The 2022 National Drug Control Strategy from the White House Office of National Drug Control Policy (ONDCP) outlines a broad plan to improve access to treatment, expand harm reduction efforts, and increase the use of evidence-based prevention programs at the community level. It also provides a framework to enhance national data systems for better policy-making and evaluation of the plan’s effectiveness. However, the strategy lacks several key elements necessary for its full success, including a structure for a comprehensive national service delivery system. This structure should be informed by epidemiological data and should include training and credentialing for professionals delivering prevention, treatment, and harm reduction services.

This paper proposes recommendations to build such a framework, focusing on prevention efforts. Addressing risk factors among vulnerable populations and creating supportive environments have consistently proven effective in diverting individuals from substance use disorders (SUDs). Investing in these prevention strategies could significantly reduce SUD rates in current and future generations of youth, thereby easing the burden on healthcare and social systems. The proposed national strategy is grounded in scientific evidence and seeks to implement public health policies that foster child development, strengthen families, enhance educational experiences, and create positive environmental conditions.

In addition to laying out a framework for treatment and harm reduction strategies, the National Drug Control Strategy emphasizes the importance of community-level implementation of evidence-based prevention programs. The goal is to foster healthier outcomes for at-risk populations, particularly youth, by addressing conditions that lead to substance use and providing supportive interventions. However, one of the critical gaps in the current strategy is the absence of a fully integrated, national service delivery system that is informed by real-time epidemiological data. This type of structure would allow for more targeted and effective interventions in preventing substance use disorders (SUD).

Furthermore, the current strategy does not adequately account for the need to credential and train community service providers in the delivery of evidence-based prevention, treatment, and harm reduction services. Building a trained workforce is essential to ensuring that the programs are delivered effectively and consistently across diverse communities. Without a structured, standardized system, there is a risk that the implementation of these programs could be inconsistent, leading to varied outcomes.

The paper also stresses the importance of creating environments that support the healthy development of youth, both in their homes and communities. By addressing factors such as family support, educational opportunities, and positive environmental conditions, prevention programs can divert youth away from high-risk behaviors, including substance use. Investment in these approaches is expected to yield long-term benefits, reducing the social and healthcare costs associated with SUD, and promoting greater well-being in future generations.

Lastly, the need for a strong, evidence-based national strategy is critical to ensure that all policies and prevention services are grounded in scientific research. This includes public health policies that target the root causes of substance use and focus on upstream interventions, such as early childhood development and family support programs.