Problem: Organizing the Community for Prevention

After 70 years, the public now recognizes infectious disease control as “belonging” to the local health department, water quality to the public works department, and blood supply to the Red Cross. Substance abuse prevention, in contrast, lacks a traditional organizational home in the community infrastructure. Instead, every community has been expected to create its own structure for drug abuse prevention with little or no guidance from historical experience, but with lots of advice on the need to be “participatory” or “stakeholder-driven.” Without an overall structure, however, substance abuse prevention is guaranteed to be wasteful and inefficient simply because so many groups are willing to independently finance and organize potentially competing prevention efforts.