The project applied the core principles of the SPI: collaboration, comprehensive responses, and prevention. Reno attempted to reduce prescription drug abuse by increasing knowledge about the problem (education/prevention); reducing the number of prescription pills available for illicit use (supply reduction); and aggressively investigating and prosecuting offenders (law enforcement suppression). Although evaluation results are preliminary and additional research would increase confidence in the findings, they suggest progress in the process-related goals of increased education, reduced availability, and improved suppression. There are a number of potential indicators of impact for educational and enforcement efforts; for example, arrests for prescription-related offenses increased notably during the first 2 years of the SPI grant period. Other important outcomes that will be examined in assessing program impact include emergency room visits, drug treatment admissions, ambulance "runs," and school-based reports of drug activity. Reno's experiences also highlight the difficult challenges that law enforcement agencies must address in efforts to combat prescription drug abuse. Challenges are discussed in engaging the medical community, educating the public about the dangers of prescription drug abuse, reducing drug availability, and engaging prosecutors. The report advises that prescription drug abuse is a problem that cannot be effectively addressed by traditional law enforcement alone. Other stakeholders must be involved in a comprehensive effort, including parents, schools, medical professionals, and prosecutors. 1 table