Index
A
Academic programs and research, 3, 12, 15, 20
attitudes toward, 79
collaborative research with CBOs, 12-13, 76, 79, 87, 96, 98-99, 102 -103, 140, 141, 144
information linkages with CBOs, 12-13, 20, 35, 68, 111-112, 119,135, 137
preventive interventions, 102-103
primary care services, 35
state funding, 8
see also Medical education;
Professional education
Acupuncture, 37-38, 150, 175, 195, 244
ADAMHA Reorganization Act of 1992, 95-96
Addiction Severity Index, 103, 155-156, 172
Administrators and managers, 211, 248
associations of, opinions, 65, 95-97
CBOs, 5, 10, 27-29, 35, 41-42, 47-51, 59-60, 64, 66, 68, 76, 77,90, 93, 94, 99, 100, 112, 117, 123, 135, 187, 189, 190, 232, 247, 249
see also Case management;
Management information systems
Adolescents, 34, 74, 87, 148, 194, 238, 239-240
Advocacy groups, 11-13, 31, 46-47, 51, 118-120 passim, 198, 227
Internet sites, 227-228
African Americans, 139, 140, 143, 159, 160, 193, 194, 214, 249
Aftercare, see Followup treatment
Age factors, 152, 153, 193, 194, 209
see also Adolescents;
Children
Agency for Health Care Policy Research, 10, 14, 63-64, 226
Agricultural Extension Service, 69
AHCPR, see Agency for Health Care Policy Research
AIDS, see Human immunodeficiency virus
Alcohol abuse, 27-28, 49, 50, 61, 73, 95
adolescents, 239
Alcohol and Drug Services Survey, 192, 193, 194
cocaine abuse and, 38-39
Community Reinforcement Approach, 169
NIH heroin addiction treatment
guidelines, 209
outcome monitoring, 153-160 passim, 167, 168, 169
pregnant women, 36
Alcohol and Drug Research Study, 37
Alcohol and Drug Services Survey, 187-197
Alcoholics Anonymous, 24, 27-29, 85, 138, 140, 160, 162-164, 169, 175
Aliviane, 77
American Cancer Society, 46
American Heart Association, 46
American Lung Association, 46
American Medical Association, 62, 200
American Psychiatric Association, 61
American Society of Addiction Medicine, 61, 100, 161
Amphetamines, see Methamphetamines
Antabuse (disulfiram), 167, 169, 242
Antidepressants, 170
Anxiolytic buspirone, 170
Arapaho House Comprehensive Substance Abuse Treatment Center, 73-75, 78, 79, 82
Arizona, 20
ASI, see Addiction Severity Index
Asians/Pacific Islanders, 139, 194, 244
Assessment methodology, see Evaluation methodology;
Quality control
Attitudes, vi
AA members, 27-29
abuser motivation, 33, 50, 80, 156-157, 162, 163, 175, 235, 241-242, 247
contingency management, 34
methadone maintenance, 32, 49-50
self-esteem, 80
stigma, 9, 11, 16, 17, 25, 32, 46-48, 49-50, 116, 153, 205, 210, 213
treatment facilities placement, local residents, 38, 46, 47, 49-50
trust building, xv, 3, 5, 56, 57, 66-70, 74, 98, 112
B
Barbiturates, 194
Behavioral interventions, 2, 6, 7, 18, 19, 20, 24, 59, 67, 74, 86, 150, 164-165, 170-171
NIH heroin addiction treatment guidelines, 202, 208, 209
see also Contingency management;
Counseling and counselors;
Group therapy
Benzodiazepines, 194
Biopsychological factors, vii,6, 16, 17, 80
methamphetamine abuse, 229
opiate addiction, 200-201, 203-204, 212
outcome analysis, 152
recovering addicts, 149
see also Drugs to treat abusers;
Genetic factors;
Medical interventions;
Mental illness;
Withdrawal
Black persons, see African Americans
Block grants, 7, 17, 27, 42-43, 65, 114, 197
methadone, 31
Buprenorphine, 49, 151, 166, 207, 209
C
Cancer treatment, 11, 46, 68-69, 96, 100-102, 107
cost-effectiveness, 5, 101, 112
see also Community Clinical Oncology Program
Case management, 34, 74, 97, 173, 238, 248, 250
CASPAR, 102
CBOs, see Community-based drug treatment organizations
CCOP, see Community Clinical Oncology Program
Center for Mental Health Services, 95
Center for Substance Abuse Prevention, 94-95
Center for Substance Abuse Treatment, v, vii, 9, 17-18, 116, 124, 231
collaborative research support, 10, 13-15, 18, 74, 94, 100, 117-118, 120
definitional issues, 23
technology transfer, 58, 59-60, 115, 120, 136
treatment protocols, list of approved, 233-234
Center on Alcohol, Substance Abuse, and Addiction, 20, 96, 98-99, 108
Certification, see Licensing and certification
Children, 32, 34, 35, 36, 65, 153-154
