The specific illicit drugs that had the highest levels of past year dependence or abuse in 2011 were marijuana (4.2 million), pain relievers (1.8 million), and cocaine (0.8 million). Between 2004 and 2011, the number with pain reliever dependence or abuse increased from 1.4 million to 1.8 million, and between 2006 and 2011, the number with cocaine dependence or abuse declined from 1.7 million to 0.8 million. The number of persons with heroin dependence or abuse increased from 214,000 in 2007 to 426,000 in 2011. (CDC, 2009). The community as a whole should play a role in the prevention of substance abuse. There are programs such as detoxification, institutionalization, and outpatient drug maintenance programs for resources. There should be more education in the younger adults and children in the schools to help with the prevention of substance abuse. The social service areas need to intervene with persons in the early stages of substance abuse to reduce, or eliminate the use. Gaps would be caused from lack of information, lack of education and, accessibility to health insurance to get inpatient care. Lack of community health nurses can also cause a gap in