North Carolina is undergoing a transition in how it responds to water use conflicts. Before passage of the Water Use Act of 1967, water use conflicts were handled by the courts. Courts are not well equipped to implement regional resource management programs, and they typically respond to conflicts by placing restrictions on an individual water user. The Water Use Act allowed the state to implement regional water resources management programs in designated areas, as determined by the North Carolina Division of Water Resources (DWR) and Environmental Management Commission (EMC). However, the State has not always exercised that option. The State's response to four water use conflicts has been reviewed. In two early cases, in a manner similar to prior actions by the courts, the State focused its efforts on regulation of a single user rather than management of the entire resource. In a third case, a voluntary program was established by water users with oversight by the State. In the State's most recent efforts, it has incorporated the regulatory tools provided by the Water Use Act with the example of watershed-level coordination provided by the voluntary program to develop a regional management strategy for water resources in the Coastal Plain.