Leaders in some narcotics treatment programs struggle with change development and implementation. The objective of this single-case study was to explore strategies used by leaders in a narcotics treatment program to develop and implement organizational change initiatives successfully. Participants included 4 leaders who had developed and implemented successful change initiatives repeatedly for more than 10 years in a narcotics treatment program in the southeastern United States. Bertalanffy's general systems theory was the basis for the conceptual framework. Data collection included semistructured interviews of leaders of a narcotics treatment program and collection of archival data, such as reports relating to strategic planning, core value analysis, and risk assessments. Data analysis, using qualitative analysis software revealed 3 themes: communication, education through research, and resistance. The identified themes aligned with the conceptual framework, as the themes work together as a unit. Recommendations for action include further research for the application of social media in the treatment of patients. Leaders of narcotics treatment programs may use the findings to improve the success of social change development and implementation. Successful social change within these programs could result in the betterment of community relations and an increase in productive members of society who contribute to the economic health of the community.