Campbell County CARA Initiative - The Campbell County Drug Free Alliance (CCDFA) aims to prevent youth substance use in Campbell County, Kentucky, with a focus on opioids, methamphetamine, and prescription drug misuse. The county continues to experience significant impacts from the broader substance use crisis, including elevated overdose burden and ongoing community exposure to high-risk substances. Youth in Campbell County remain at increased risk due to household access to medications, normalization of substance use, and early initiation factors that contribute to misuse and long-term harm. These conditions highlight the need for sustained community-level prevention efforts that address both access and attitudes toward substance use. CCDFA will implement a five-year, evidence-based prevention initiative that will engage all twelve community sectors, including youth, parents, schools, healthcare providers, law enforcement, and community organizations, to strengthen collaboration and build long-term prevention capacity. Strategies will focus on expanding youth leadership through a Youth Advisory Council, increasing prevention education through community-wide messaging campaigns, and strengthening family engagement through school-based family nights and parent education opportunities. The project will also increase access to prevention resources such as medication lock boxes, disposal pouches, and pill organizers distributed through trusted community partners, including law enforcement, pharmacies, schools, and social service agencies. Environmental strategies will focus on reducing access to prescription medications in the home and reinforcing safe storage and disposal practices. CCDFA will further support prevention efforts through youth-led media campaigns, a prevention podcast series featuring local professionals, and community recognition initiatives that reinforce positive norms and behaviors. These strategies are designed to strengthen protective factors, reduce risk factors, and shift community attitudes related to youth substance use. The expected outcomes align with CARA goals to reduce youth substance use and change community norms regarding opioid, methamphetamine, and prescription drug misuse. Short-term outcomes include increased community awareness of prevention messaging and expanded distribution of medication safety tools. Intermediate outcomes focus on increased adoption of safe medication storage and disposal practices and greater engagement in prevention programming. Long-term outcomes aim to reduce youth substance use rates and decrease acceptability of youth substance use while increasing perceived risk and parental disapproval. Through these efforts, CCDFA seeks to create sustainable community-level change by reducing youth access to opioids, methamphetamine, and prescription drugs while strengthening protective factors and supporting a healthier, safer environment for youth in Campbell County.