Abstract Substance use disorders (SUDs) disproportionately affects Native Hawaiians, yet conventional treatments often overlook the cultural, spiritual, and relational foundations of well-being for Native Hawaiians. This gap represents a human services problem, as it perpetuates health disparities, limits recovery, and slows social change within Native Hawaiian communities. The purpose of this qualitative single case study was to identify culturally relevant components for an SUD treatment program tailored to Native Hawaiians. The research question guiding this study was, what are culturally appropriate components for a SUD program for Native Hawaiians. The Nā Pou Kihi framework grounded the exploration of Indigenous approaches to healing that may be integrated into treatment models. Case data were gathered through an interview with a cultural practitioner and secondary sources, then analyzed using thematic analysis. Findings revealed that effective treatment affirms cultural identity, restores reciprocal relationships with ʻāina, promotes accountability and reconciliation through practices such as Hoʻoponopono, and embeds spirituality as a foundation for recovery. Results suggest that culturally grounded programs foster intergenerational healing, cultural resurgence, and community-level social change. Recommendations include increasing funding for culturally based services, training providers in Native Hawaiian health frameworks, and strengthening partnerships between licensed professionals and cultural practitioners to advance equity and contribute to long-term social change
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