Work

Reframing Substance Misuse Prevention: a RE-AIM Analysis of Federal Infrastructure and Future Directions

Year: 2026

Type: article

Abstract: Substance misuse prevention is a significant component of public health policy in the USA. Currently, federal prevention efforts rely primarily on a coalition-based framework supported through four mechanisms: (1) the Substance Use Prevention, Treatment, and Recovery Block Grant, (2) the Drug-Free Communities Program, (3) the Partnerships for Success initiative, and (4) Community Anti-Drug Coalitions of America. Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, this article critically analyzes the performance of this system and considers scalable alternatives. Findings indicate that while coalitions mobilize local stakeholders, the model is resource-intensive, inconsistently implemented, and limited in its capacity to achieve sustained, population-level impact. Proposed alternatives include integrating prevention science into professional education, mandating EBPP delivery in universal settings such as schools, embedding routine screening and early intervention, creating a national repository of free prevention programs, and expanding the use of digital applications and wearable technologies. Implications include restructuring federal funding priorities, embedding prevention within existing infrastructures, and advancing research on cost-effectiveness, sustainability, and equity.

Source: Prevention Science

DOI: 10.1007/s11121-026-01920-4

Authors: Dane Minnick, Laura Curran, Khary K. Rigg

Institutions: University of South Florida Sarasota–Manatee, University of South Florida

Language: English

Topic: Substance Abuse Treatment and Outcomes

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Peace, justice, and strong institutions

Open Access status: hybrid

Estimated APC paid: $3,790