This article addresses issues of chemical dependency treatment of individuals who are deaf or hard of hearing and reports on specialized treatment approaches developed by the Minnesota Chemical Dependency Program for Deaf and Hard of Hearing Individuals. This population faces special barriers to treatment and recovery including lack of recognition of a problem within the community; confidentiality issues; lack of substance abuse resources for deaf/hard of hearing people; enabling on the part of family, friends and professionals; funding concerns; and lack of support for ongoing recovery. Issues related to communication affect deaf and hard of hearing persons along the substance abuse services continuum. The Minnesota program's specialized treatment approaches are designed to accommodate the communication and cultural needs of clients. Based on the Twelve Steps of Alcoholics Anonymous, the program features the use of drawing, role play, education, and American Sign Language and other appropriate communication systems. Discussion examines the program's treatment philosophy, purpose statements, and expected outcomes. Also covered are behavior management philosophy and techniques, aftercare considerations, and information about treating mentally ill clients who are chemically dependent. Appendices provide sample client assignments. (Contains 13 references.) (DB)