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SPF Overview

SAMHSA’s Strategic Prevention Framework (SPF) is a model that guides the selection, implementation, and evaluation of evidence-based, culturally appropriate, sustainable interventions addressing substance abuse. The SPF comprises five key steps:

Sustaining Effective Prevention Efforts: A Planning Toolkit

Sustainability in prevention is about figuring out what’s working well and how communities can continue to experience the benefits of prevention efforts over time. This requires the participation, resolve, and dedication of diverse community members—and a lot of careful planning. This online toolkit is designed to help coalitions engage in a thoughtful sustainability planning process.


We often think of sustainability as the ability to find another source of funding after an initial grant ends. But sustainability is not only about sustaining funds; it is also about sustaining the gains you have made in addressing a health problem—in this case, preventing or reducing opioid misuse. It means constantly building on your efforts by retaining and improving the strategies that are shown to be effective in achieving your identified outcomes, and discontinuing or modifying those that do not seem to be working as well.

Cultural and Linguistic Competence

Cultural competence is the ability of an individual or organization to interact effectively with people from different cultures.28 Developing cultural competence is an evolving, dynamic process that takes time and occurs along a continuum.28

For your efforts to prevent or reduce opioid misuse to be effective, you must consider cultural competence at each step of the SPF model—you must understand the cultural context of your target community and have the required skills and resources for working within this context.

Opioid Misuse Overview

Opioid misuse includes use of the illegal drug heroin and misuse of opioid prescription medications. It affects diverse groups of people across the nation—from a middle-aged woman who becomes addicted to an opioid pain reliever originally prescribed for a sports injury to a young person who is using illegal opioids to get high. Opioid misuse is a complex problem that requires comprehensive, coordinated, evidence-based solutions.