Substance abuse has huge direct and indirect costs to society. In North Carolina, between 2005-2006, more than 700,000 people ages 12 and older (8.5%) reported being addicted to alcohol, drugs, or both. The prevention, diagnosis, and treatment of substance abuse is difficult for several reasons. The NCIOM Task Force on Substance Abuse Services looked at how to improve the statewide substance abuse service delivery system. This report presents the task force’s findings and recommendations.