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2.
Dissemination of research results to practitioners in the community:
expensive to get information to community practitioners; they do not read the newsletters often produced by research centers or federal agencies;
application of some research results requires additional staff training; there are no funds to pay for this;
some research findings would require considerably increased staff time and/or staff credentials to bring these findings to the patient; these cannot be implemented in a time of declining state and private budgets for addiction services;
some research findings require sophisticated resources, additional financing, etc., to apply; such findings have low-to-nil utility in the community (e.g., much "matching" research).
3.
The highly selective criteria for many research protocols bias the research towards atypical rather than typical patient-subjects. For example, most research appears to involve "proactive" patients, urban patients, patients who have transportation to a center where research is conducted, can get referred into a research program, or come across the "right" gate keepers. These traits do not apply to most patients in community settings.
4.
Much of the research appears to be based on models or concepts that clearly have not worked in this field. Examples, include research strategies that have approached patients as though addiction were an "acute care" disorder, rather than a chronic relapsing disorder in which recovery (even if it does occur) continues over years rather than weeks. Another flawed approach has been the search for a psychosocial or biomedical "silver bullet," in which one acute or subacute treatment method will "cure" addiction.
RECOMMENDATIONS FOR FUTURE RESEARCH FUNDING
1.
More clinicians (or at least clinicians who are active applied researchers) should be appointed to committees charged with funding research.
2.
Research goals should have as a criterion the applicability of any anticipated research findings to patients in community settings.
3.
Research models should reflect the realities of addictive disorders (e.g., chronic, often recurrent disorders; associated psychosocial and biomedical problems; requiring years for recovery-maintenance-management).
4.
Is there a way that public policy (on state as well as national levels)
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