mentioned above is an erroneous statement. A number of studies have shown that Indian males metabolize alcohol as rapidty, or more rapidly, than non-Indians of various ethnic and...