Highlighting the Power of Prevention Coalitions to Reduce Youth Substance Use

September 23, 2026 | ASTHO Staff

Youth substance use prevention is both an immediate public health priority and a long-term investment in future generations. Early substance use can have long-term consequences, including higher risk of substance use disorder, poorer educational and economic outcomes, and other health and social problems in adulthood. Although youth substance use has declined over the last two decades, primary prevention efforts remain necessary to protect the health of young people.

The Drug-Free Communities (DFC) support program is the nation’s leading effort to prevent and reduce youth substance use. Funded and administered by the Office of National Drug Control Policy (ONDCP), the DFC program supports hundreds of community-based coalitions across the United States. In 2024, one in five Americans (19%) lived in a community with a DFC-funded coalition, with prevention efforts tailored to a wide range of geographic settings and demographics. DFC coalitions demonstrate the impact of:

• Community-driven partnerships that facilitate the implementation of evidence-based primary prevention strategies.
• Youth engagement.
• Sustainable, long-term, and adaptable infrastructure.

Recently, ASTHO worked closely with CDC and ONDCP to publish 13 manuscripts as a special supplement to the Journal of Public Health Management and Practice. The supplement outlines the impact of DFC coalitions and the strategies they implement to help reduce youth substance use.

Early Insights

The supplement features commentaries and editorials from leaders in this field, including:

• ONDCP Director Sara Carter: “Prevention on Offense: How the Drug-Free Communities Program Drives National Strategy to Solidify a Drug-Free America”
• Tennessee’s STAND Coalition Leader and newly hired ONDCP Assistant Deputy Director of Use & Prevention Grants Trent Coffey: “Building Generational Impact—What 30 Years of DFC Teaches Us About Sustainable Prevention”
• CDC’s DFC Branch Chief Karen Voetsch: “Built to Adapt—Cross-Sector Coalitions Still Driving Youth Substance Use Prevention through the Drug-Free Communities Program”
• Guest Editor and Researcher Dr. Sarah Stoddard: “Beyond Just Saying No: What the Evidence Tells Us About Substance Use Prevention”

External Evaluation

The external evaluators of the DFC program, ICF, reviewed 20 years of process and outcome data in their article, “Community-Based Prevention: Findings From Nearly 3 Decades of the Drug-Free Communities Support Program.” Their evaluation found:

• DFC has national reach: From 2021-2025, more than 1,000 Drug-Free Communities coalitions worked across the United States to support community-led youth substance use prevention.
• School partnerships are widespread: Nearly all coalitions reported partnerships with at least one school, while most collaborated with multiple schools in their communities.
• Youth are engaged: A majority of coalitions had youth representation, and nearly 70% of coalitions reported hosting a youth advisory group.
• Data show a decline: DFC coalition-reported longitudinal data show that youth past 30-day substance use declined over time across DFC-supported communities, while coalitions maintained strong multisector partnerships, school connections, youth engagement, and a focus on protective factors such as connectedness and healthy community norms.

DFC Coalition Reflections

DFC coalitions are the backbone of effective youth substance use prevention, driven by cross-sector partnerships among schools, youth, public health, health care, public safety, parents, and community or faith-based organizations. This special supplement showcases how coalition infrastructure creates lasting community capacity — not just short-term projects. The supplement contains the following articles about coalitions’ experiences and impact through DFC funding:

• “Developing Community Partnerships and Authentically Engaging Youth to Prevent Substance Use: Successes From the Pyramid Coalition in Hidalgo County, New Mexico”
• “Building a Rural, Coalition-Based Approach to Youth Substance Use Prevention: The Drug Free Dickson Coalition Model” (Tennessee)
• “Nearly Two Decades of Sustaining a Coalition to Prevent Youth Substance Use: Reflections from the Genesee County Prevention Coalition, Michigan”
• “Strengthening Rural Prevention Through Collaborative Partnerships, Funding Diversification, and Youth Engagement” (North Carolina)

Expert Highlights

Additionally, key researchers and practitioners highlight the evidence and impact of strategies being implemented by coalitions. These articles also showcase key examples and contributions from coalitions across the country.

Prevention Works — and the Evidence Continues to Grow

In the article “From Evidence to Action: Implementing Evidence-Based Interventions for Youth Substance Use Prevention through Drug-Free Communities and CDC’s ENGAGE Framework,” researchers and coalitions describe successfully translating research into practice through evidence-based interventions, many of which are featured in CDC's ENGAGE resource. Coalitions tailor primary prevention strategies to their unique needs while leveraging federal support and the evidence base (hence the tagline, “Local Problems Require Local Solutions”).

Youth Are Leaders, Not Just Beneficiaries

Youth engagement is a defining feature of successful coalitions. The article “Not Just a Strategy, but the Heartbeat of our Work. The Importance of Youth Engagement in Drug-Free Communities Coalitions” includes examples from coalitions across rural, tribal, and urban communities where young people strengthen prevention efforts through peer leadership, community outreach, and shaping positive social norms.

Sustainable Prevention Requires Strong Community Infrastructure

Long-term success depends on building organizations, partnerships, and leadership that persist beyond individual grants. The article “A Prescription for Program Sustainability: The Drug-Free Community Sustainability Model in Practice” emphasizes sustainability through diversified funding, capacity building, and institutional partnerships. A strong coalition infrastructure enables communities to adapt to emerging drug threats while maintaining trusted local relationships. As part of this article, examples from both rural and frontier communities demonstrate that effective prevention can be achieved regardless of geography when local capacity is strengthened.

Prevention Must Be Responsive to Emerging Challenges

The landscape of substances available to youth continues to evolve, requiring prevention systems that are agile and informed by community-specific data to drive community-led approaches. In the article “Coalitions as Prevention Infrastructure for Youth Substance Use: Coordinated, Local Relevance, and Sustainability,” contributing coalitions share how they are adapting to changing substance use patterns by using local data and cross-sector collaboration, rather than one-size-fits-all solutions.