In this place, there are no alcoholics, only people who may or may not choose to drink on any given day. There is no such thing as a pattern of addiction because the past and the future are alien concepts that don't apply here. In this place, there is no group therapy, only "talking circles"; there are no doctors or patients, only medicine men and women and their relatives, connected to each other by blood, clan, or spirit.

This place is the Na'nizhoozhi Center, Inc., in Gallup, New Mexico. It is one of the most successful treatment centers for people who, in conventional medical parlance, are substance abusers. Yet it relies little on conventional medicine. It is the largest alcohol addiction treatment center in the United States, since 1992 having served more than a quarter million people, most of whom are Hopi, Zuni, or Navajo.

NCI has been a laboratory of sorts for an alternative approach to treating alcohol abuse, emphasizing the spiritual dimension of healing embedded in Native American practices and teachings. All counselors at the center are traditional medicine men or women who have undergone rigorous traditional training since they were children or young adults.

They facilitate healing using a combination of sweat lodge ceremonies, prayers and blessings, herbal medicines, talking circles, drumming, singing, dancing, and extended periods of sitting, fasting, or physical exertion. They do not psychologize, philosophize, or pathologize, says psychologist Kevin Foley, Ph.D., director of clinical services.

"Focusing on the root of the problem is not a Native way to address healing," he explains. "Their cultural approach is to work on resiliency factors rather than uproot the problem. Native Americans are present-time-oriented and work toward healing by being who they are today rather than digging up the past and reliving the pain and emoting and catharsis. It's not good to reopen wounds unless they are right at the surface. Then we talk about it, but also work to move on. Mindfulness about life is really getting up in the morning and saying prayers to the sun, the wind, the animals, and the birds, and staying present to that which is really healing."

Of course, there is the matter of life's pain, loss, loneliness, and frustration, all of which trigger the urge to drink in the first place. Counselors work with relatives to identify those triggers so that they recognize when it is time to sing a song, not go out and get a drink. Counselors also provide teachings on how to contend with these challenges through traditional story and legend that "come from the heart, not something like Greek mythology," explains Lawrence Largo, a counselor at the center who has been a medicine man for 21 years. Teachings are designed to help people align themselves with their traditions, their clans, and their family responsibilities.

"We build up the trust," Largo explains. "We teach: Trust yourself, trust what your spirit is trying to say to your inner being, trust the purpose the great spirit has given you to fulll here. You are the one who can work for you; it is you who need to feed that inner spirit. We might first give vomiting medicine [herbs in the sweat lodge] to get out the rottenness and decay and then we help them concentrate and open up and talk about ... the isolation, frustration, depression, whatever they never talked about. But then we tell them, 'Now you leave it here, you don't talk about it again, and from here you are reborn from mother earth and her natural elements.'"

Outside the lodge, Largo says, relatives are taken through a cedar- or tobacco-burning ceremony and given prayers to help them ward off the urge at moments of weakness or difficulty.

The backdrop for these teachings is Gallup, one of the poorest cities in America, with an unemployment rate over 70 percent. Not long ago, it was also one of the drunkest -- in the eighties, the alcohol-related mortality rate was 19 times the national average. But Gallup has seen its intoxication, injury, and death rates fall dramatically since NCI opened its doors in 1992. Clearly, the center is doing something right. Some 60 percent of its clients stay dry after treatment, a rate far above the national average. Is that because the center treats addiction with a spiritual cure?

"Western society calls it addiction. We don't," says Foley. "It may be a result of circumstance and life choice that a person lives his whole life drinking. But we have hope and faith that someday -- any day, today, tomorrow -- a person who has been drinking for 39 years can stop. We have more faith here in the potential of humans. We have faith in humanity."

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