The excessive use of drugs, including alcohol, heroin, cocaine, and prescription drugs, wrecks lives, families, and communities. Excessive use decreases quality of life and increases the likelihood of injury and death from domestic abuse, risky sexual behavior (HIV/AIDS, hepatitis), organ damage, cancers, neurological defects, car crashes, and a host of other threats. Due to crime, lost productivity at work, and increased health care, drugs (when including alcohol and tobacco) cost the United States $700 billion dollars a year (National Institute on Drug Abuse [NIDA], n.d.).This chapter focuses on a community psychology approach to substance use and misuse. The chapter addresses the potential of innovative, communitybased treatment and prevention approaches to counter the multiplicatively harmful effects of decades of drug war policy in the United States. The chapter attempts to recognize that these challenges are part of complex, contextual systems, across the individual lifespan, challenges that impact (and are impacted by) other individuals, families, communities, and society. Although tobacco is an addictive and dangerous substance, this chapter focuses on the misuse of alcohol, prescription pills, and the illicit drugs that affect approximately 24.6 million (or 9.4%) people in the United States (Substance Abuse and Mental Health Services Administration [SAMHSA], 2013). Because of the more specific and sometimes stigmatizing nature of clinical diagnoses, including abuse and dependence, we focus, almost exclusively on the terms, and distinctions between, use and misuse. Misuse goes beyond mere use, emphasizing the We thank Christopher B. Keys, Meg A. Bond, Keith Humphreys, and Deanne Chung for help in editing this chapter.