The Border Binge-Drinking Reduction Program provides a process for changing the social and community norms associated with underage and binge drinking that has proven effective at reducing alcohol-related trauma caused by young American’s binge drinking across the U.S.-Mexican border. The program is a binational effort to curb irresponsible drinking practices, employing environmental management techniques including (1) regular surveys of youths returning from a night of drinking with anonymous blood alcohol concentration (BAC) breath tests; (2) strong media advocacy, using information from the surveys to characterize the problem, mobilize the community to action, and reframe the issue from an accepted norm to a health and safety issue for the binational community; (3) formation of the Binational Policy Council, which recommends policy changes on both sides of the border and provides spokespeople for the media advocacy and community organizing components; (4) increased enforcement of existing laws and policies, such as ID checks at border crossings and in bars in Tijuana, Mexico; and (5) implementation of policies and practices that impact the environment where dangerous cross-border drinking occurs.