Do you see the paradox? We're improving access to care and increasing treatment services, but the needs continue to rise. Until we address the structural roots of risk at the community level, we're not going to solve our substance use and mental illness problems. Logan Reid and Heidi Dutson discuss why we need more Primary Prevention! References: Elder, R. W., Lawrence, B., Ferguson, A., et al. (2010). The Effectiveness of Tax Policy Interventions for Reducing Excessive Alcohol Consumption and Related Harms. American Journal of Preventive Medicine, 38, 217-229. https://doi.org/10.1016/j.amepre.2009.11.005Wagenaar, A. C., Salois, M. J., & Komro, K. A. (2009). Effects of beverage alcohol price and tax levels on drinking: a meta‐analysis of 1003 estimates from 112 studies. Addiction, 104, 179-190. https://doi.org/10.1111/j.1360-0443.2008.02438.xWagenaar, A. C., Tobler, A. L., & Komro, K. A. (2010). Effects of Alcohol Tax and Price Policies on Morbidity and Mortality: A Systematic Review. American Journal of Public Health, 100, 2270-2278. https://doi.org/10.2105/ajph.2009.186007Saad, C., Cheng, B. H., Takamizawa, R., Thakur, A., Lee, C. W., Leung, L., Veerman, J. L., & Aminde, L. N. (2025). Effectiveness of tobacco advertising, promotion and sponsorship bans on smoking prevalence, initiation and cessation: a systematic review and meta-analysis. Tobacco Control. https://doi.org/10.1136/tc-2024-058903Sornpaisarn, B., Shield, K. D., Cohen, J. E., Schwartz, R., & Rehm, J. (2015). Can pricing deter adolescents and young adults from starting to drink: An analysis of the effect of alcohol taxation on drinking initiation among Thai adolescents and young adults. Journal of Epidemiology and Global Health, 5, S45. https://doi.org/10.1016/j.jegh.2015.05.004