Although alcohol, tobacco and other drug abuse problems are of national importance, the effects are felt most keenly at the local level, where substance abuse damages individuals, families, neighborhoods and whole communities. As American cities struggle to reduce substance abuse and ameliorate its related harms — from child abuse and neglect to transmission of HIV/AIDS — new research confirming the local nature of drug use trends and a prevailing philosophy of government that favors locally-devised approaches are increasingly putting city leaders and their drug control policies in the spotlight. During the 1990s, data collected by the National Institute of Justice (NIJ) on drug use among arrestees in numerous cities across the country revealed sharp differences by location and over time.(1) Effective local responses to drugs, NIJ concludes, must be informed by a clearer appreciation of the circumstances of each region, state, county and city in the country. The importance of tracking local trends is already shaping major research efforts, including the National Household Survey on Drug Abuse, whose 1999 results will include state-by-state estimates for the first time.(2)

At the same time, leaders of diverse cities are identifying some common themes and challenges that they face in confronting drug abuse. At its annual conference in June 1999, the U.S. Conference of Mayors adopted resolutions calling for full funding of AIDS-related medical care; full parity for substance abuse treatment services under health insurance plans; earmarking treatment funds to expand city programs; providing adequate drug treatment in state prisons; and establishing effective drug courts. The Conference of Mayors is also calling for the establishment of State Substance Abuse Prevention and Treatment Planning Councils that would give city leaders a seat at the table in coordinating state substance abuse services.(3)

In recent years, private and public groups have developed fundamental tools for studying drug-related data at the local level, including seminal guides by the Brandeis University Institute for Health Policy and Join Together and by the National Institute on Drug Abuse (NIDA).(4) These documents have simplified efforts to study alcohol, tobacco and other drug indicators at the local level, capturing the complexity of the problems by incorporating data from a wide range of disciplines.

Since 1995, Drug Strategies has published "profiles" of alcohol, tobacco and other drug problems in seven states and three cities. These studies provide an independent assessment of the nature and extent of substance abuse and the effectiveness of local responses, pointing out relevant trends in drug use, crime, cost to society, health policy and health status. The profiles have broken new ground in agency collaboration, produced important policy recommendations and received significant media attention.

Lessons from the Field: Profiling City Alcohol, Tobacco and Other Drug Problems is a step-by-step guide based on Drug Strategies' own experience. This project was made possible by a grant from the Robert Wood Johnson Foundation. In preparing Lessons from the Field, Drug Strategies consulted numerous experts, and a draft of the report was reviewed by the distinguished individuals listed on the inside back cover. While we are grateful for their insight and wisdom, Drug Strategies is solely responsible for the content of this report.

2. Tom Virag. "National Household Survey on Drug Abuse to Increase Fivefold in 1999." Hypotenuse. October 1998. Vol. 35, No. 7: 6-7.

3. The U.S. Conference of Mayors (USCM) adopted its drug policy resolutions at its 67th Annual Conference, June 1999, in New Orleans. The USCM is the official nonpartisan organization of cities with populations of 30,000 or more. There are about 1,100 such cities in the country today. Each city is represented in the Conference by its mayor.

4. Assessing Drug Abuse Within and Across Communities: Community Epidemiology Surveillance Networks on Drug Abuse. Rockville, MD: National Institute on Drug Abuse (NIDA), 1998.

Beyond Anecdote: Using Local Indicators to Guide Your Community Strategy to Reduce Substance Abuse. Boston, MA: Join Together, 1999.

Data Collections on Key Indicators for Policy: Alcohol, Illicit Drugs, and Tobacco. Waltham, MA: Brandeis University Institute for Health Policy, 1995.

How Do We Know We Are Making A Difference? A Community Substance Abuse Indicators Handbook. Boston, MA: Join Together and the Brandeis University Institute for Health Policy, 1995.