The model of paying for addiction services varies from community to community. Research might address whether "carve in" administration/ funding is better than, worse than, or the same as "carve out" administration/funding. There are many theoretical advantages and disadvantages to both, or to perhaps some combination of both. Research is needed to assess the influence of these different approaches on addiction treatment.


    The distinction between prevention (especially early intervention at the point of heavy use or early prediagnostic problematic use) and treatment are less relevant in the addictions than they may be in infectious disease, cardiovascular disease, cancer, etc. Currently, the "prevention" people receive different funding streams and do not address "early case" or "precase" finding. Likewise, clinicians do encounter early cases and heavy users, but cannot be funded to provide care if the person does not meet diagnostic severity or if their social impairment is still minimal. This is especially apropros of adolescents, who often do not meet diagnostic criteria, but are vulnerable to an addictive career. Can research address the special dimensions of prevention in the addiction field?


    Research regarding addiction services under welfare reform is urgently needed. These reforms are cutting off payments to addicted persons. Most people at the community level believe that this may have serious social effects, but are not agreed on what is apt to occur. States and communities would like information about the consequences of welfare reform on addicted persons, along with how best to manage this.


    More quasi-experimental designs would be appreciated, since these seem to provide more practical information than highly controlled (but also highly biased and nonapplicable controlled, random assignment studies). For example, the results from policies and strategies employed in the fifty different states should be informative. Could such data be collected, compared, and analyzed?


    Long-term studies and longitudinal studies (over at least one year, and sometimes several years or a few decades) are needed. Community agencies provide services for years and even decades in many, perhaps most cases.


    Cocaine abusers are going to prison in large numbers, relative to alcohol, cannabis, opiate, etc. abusers. Overlapping this is the fact that Afro-American patients are using cocaine more and going to prison more often. Community people would like to find ways of keeping cocaine patients and Afro-American patients in treatment rather than in prison. Can research help address this issue? Understanding of the complexities involved might also help (e.g., organic brain damage from cocaine, reversible vs. irreversible effects, ethnic differences in the acceptance of cocaine, community approaches to getting cocaine out of the community).


    Can research tell us how best to detect and treat patients with

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