For the past half century, Alcoholics Anonymous and its 12-step recovery program has been the dominant method for treating alcohol abuse in the United States. Reservation communities have been no exception. Erica Prussing describes in her research White Man’s Water: The Politics of Sobriety in a Native American Community (University of Arizona Press, 2011), a one-size-fits-all approach to treatment does not, in fact, fit all. We discuss how communities try to make sense of the changes that have been forced upon them and the differening choices made by different generations. There is also a sexual difference in the way alcohol is used and the repercussions it has on people, families and the meaning behind who controls sex and the implication that drinking has upon social norms within a nation. Prussing lived for three years on the Northern Cheyenne Reservation in Montana, working with community organizations, building long-lasting relationships, and gathering testimonies of alcohol’s often disruptive impacts on the lives of many Northern Cheyenne. While many young women have embraced the 12-step program, others – particularly of the older generation – find its moral assumptions foreign and unhelpful. What emerges from Prussing’s account is not a reductive and totalizing “Cheyenne culture” but rather a complex negotiation of tradition, community, and recovery in the face of persistent colonial challenges. This nuance and attention to detail makes Prussing’s call for indigenous self-determination in health care all the more powerful. Erica Prussing is a medical and psychological anthropologist with special interests in the cultural politics that surround health and health care for indigenous peoples. She is currently Associate Professor of Anthropology and Community & Behavioral Health, and serving as Academic Coordinator for the American Indian & Native Studies Program, at the University of Iowa. She earned a Ph.D. in anthropology from the University of California at San Diego in 1999, and an M.P.H. specializing in epidemiology from the University of California at Berkeley in 2000. She completed postdoctoral training in mental health services and health outcomes research at Children’s Hospital and Health Center in San Diego. Her recent publications about sobriety on the Northern Cheyenne Reservation appear in journals such as Ethos, Culture, Medicine and Psychiatry, and Alcoholism Treatment Quarterly, as well as in the monograph White Man’s Water: The Politics of Sobriety in a Native American Community (published in the First Peoples: New Directions in Indigenous Studies series at University of Arizona Press, 2011). Her current research examines how anthropology can shed critical light on the concepts and reasoning used in epidemiology, and provides an international comparison of how indigenous peoples are increasingly using community-based epidemiological research to achieve greater local control over how their health needs are defined and addressed.