Local variation in the extent of illicit drug use and in the pattern of specific drugs consumed as well as in the extent and nature of the problems arising from drug use supports the need for coordination at the local level. Efforts on the part of Congress and the executive agencies to set priorities and prescribe drug policy to State and local governments and to thereby ignore the local variation in drug problems and the inherently local nature of the instruments of policy are misguided. The local institutions wield the instruments of drug policy that now emerge as most promising: prevention and early intervention, treatment, and street-level law enforcement. State and local decisionmakers require sufficient latitude to make and implement drug control policy. 3 figures, 2 tables, and 144 footnotes