TABLE I-1 Drug Abuse Treatment—What We Know and Current Practice

Treatment Processes and Inputs

What We Know and Current Practice

Treatment Process

Review Findings

Assessment

Advances in assessment methods recently achieved

Physical health not routinely assessed in drug-free outpatient treatment

Mental health assessed, formal diagnosis less frequently

Prevalence of addiction severity assessment unknown

HIV assessment infrequent but growing

Treatment planning

Research on patient-treatment matching increasing

Prevalence of individualized treatment planning unknown

Current treatment goals are abstinence, physical health, relationship improvement, not "responsible use"

Core treatment mechanisms

Expert opinion identifies acceptance of responsibility, relapse prevention, denial reduction as core mechanisms of effective treatment

Current practice involves individual and group therapy and addiction education

High-dose methadone treatment is effective but many programs restrict dosage levels and client participation in treatment planning

Supportive treatment services

Supportive legal, family, job, and medical services are important for effective treatment

Less than half of treatment settings provide supportive services

AIDS prevention and counseling infrequent

Aftercare

New relapse prevention treatment and education available

Follow-up and aftercare is critical to effective treatment

Less than three-quarters of outpatient and half of methadone units have formal written follow-up plans



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