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In this study, we explored the approaches to identifying and addressing family\u2010based substance\u2010use problems that were implemented by nine home\u2010visiting programs serving American Indian\/Alaska Native (AI\/AN) communities that are funded through the federal Tribal Maternal, Infant, and Early Childhood Home Visiting Program (Tribal MIECHV). These programs demonstrated a high awareness of substance\u2010use problems and took concrete action to address them above and beyond that included in the home\u2010visiting model they used. All nine programs reported that they provided substance\u2010use preventive services and screened for substance\u2010use problems. While all programs referred to substance\u2010use treatment programs when needed, in six programs the home visitor provided substance\u2010use services. Through Tribal MIECHV, the intense need for substance\u2010use education, assessment, service delivery, and referral in many AI\/AN communities is pushing the home\u2010visiting field forward to address this increasingly critical issue for low\u2010income families across the United States and the world.<\/jats:p>","DOI":"10.1002\/imhj.21706","type":"journal-article","created":{"date-parts":[[2018,5,3]],"date-time":"2018-05-03T09:50:49Z","timestamp":1525341049000},"page":"287-294","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["ADDRESSING SUBSTANCE\u2010USE PROBLEMS IN TRIBAL HOME VISITING"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4475-8596","authenticated-orcid":false,"given":"Douglas K.","family":"Novins","sequence":"first","affiliation":[{"name":"University of Colorado  Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Ferron","sequence":"additional","affiliation":[{"name":"Ferron and Associates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Abramson","sequence":"additional","affiliation":[{"name":"Inter\u2010Tribal Council of Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5071-1877","authenticated-orcid":false,"given":"Allison","family":"Barlow","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,3]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"Administration for Children and Families. (2016a).Home visiting evidence of effectivenessRetrieved October 18 2017 fromhttp:\/\/homvee.acf.hhs.gov\/"},{"key":"e_1_2_5_3_1","unstructured":"Administration for Children and Families. (2016b).Tribal Maternal Infant and Early Childhood Home Visiting (Tribal MIECHV) Program 2016 performance measurement redesign. 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