. "Appendix C: Commissioned Paper: Drug Treatment Programs and Research: The Challenge of Bidirectionality." Bridging the Gap Between Practice and Research: Forging Partnerships with Community-Based Drug and Alcohol Treatment. Washington, DC: The National Academies Press, 1998.
The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
ation in American life (Bellah et al., 1985; Harrell and Peterson, 1992; Stouffer et al., 1949).
Based upon these trends, there is an emerging view that residential community is increasingly problematic and in decline in the United States. There is a sense that most Americans have fewer, weaker, and more conditional social affiliations today than at the turn of the century (Stein, 1960). Evidence from drug treatment research shows the importance of social support while in treatment as well as supportive social relationships to sustain recovery. If these trends in community are accurate, they must heavily impact drug abuse and the prospects for successful treatment.
An alternative view of the very same evidence is that community is not in decline, but is only in transition (Fischer, 1982; Wellman and Wortley, 1990). In this alternate interpretation, there are many people trying to maintain the older and now outmoded form of folk community, a point missed in the research on black poverty (Williams, 1992), drug abuse, and crime in the United States (Harrell and Peterson, 1992). Where residents are able to maintain control over their public space, violent crime is lower (Simpson et al., 1997). Community based upon kinship, neighbors who hopefully will not move, a clear residential area social identity, local autonomy and decision making, and same ethnicity and race may be waning. There is a declining economic and cultural basis for such community (Anner, 1996). A young urban professional can live in the very same area in decline for traditional residents. This new resident may experience a community in emergence, because his social relationships are based upon friends and work associates, and are diffused rather than local. This new social identity is not defined by physical neighborhood and community (Fischer, 1982).
In the alternative view of community, we can hypothesize that community-based drug treatment serves drug abuse clients from traditional racial, ethnic, and social class communities in transition. Communities in transition have compromised employment bases, are heavily dependent upon social services, are centers of drug dealing and trafficking, and are heavily policed (Lynn and McGeary, 1990). In these communities, drug abuse is conditioned by poverty, and successful recovery from drug abuse is conditioned by efforts to achieve freedom from poverty. Alternatively, recovery from drug abuse among people with the appropriate education, skills, and employment is now more likely to take place in HMO-, union-, professional, and private hospital-based drug treatment programs. For clients from new communities, drug use is likely to be initiated from experimentation and curiosity, and sustained by background trauma, and personal and professional stress rather than poverty.