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Acknowledgments The committee wishes to acknowledge the thoughtful and timely contributions of the numerous individuals who made this report possible. While it assumes full responsibility for whatever the faults of the study may be, the committee acknowledge at the same time that many of its virtues come from the generous input of others. Regrettably, it is able to thank explicitly only a small number of those to whom thanks is due. Susan Farrell, Director of the Office of Policy Analysis of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and our project officer throughout the study, provided sympathetic but trenchant criticism of our work, guided us through the thickets of legislative and institutional history, and provided us with informed access to the bountiful material and personal resources of her organization. Our thanks go also to NIAAA director Enoch Gordis, who provided detailed initial guidance and helpful continuing support. Many other members of the staff of NIAAA and related federal agencies were of great assistance, including John Allen, Loran Archer, Richard Fuller, James Kaple, Barry Montague, John Noble, Al Woodward, and Herbert Yahr. There are too many debts to the staff of the Institute of Medicine (IOM) to acknowledge fully. Samuel O. Thier, IOM President, provided support throughout and contributed to the deliberations of the committee. Fredric Solomon made available to us his many years of experience both with the division and with the organization as a whole. Nancy Diener, Lou Cranford, and Janet Stall handled the financial intricacies of the project. Bradford Gray shared with us his detailed knowledge of health care in the private sector. Sam Johnson and the IOM Library provided crucial bibliographic support, and the reference staff of the library of the Addiction Research Foundation in Toronto were extremely helpful. Leah Mazade, our editor, is largely responsible for the clarity and directness of expression in the manuscript. Our particular thanks for consistent and thoughtful guidance go to Marian Oste~weis. A particular acknowledgment of the deepest gratitude must go to our chairman, Robert D. Sparks, M.D. Our ability to achieve consensus and complete this report owes more to his helmsmanship than to any other factor. His consistent humanity, balanced judgment, openness and flexibility were crucial to our efforts. At the same time that this study was being conducted, two other related studies, one on a research agenda for treatment and prevention of alcohol problems, and another on coverage for substance abuse treatment, were also being conducted. We are particularly grateful to those who kept us abreast of developments within these studies, including especially Roger Meyer, Robert Murray, Larry Lewin, Alice Fraenkel, Dean Gerstein, and Rick Hardwood. Three members of our committee, Thomas Babor, Merwyn Greenlick, and Mark Pauly, provided overlapping membership with these related studies. But thanks must also go to all members of the project committees, whose interchanges were unfailingly stimulating and useful. Kaye Fillmore and her colleagues Elizabeth Hartka, Bryan Johnstone, Richard Speiglman, and Mark Temple contributed a background paper on Spontaneous remission. Rick Harwood contributed another on aspects of financing. Harold Holder, Richard Longabaugh, William Miller, and Anthony Rubonis contributed another on cost effec- tiveness. Marcus Grant and Bruce Ritson contributed the analysis of treatment services in other countries, collating and summarizing responses from their colleagues in the World Health Organization study on the effectiveness of brief intervention. All were extremely useful in the preparation of the report. More than fifty colleagues contributed summaries of their experience and viewpoints on the assessment process. 505

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506 BROADENING THE BASE OF TREATMENT FOR ALCOHOL PROBLEMS Leonard Saxe shared with the committee his experience in traversing the same territory. Norman Hoffmann and Dan Newman addressed some of the problems involved in obtaining and interpreting data on treatment populations. William Bulynski facilitated our access to much important information on treatment services, Lrvin (Sam) Muszynski provided valuable advice on financing, and Thomasina Borkman elucidated many aspects of social model programs. Lauri Greig's assistance was critical in the preparation of the section on special populations. Well over one hundred colleagues responded to a general request for information, and many participated in our public hearings. Particular thanks are due to Helen Annis, Leclair Bissell, Floyd Bloom, Sheila Blume, Vincent Dole, John Ewing, Jack Mendelson, Stanton Peele, Marc Schuckit, and George Vaillant, who responded generously to detailed requests for particular information. Many colleagues ~ many settings welcomed our visits and incessant questions. Marc Schuckit also provided extensive direct consultation with staff and committee members in areas of his special competency. The committee members extend their great gratitude to Fred Glaser and Herman Diesenhaus, who as staff members always and colleagues generally, made the difficult task of preparing the written report possible. Secretarial and administratives services were provided to the committee through the effective and cheerful activities of Barbara Kelley; we thank her effusively. Elaine Lawson continued these efforts, seeing the report through to publication. Finally, we acknowledge most particularly the forbearance of our families and friends. They sustained with grace and good humor the irretrievable loss of the many hours of companionship that were required for the completion of this task. We hope that what has been accomplished is in some way worthy of that sacrifice.