West Virginia recognizes the disastrous impact of substance abuse. Television and newspaper reports inform of lives destroyed, communities devastated and crimes committed. Our legislature and governor are attempting to combat substance abuse problems with the recent allocation of $7.5 million for substance abuse prevention, treatment and recovery services. The challenge that faces West Virginia is how to best allocate these funds to maximize treatment effectiveness. As providers of substance abuse services, three areas we commonly encounter significantly limiting the effectiveness of prevention and treatment could be described as availability, affordability and acceptance.