The purpose of this study was to examine the demographic and clinical characteristics among American Indian (AI) patients and other patients with Psychoactive Substance Use Disorders (PSUD). The study was conducted at a university-based, alcohol-drug program in the Upper Midwest. One hundred AI patients presenting sequentially with PSUD were contrasted with 200 other patients (selected at random from 620 patients) presenting at the same clinical facility during the same period with PSUD. Data included demographic characteristics, current DSM-III-R PSUD diagnoses, previous treatment for PSUD, and family history of PSUD. Findings indicated several special aspects of PSUD among AI patients, which have implications for program planning and treatment evaluation.