In 1989, the Robert Wood Johnson Foundation launched a program to fight substance abuse called Fighting Back®: Community Initiatives to Reduce Demand for Illegal Drugs and Alcohol. This chapter recounts the history of that program highlighting its strengths and weaknesses and the controversy that it sparked. Its goals were to reduce drug and alcohol use among children and adolescents; to reduce drug and alcohol-related deaths among youth; to reduce the number of health problems related to drug and alcohol abuse; to reduce work injuries resulting from substance abuse; and to reduce drug-related crime. Fighting Back focused on establishing community coalitions composed of a broad range of local citizens, agencies and other organizations. The issues surrounding Fighting Back, apart from being controversial, turned out to be complex, messy, and long-lived. The author describes the particular experiences of Worcester, Massachusetts and Vallejo, California. An evaluation of its success in 2003 reignited the controversy about the program and more profound underlying issues, such as, whether a public health approach to fighting substance abuse is appropriate. The program ended in mid-2003 after the Foundation had authorized a total of $88 million in grants.