Two Decades of Investment in Substance-Use Prevention and Treatment

RWJF Retrospective Series: Two Decades of Investment in Substance-Use Prevention and Treatment

RWJF’s 20-year investment to reduce harm from alcohol and other drugs in the U.S. is examined in this latest retrospective.

The Robert Wood Johnson Foundation (RWJF) worked to reduce harm from alcohol and other drugs in the United States for over two decades—an investment of nearly $700 million. This retrospective analysis, part of the RWJF Retrospective Series, assesses RWJF’s investment, what was achieved through its efforts, and the strengths and challenges of the Foundation’s approach.

The Foundation’s investment in the field can be roughly categorized into six “eras” of work:

1986–1990: Early community-based prevention

1991–1994: Expansion of prevention

1995–1999: Greater emphasis on policy/environmental approaches

1997–2001: Prevention and treatment rebalance

2001–2005: Heavy emphasis on treatment

2006–2009: Pullback from the substance-use field  

“Investment in substance abuse was one of [the Foundation’s] first forays into the work outside clinic doors. We built comfort and understanding about influences on health outside of medical treatment.” —A Senior RWJF Leader

RWJF contributed toward progress on the substance-use problem through meaningful impact in five major areas:

  1. Increased knowledge about the substance-use problem;
  2. Influenced alcohol and drug policies;
  3. Informed and spreading promising prevention programs;
  4. Improved systems of care for substance-use disorders; and
  5. Built field infrastructure to strengthen substance-use research, policy, and practice.

RWJF had an unprecedented investment in the field, contributing to change over time. Observations of how RWJF developed its overarching and program-specific strategies, conducted ongoing evaluation and learning, and exited the field are highly relevant for future public health work.


FSG conducted an analysis from May 2011 to March 2012, including interviews with internal and external stakeholders, extensive reviews of secondary documents and data sources, in-depth, expert assessment of five major programs, surveys of internal and external advisers, and citation analysis. These report findings were reviewed and validated by an external, expert advisory board.

FSG is a nonprofit consulting firm specializing in strategy, evaluation, and research. Learn more about FSG on their website.