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The Problem of Substance Abuse Substance abuse is America’s number one health problem—a problem that touches the life of every American child, family, congregation and community. Contrary to popular perception, America’s substance abuse problem results not only from illegal drugs like crack cocaine, but also from the “recreational” use of so-called “soft” drugs, like marijuana, and the “extra-medical” use of prescription medicines.1 A brief accounting of American’s substance use and its consequences places the issue in perspective.