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 treatment programs, individual treatment providers and networks of care. State and federal government and employers and purchasing alliances could then be encouraged to use these data to inform their health care purchasing and contracting decisions. Consumer groups should also advocate for the development of standards of care in community-based clinics, treatment networks, integrated delivery systems, and managed care networks. Such standards could be used in accreditation of treatment programs and are best if based on findings from clinical research as well as broadly accepted clinical consensus.


Research collaboration, especially collaboration in services research, requires skills and knowledge not generally provided in most graduate training programs. In order to foster collaborative research, it is necessary to enhance these skills in the next generation of drug abuse researchers. At the same time, despite the plethora of prior recommendations for addressing this problem, clinical training programs often fail to provide the background and orientation for treatment research. Thus, both clinical and research training programs need to be more attentive to the need for collaboration to improve treatment in this field.

The committee made three recommendations specific to preparing trainees for active participation in clinical research studies.

RECOMMENDATION 10. NIDA and other research funding agencies should support predoctoral and postdoctoral research training programs that provide experience in drug abuse treatment research and health services research within community-based treatment programs. Programs funded should have the full and active participation of community-based treatment programs and should include resources to fund the costs of participation for the treatment programs.

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