The purpose of this issue guide is to help people talk together about what we should do when alcohol and drug use becomes a problem to society. It begins with an overview of substance use and abuse in the United States and the impact this has on individuals, families, and communities. It then offers three options for addressing the issue, along with potential actions that could be taken. These are starting points for the conversation, which may lead to other insights and possibilities. People from seven organizations across the country participated in developing the guide, conducting interviews, surveys, and conversations with diverse people in their communities to capture different views on the issue. The organizations included the Community College of Baltimore County, San Diego Deliberation Network, Tennessee State University, University of Alaska Anchorage, Walden University, SUNY Broome Community College, and the West Virginia Center for Civic Life. The guide may be used to support a single conversation or a series of conversations. The following suggestions can help you get started: