their use. Measurement of the impact of guidelines on clinical care delivery will optimally include short-, intermediate-, and long-term treatment outcomes.

Consumers are rarely involved in the issues of how drug abuse treatment research is supported and conducted. Although many community-based treatment programs were founded by men and women in recovery and counselors in recovery make up a significant portion of the workforce, there are few advocacy groups for patients and their families. In view of the stigma and legal hazards attached to illicit drug abuse, the reluctance to advocate is understandable but unfortunate. Consumer advocacy for state-of-the-art services has improved care for individuals with cancer, and with HIV/AIDS. Drug abuse treatment may enjoy similar benefits if drug treatment consumers become informed consumer advocates.

RECOMMENDATION 9. CSAT and NIDA, in collaboration with state substance abuse authorities, should develop public awareness programs to encourage consumers and their families to recognize high quality treatment programs so they will begin to demand that treatment programs include research-proven treatment approaches within their treatment models.

These groups should consider a variety of approaches to accomplish this goal. These include:

• Encouraging provider quality scorecard development to assure that consumer-oriented quality and satisfaction data, including shortand long-term outcomes data, are available to the public. Scorecard development is an early stage but growing movement in health care generally and could provide useful information about community-based treatment programs.

• Reviewing and updating the formats and content of communication vehicles to assure that treatment and research information is accessible to consumers and to the community-based treatment organizations.

It is also critically important that representatives of consumers and their families, with the support and assistance of the research, treatment, and policy communities, promote local as well as national advocacy groups to work with state funding agencies, insurers, managed care organizations, and self-insured employers to encourage the use of valid and reliable measures of treatment outcomes. Such measures serve as a basis for evaluating the efficacy of specific treatment modalities and the cost effectiveness of