Navigating abstinence-based perspectives in substance use care can be complex. Within Indigenous communities, these complexities also intersect with the impacts of colonialism. Abstinence-based perspectives may arise or align with Indigenous teachings, they may stem from imposed colonial values, or both may be true. It is important to recognize that there are a variety of explanations for why abstinence-based approaches may be promoted, and that these can offer a healing path for individuals when aligned with Indigenous worldviews.  In this episode of the Addiction Practice Pod, award-winning journalist David P. Ball and First Nation Health Authority’s Medical Officer of Mental Health and Wellness, Dr. Nolan Hop Wo, discuss potential benefits and harms from abstinence-based approaches to substance use care. We also hear from Keshia Cleaver, Harm Reduction and Program Advisor with The Four Directions Team at First Nations Health Authority, on why abstinence-based perspectives are common in some Indigenous communities, and how to meet communities where they are at with harm reduction. You can find additional resources and clinical pearls from the episode in the show notes: bit.ly/APP-S4E2 (http://bit.ly/APP-S4E2)Artwork by Brianna Bear (https://briannabearart.bigcartel.com/)