Alcohol and Drug Services Survey, 194, 195
school-based preventive interventions, 73-74, 97, 102-103, 240
see also Adolescents
Chinese Americans, 139
Clinical protocols, 6, 49, 96, 100, 161
CSAT, list of approved, 233-234
Clinical trials, 32, 37, 38, 62, 68, 79, 86, 90, 100-101, 106, 148 , 152, 174
CME, see Continuing medical education
Cocaine, 20, 22, 30, 33, 40(n.1), 49
adolescents, 239
alcohol abuse and, 38-39
Alcohol and Drug Services Survey, 193, 194
NIH heroin addiction treatment guidelines, 206, 209
outcome monitoring, 153, 155, 159, 160-161, 163, 164, 167-168, 171
prison treatments, 249
treatment guidelines, 61
Colleges and universities, see Academic programs and research
Colorado, 73-74
Community-based drug treatment organizations, 2, 5, 6, 17, 18, 42-43
academic researchers, collaboration, 12-13, 76, 79, 87, 96, 98-99, 102-103, 140, 141, 144
academic researchers, information linkages, 12-13, 20, 35, 68, 111 -112, 119, 135, 137
administrators and managers, 5, 10, 27-29, 35, 41-42, 47-51, 59-60, 64, 66, 68, 76, 77, 90, 93, 94, 99, 100, 112, 117, 123, 135, 187, 189, 190, 232, 247, 249
Agricultural Extension Service as model, 69
Alcohol and Drug Services Survey, 187-197
cancer treatment as model, 5-6, 11, 46, 68-69, 96, 100-102, 107-108, 112-113, 118
counselors in recovery, 24, 27, 41, 44, 45, 75
cultural factors, 20, 24, 98, 131
definitional issues, 2-3, 23-25, 135-141
employment issues, staff, 12-13, 15, 41, 43-46, 59, 76-68, 113
training, 12-13, 15, 41, 43-46, 59, 76-68, 113
historical perspectives, 21-23, 138, 141-143
models, 5-6, 58-70, 83, 85, 101-102, 107-108, 112-113
multimodal treatments, 35
research contributions of, 73-88, 96, 111-114
research recommendations, 7, 12-13
site visit vignettes, 27, 28, 29, 31, 74, 89-90
small providers, 27,29, 41, 59, 60, 84, 85, 141, 190, 191
structural factors, 40-42, 51-52, 59-60
training of staff, 12-13, 15, 41, 43-46, 59, 76-68, 113
understudied approaches, 35-40
underutilized research, 32-34, 116-117, 135-136, 147-176
woman-centered, 36
Community Clinical Oncology Program (NCI), 5-6, 68-69, 96, 100-102, 107-108, 112-113
infrastructure, 5, 101-102, 106, 112-113
Community-level factors, other, 87, 101
adolescent outreach, 240
definitional issues, 136-137
education and training, 43-44
treatment facilities placement, attitudes, 38, 46, 47, 49-50
Community Reinforcement Approach, 169-170, 240-242
Consensus conferences, 63-64, 117, 199
Consumer participation, 2, 4, 6, 10, 31-32, 84, 113, 118-119, 120, 214
cultural factors, 24(n.4)
foreign language speakers, 20, 99
professional licensing, 8, 44, 115
see also Advocacy groups;
Public education;
Stakeholders
Consumer scorecards, 11, 61-63, 118
Contingency management, 30-31, 33-34, 43, 169-170, 175
Continuing care, see Followup treatment
Continuing medical education, 8, 12, 15, 48
guidelines, 62-64
Cost and cost-effectiveness factors, vi, 1, 18, 31, 35, 49, 93, 95, 247, 248
adolescents, treatment, 239-240
cancer treatment as model, 5, 101, 112
consumer participation, 5, 11-12, 119
drug addiction, national losses, 144, 147, 206, 212-213
drugs to treat abusers, 28, 33
employer treatment programs, 147
innovation, 60(n.2)
institutional care, 25
literature review parameters, 148
NIH heroin addiction treatment guidelines, 206, 209, 212-213
research/practice links, 4, 76-77, 111-112
treatment/patient matching, multiple problems, 173
see also Funding
Counseling and counselors, 20, 37, 41, 44, 86, 231
abusers as counselors, 24, 27, 41, 44, 45, 75, 138;
see also Group therapy
NIH heroin addiction treatment guidelines, 203
outcome monitoring, 164-165, 170-172, 175
theoretical basis, 80
therapy vs, 164-165, 170-171, 175
training, 84
see also Marital status and therapy;
Peer support
Crime and criminal justice system, vi, 2, 3, 20, 43, 96, 143, 144
adolescents, 239
Alcohol and Drug Services Survey, 191, 192
Department of Justice, 213
driving while under the influence, 19
heroin addiction and, 200, 206, 209
historical perspectives, 22
naltrexone use by probationers, 167
outcome monitoring, 152, 160, 165, 171, 176, 209
