• We advocate MMT as a benefit in public and private insurance programs, with parity of coverage for all medical and mental disorders.

• We recommend targeting opiate-dependent pregnant women for MMT.

• MMT must be culturally sensitive to enhance a favorable outcome for participating African American and Hispanic persons.

• Patients, underrepresented minorities, and consumers should be included in bodies charged with policy development guiding opiate dependence treatment.

• We recommend expanding the availability of opiate agonist treatment in those States and programs where this treatment option is currently unavailable.

Lewis L. Judd, M.D.

Conference and Panel Chair

Mary Gilman Marston Professor Chair

Department of Psychiatry

School of Medicine

University of California, San Diego

La Jolla, California

Clifford Attkisson, Ph.D.

Dean of Graduate Studies

Associate Vice Chancellor for Student Academic Affairs

Professor of Medical Psychology

University of California, San Francisco

San Francisco, California

Wade Berrettini, M.D., Ph.D.

Professor of Psychiatry and Director

Center for Neurobiology and Behavior

Department of Psychiatry

School of Medicine

University of Pennsylvania

Philadelphia, Pennsylvania

Nancy L. Buc, Esq.

Buc & Beardsley

Washington, DC

Benjamin S. Bunney, M.D.

Charles B.G. Murphy Professor and Chairman

Professor of Pharmacology

Department of Psychiatry

Yale University School of Medicine

New Haven, Connecticut

Roberto A. Dominguez, M.D.

Professor and Director of Adult Outpatient Clinic

Department of Psychiatry University of Miami School of Medicine

Miami, Florida

Robert O. Friedel, M.D.

Heman E. Drummond Professor and Chairman

Department of Psychiatry and Behavioral Neurobiology

The University of Alabama at Birmingham

Birmingham, Alabama

Front Matter (R1-R22)

Executive Summary (1-15)

1 Introduction (16-26)

2 The Gaps Between Research, Treatment, and Policy (27-55)

3 Approaches to Closing the Gaps (56-72)

4 Benefits and Challenges of Research Collaboration for Community-Based Treatment Providers (73-88)

5 Benefits and Challenges of Community-Based Collaboration for Researchers (89-110)

6 Findings and Recommendations (111-120)

Appendix A: Statment of Task (121-124)

Appendix B: Workshops and Roundtable: Agendas and Participants (125-134)

Appendix C: Commissioned Paper: Drug Treatment Programs and Research: The Challenge of Bidirectionality (135-146)

Appendix D: Commissioned Paper: The Treatment of Addiction: What Can Research Offer Practice? (147-185)

Appendix E: Commissioned Paper: The Substance Abuse Treatment System: What Does It Look Like and Whom Does It Serve? Preliminary Findings from the Alcohol and Drug Services Study (186-197)

Appendix F: National Institute of Health Consensus Development Statement on Effective Medical Treatment of Heroin Addiction (198-225)

Appendix G: Useful Internet Resources -- Examples (226-232)

Appendix H: List of Currently Available CSAT Tretment Improvement Protocols (TIPs) (233-234)

Appendix I: Opportunities for Collaboration (235-245)

Appendix J: Summary of Interviews with Minnesota State Alcoholism-Addiction Leaders (246-250)

Index (251-264)