The substance abuse prevention field is at a crossroads. In this time of healthcare reform, the opportunity exists to combat substance abuse and related harms with concerted, community-based and comprehensive efforts to change norms, behaviors, systems and contexts that contribute to substance abuse problems in our communities. The purpose of this paper is to discuss how a truly comprehensive response to substance use and abuse in our country can be implemented. Specifically, this response includes BOTH environmental/policy efforts and individually-focused prevention efforts in order to reduce substance abuse population-wide. Furthermore, it is critical to recognize the invaluable role local, community-based coalitions play in implementing a comprehensive array of evidence-based strategies to reduce underage drinking, tobacco use and illicit drug use. Coalitions have had great success at choosing and implementing the right combination of strategies to address local conditions contributing to substance use and abuse in their communities. Continued efforts are needed to support the role coalitions play in creating safe, healthy and drug-free communities.

This paper was developed to be responsive to the coalition field. It provides evidence to support their use of environmental strategies to address substance abuse in their communities. Environmental strategies are used to change the context (environment) in which substance use and abuse occur. Environmental strategies incorporate efforts aimed at changing or influencing community conditions, standards, institutions, structures, systems and policies (Babor, 2003). This paper was written to help coalitions understand how environmental strategies are critical elements of a comprehensive plan to reduce substance use and abuse. As such, the paper provides an overview of the research on the effectiveness of a variety of environmentally focused-strategies to reduce underage drinking, tobacco use and drug use. These strategies are especially effective at reducing access and availability of substances for youth and young adults and mitigate the damage caused to the community. Environmental strategies also are critically important to support individually and family-focused interventions. It is up to the coalition to pick the right combination of individual, family and community-level interventions to reduce substance abuse in their community.