With the sorting out of community-based drug treatment, the first open question is: Who will respond to the growing need in traditional communities for drug treatment? It is questionable whether institutionally based programs in universities and hospitals, and the few community-based programs that make the transition to the new community, can meet the need. The continuing need for drug treatment will not go away because there is less government funding and fewer treatment programs. The consequence for neglect of drug and alcohol abuse through prevention and treatment costs the nation an estimated $77.6 billion per year in federal entitlements (CASA, 1996). This does not include the costs to the nation of drug-related crimes and criminal justice costs for using jail and prisons for drug treatment. The second open question is whether there is the capacity in communities in decline or transition to continue to produce new drug treatment programs. General social movements have uncanny abilities to continue generating organizations to address community needs and to rise anew when they are least expected (McCarthy and Zalder, 1973) and even attempt to affect expressed needs through invention (Abbott, 1987). When the current generation of drug treatment programs declines far enough, we may very well witness the emergence of another generation of drug treatment initiatives which may not be so ready to compromise their missions for government funding (Frye, 1991).
Despite the problems and open questions, bidirectionality between community-based treatment practitioners and drug treatment researchers is possible. But it will require researchers to see the community-based research movement and mission as a source of new theory, as people with potentially useful insights about drug abuse and treatment, and as a well of experience waiting to be tested that can benefit both clients, practitioners, and science. Community-based practitioners can also benefit from alliances with researchers sensitive to community-based issues. Practitioners want to know the outcomes of their best efforts and improve outcomes for clients. Many want their ideas tested and improved upon. They want to know why some clients recover and others do not. They also want to be able to learn from research, and to show specifically where their work has value. For these reasons collaborative research is crucial. Community-based drug treatment is not simply an attempt to treat individual addicts in their community. Whether one takes the view that community is in decline or in transition, community-based drug treatment is part of a larger effort to struggle with neighborhood decline or transition. It is an effort to maintain residential community as a vital human institution for the majority of people who do not have a place in the postmodern world.