Summary/Abstract The recent report issued by the Surgeon General's Office, “Facing Addiction in America,” the first of its kind issued by the Surgeon General, brought into stark relief the major impact of substance misuse and use disorders and the need to rethink how prevention and treatment services are currently delivered in the United States. While isolated aspects of substance misuse are improving, such as tobacco cessation and opioid prescribing practices, enormous service gaps persist that allow the ongoing and enormous negative impacts of risky and problem substance use. Further, these negative impacts put a particular burden on gender and ethnic minorities and other disadvantaged populations and communities. The isolation of specialist substance abuse treatment from mainstream medicine, the report further points out, presents a barrier to a potentially more effective public health model to reduce substance-related harms. If this landscape of epidemic substance misuse, use disorders, and related conditions is to improve and patient and public health and safety outcomes enhanced, prevention and treatment services delivery require rethinking. The Addiction Health Services Research conference, held since 2005, has annually brought together researchers, policy makers, and treatment providers to focus upon how such systems redesign might most effectively be implemented and sustained. In the current application, we propose to enhance this conference by specifically focusing on improving the well-being of gender and ethnic minorities and other marginalized groups struggling with risky and problem substance use and by encouraging participation by underrepresented scientists through establishment of a NIDA Minority Investigator Award and enhancement of a junior investigator mentoring program. A slate of distinguished plenary speakers, discussion of cutting-edge health services research findings, the development of collaborative relationships, and support of the careers of junior and minority investigators is proposed to move forward an agenda of broadening the positive impact of prevention and treatment services for substance misuse and use disorders.