Data came from official records; interviews with local and State officials, treatment providers, and community leaders; and site visits to selected programs. Results revealed an increase in cocaine use and street dealing of drugs as well as an apparent decline in heroin use. Prevention efforts include school health education that includes the crucial elements of the social influence model, the establishment of Student Assistance Programs, and community prevention efforts. The area has just over 270 drug treatment programs, with alcohol the primary drug of abuse and admissions for cocaine abuse increasing. More subsidized treatment is needed. Law enforcement efforts have increased during the 1980's and include community policing and crackdowns, both of which appear to be effective in dealing with local drug problems. In the 1990's, greater efforts are needed to address problems on a metropolitan as well as local basis. More funding for prevention efforts and a focus on drug abuse in general rather than on specific drugs are also needed. Figures, tables, map, footnotes, appended methodological information, and 89 references