Build awareness of substance use as a public health problem.

Civic and advocacy groups, neighborhood associations, and community-based organizations can all play a major role in communication, education, and advocacy efforts that seek to address substance use-related health issues. These organizations provide community leadership and communicate urgent and emerging issues to specific audiences and constituencies. Communication vehicles such as newsletters, blogs, op-ed articles, and storytelling can be used to raise awareness and underscore the importance of placing substance use-related health issues in a public health framework. Community groups and organizations can host community forums, town hall meetings, listening sessions, and education and awareness days. These events foster public discourse, create venues in which diverse voices can be heard, and provide opportunities to educate the community. In addition, they can promote an awareness of the medical nature of addiction, to encourage acceptance of opioid treatment programs and other substance use disorder treatment services embedded in the community. Communities also can sponsor prevention and recovery campaigns, health fairs, marches, and rallies that emphasize wellness activities that bring attention to substance use-related health issues.

Invest in evidence-based prevention interventions and recovery supports.

Prevention research has developed effective community-based prevention programs that reduce substance use and delinquent behavior among youth. Although the process of getting these programs implemented in communities has been slow, resources are available to help individual communities identify the risk factors for future substance use among youth that are most prevalent within their community and choose evidence-based prevention strategies to address them. Research shows that for each dollar invested in research-based prevention programs, up to $10 is saved in treatment for alcohol or other substance misuse-related costs.22-25

Implement interventions to reduce harms associated with alcohol and drug misuse.

An essential part of a comprehensive public health approach to addressing substance misuse is wider use of strategies to reduce individual and societal harms, such as overdoses, motor vehicle crashes, and the spread of infectious diseases. Communities across the country are implementing programs to distribute naloxone to first responders, opioid users, and potential bystanders, preventing thousands of deaths.26 Others have implemented needle/syringe exchange programs, successfully reducing the spread of HIV and Hepatitis C without seeing an increase in injection drug use. These and other evidence-based strategies can have a profound impact on the overall health and well-being of the community.


22. Hawkins, J. D., Catalano, R. F., Kosterman, R., Abbott, R., & Hill, K. G. (1999). Preventing adolescent health-risk behaviors by strengthening protection during childhood. Archives of Pediatrics and Adolescent Medicine, 153(3), 226-234.

23. Spoth, R. L., Redmond, C., Trudeau, L., & Shin, C. (2002). Longitudinal substance initiation outcomes for a universal preventive intervention combining family and school programs. Psychology of Addictive Behaviors, 16(2), 129-134.

24. Aos, S., Phipps, P., Barnoski, R., & Lieb, R. (2001). The comparative costs and benefits of programs to reduce crime. Version 4.0. Olympia, WA: Washington State Institute for Public Policy.

25. Pentz, M. A. (1998). Costs, benefits, and cost-effectiveness of comprehensive drug abuse prevention. In W. J. Bukoski & R. I. Evans (Eds.), Cost-benefit/cost-effectiveness research of drug abuse prevention: Implications for programming and policy. NIDA Research Monograph No. 176. (pp. 111-129). Washington, DC: U.S. Government Printing Office.

26. Wheeler, E., Davidson, P. J., Jones, T. S., & Irwin, K. S. (2012). Community-based opioid overdose prevention programs providing naloxone—United States, 2010. MMWR, 61(6), 101-105.