Preventing Substance Misuse

Vibrant behavioral health is rooted in community conditions such as strong social connections, economic opportunity, hope, and control of destiny. Substance misuse is preventable. While traditional responses focus on downstream strategies that address immediate harm, upstream approaches reduce exposure to risk and address the trauma and inequities that heighten vulnerability. Importantly, upstream approaches directly complement and reinforce the goals of harm reduction, treatment, and long-term recovery.

Our approach reflects the full prevention continuum, considering both what must be prevented and what must be created in communities. We emphasize primary prevention—reducing drivers of misuse and building protective factors—while supporting more balanced investment across secondary, tertiary, and recovery strategies. We focus on countering stigma; engaging multisector partners; and weaving multiple forms of evidence, including contextual and experiential evidence. These principles guide the tools, trainings, and technical assistance we provide to help practitioners, advocates, and policymakers better understand and implement upstream prevention strategies.

Our work contributes to stronger protective environments, reduced exposure to the drivers of substance misuse, and more coordinated and sustained primary prevention efforts. We help shift practice and investment toward upstream prevention and support communities in implementing comprehensive prevention strategies that reinforce treatment and long-term recovery.