The top three winners of the contest describe three successful approaches to helping substance abusers in rural and frontier areas deal with their problems. The first award went to an innovative program for adolescent inhalant abusers in Huron, South Dakota. The clients, mostly American Indian youths, did not have access to treatment prior to the creation of the program. The comprehensive residential treatment program provides inhalant abusers with the opportunity to detoxify, reduce impairment in neurocognitive functions, improve academic performance, and stabilize emotionally and behaviorally. Two substance abuse programs designed to address the needs of Appalachian women in Ohio are described in the paper awarded second place. The programs built on the personal and collective strengths of the individuals and the communities served. A rural coalition in northwest New Mexico is the subject of the third-place paper. The rural coalition has been the catalyst for a regional response that has closed drive-up liquor windows, built a detoxification and assessment center, reformed State drunk-driving laws, and offered new prevention and treatment services.