The Fighting Back® program started by the Robert Wood Johnson Foundation (RWJF) in 1988, was a $87.9 million national program to assist communities of 100,000 to 250,000 people to implement a variety of anti-drug strategies. It ran until the fall of 2003.

Fighting Back addressed drug problems through a community-wide approach, involving business, health care, the public school system, local government and its agencies, the police, community groups, local media, and the clergy.

It was initially managed by a national program office at Vanderbilt University (1988–1998); then RWJF moved the national program office to Join Together at Boston University School of Public Health.

Key Results

• More than 330 communities responded to RWJF's first call for proposals in 1989.
• The large number of communities competing for Fighting Back funding persuaded the Office of National Drug Control Policy (ONDCP) to employ the Fighting Back model in an expanded, federally sponsored, national initiative called the Community Partnership Demonstration Grant (CPDG) program. In 1990 and 1991, the federal Center for Substance Abuse Prevention (CSAP) funded 251 partnerships from a total budget of $375 million.
  • RWJF initially funded 15 communities in 11 states: Little Rock, Ark.; San Jose, Calif. (which received only planning funds); Santa Barbara, Calif.; Vallejo, Calif.; Oakland, Calif.; New Haven, Conn.; Worcester, Mass.; Kansas City, Mo.; Newark, N.J.; Northwest New Mexico; Charlotte, N.C.; Columbia, S.C.; San Antonio, Texas; Washington, D.C.; and Milwaukee, Wis.
  • In a later round of funding, RWJF funded seven of these sites to continue: Little Rock, Ark.; Santa Barbara, Calif.; Vallejo, Calif.; New Haven, Conn.; Washington, D.C.; Kansas City, Mo.; and San Antonio, Texas.
  • The initiatives mounted by the program sites fell into three broad categories:
    
    1. Environmental Strategies, which include local efforts designed to affect the physical and social environments that promote alcohol and drug use.
    2. Individual Strategies, which include local efforts designed to strengthen individuals (both users and non-users) to resist and recover from alcohol and drug use.
    3. Supply, Cost, and Availability Strategies, which include local efforts (primarily, public policy efforts) designed to affect the availability, accessibility, and costs associated with alcohol and drug use.
    
    The largest number of initiatives was environmental in nature, almost half addressed social or physical environments that promote or sustain alcohol and drug use. Only about a third attempted to strengthen individuals to resist alcohol and drug use; only one in five targeted the supply, cost, or availability of alcohol and other drugs.
  
  
• The evaluation by Brandeis University has shown that a sustained, 10-year community-based coalition approach with ample technical assistance and direction, top-notch people, and sites that were pre-selected, did not produce robust results in terms of decreasing substance abuse. One conclusion is that community coalitions alone are not a sufficient solution to the substance abuse problem.
• Fighting Back did demonstrate some results and lessons:
  • Its effective coalition-building.
  • The community residents' greater awareness of treatment, shown across sites.
    
    This result led Fighting Back's national program director, David Rosenbloom of Join Together, to conclude that helping communities develop more substance abuse treatment slots should be the main emphasis of substance RWJF's abuse efforts going forward. As a result, RWJF has funded a new Join Together initiative to help communities in this regard (ID# 037337).
• Another part of the Fighting Back story that the evaluation uncovered is that the substance abuse problems in these inner-city sites turned out not to be dramatically worse than they were in the suburbs. Illegal drug supply is high in these kinds of neighborhoods, but much of the demand is coming from outside.
  
  This is an important insight of the program and has been applied in other more recent RWJF initiatives, such as the Urban Health Initiative, where the program attempts to work with a broader range of communities.
• The bottom line, according to Jim Knickman, then vice president of Research and Evaluation at RWJF, is that the results indicate that the Fighting Back approach does not offer a solution to the substance abuse problem.
  
  It may offer hope that something can be done through coalitions, but what the social science field and the substance abuse field want to know is: Is this a national strategy to tackle substance abuse?
  
  The indicators of substance abuse across the sites have not decreased sufficiently for RWJF to be able to say that Fighting Back's approach should be heralded as the solution.
  
  Legislators should not think that spending money on community coalitions alone will be enough to solve such a pressing problem. Yet, coalitions may be a necessary piece of any effective strategy, and through the Fighting Back program, many lessons were learned about how to initiate and sustain community coalitions.