see also Prisons and jails
CSAT, see Center for Substance Abuse Treatment
Cultural factors
community-based treatment, 20, 24, 98, 131
organizational, vii, 5, 27-29, 60, 85-86, 108, 112, 136
religious factors, 24, 85-86, 138, 140, 244
research collaboration, vii, 24, 77, 96
see also Social factors;
specific groups
D
TEDIS, 232
Data collection, 4, 21, 81, 82, 87, 93, 96, 99, 100, 101
adolescents, 239-240
Alcohol and Drug Services Survey, 187-188
homeless persons, 103-104
see also Management information systems;
Research methodology
Demographic factors, 142-143
Alcohol and Drug Services Survey, 193, 194
clinical factors and, 16
NIH heroin addiction treatment guidelines, 205-206
outcome analysis, 152-152
types of research, 81
see also Age factors;
Children;
Employment factors;
Gender factors;
Homeless persons;
Minority groups;
Rural areas;
Socioeconomic status;
Urban areas
Department of Health and Human Services, see specific agencies
Department of Justice, 213
Detoxification methods and centers, 22, 31, 73-74, 148-176
Alcohol and Drug Services Survey, 192, 193, 195
see also Drugs to treat abusers
Diagnosis, see Identification of abusers
Diagnostic and Statistical Manual of Mental Disorders, 100, 148
Directors, see Administrators and managers
Diseases, other than alcohol/substance abuse, 41, 46, 59, 147, 152 , 204
outcome analysis, 63-64
see also Mental illness;
specific diseases
District of Columbia, 20-21
Disulfiram, see Antabuse
Doctors, see Physicians
Driving while under the influence, 19, 239
Drug Abuse Treatment Outcome Study, 34
Drug Outcome Monitoring System, 99-100
Drugs of abuse, specific, see specific drugs
Drugs to treat abusers, 41, 49, 67, 80, 117, 149, 150, 166-168, 175 , 202, 208, 214
underutilized, 32-33
see also Antabuse;
Buprenorphine;
Methadone;
Naltrexone
DSM-IV, see Diagnostic and Statistical Manual of Mental Disorders
Duration of treatment, 35, 147, 149, 150, 151, 154, 181, 161-162, 166, 207, 209, 248
E
EAP, see Employee assistance programs
Economic factors, 16, 19-20, 51-52, 112
health services research, 94
knowledge development, 9
see Cost and cost-effectiveness factors;
Socioeconomic status
Educational attainment, 152, 153
Education and training, 2, 12-13, 15, 43-45, 47, 56, 97, 99, 111, 119-120
costs, 35
families, 13
Internet sites, 228
organizational learning, 6, 76, 79, 111-112, 113
school-based preventive interventions, 73-74, 97, 102-103, 240
see also Medical education;
Professional education;
Public education;
Technology transfer
Employee assistance programs, 18
Employment factors, 47, 49, 139, 142
Alcohol and Drug Services Survey, 187, 192, 195
drug rehabilitation organizations, 59, 95, 237, 238
CBO staff, 12-13, 15, 41, 43-46, 59, 76-68, 113
job training/finding, 34, 80, 95, 169, 172, 195
outcome monitoring, 157-158, 160, 165, 169, 171, 172, 173
self-insured employers, 11-12, 119
unemployment, 20, 47, 143, 152, 158, 165, 207
NIH heroin addiction treatment guidelines, 202-204
Evaluation methodology, 9, 39, 77, 117
state policy on service delivery, 9
see also Cost and cost-effectiveness factors;
Grant review processes;
Outcome monitoring
Evidence-based treatments, 10-11, 14, 17, 56, 59-60, 63-64, 118
F
Faith, see Religious factors
adolescents, 240
Alcohol and Drug Services Survey, 192, 195
NIH heroin addiction treatment guidelines, 203
outcome monitoring, 158-159, 160, 167, 168, 173, 175, 176
training, 13
see also Parents
Federal government, vii, 2, 22, 29-30, 114, 117
see also Legislation;
Regulatory issues;
specific departments and agencies
Fluoxetine, 170
Followup treatment, 34, 87, 101, 150, 163, 195, 235, 236
see also Relapse and relapse prevention
Food and Drug Administration, 33, 152, 166, 167, 211, 212
Foreign language speakers, 20, 99
For-profit organizations, 137, 138, 140, 188, 189, 191, 196, 237
see also Health insurance;
Health maintenance organizations
Funding, vi, 7-8, 12, 14, 17, 21, 42, 49, 77, 97, 98-99, 113-115, 120, 141, 196
advocacy, 46
CBO site visit vignettes, 27-29, 31, 73-74, 89-90
clinical involvement, 247
historical perspectives, 22, 23, 25, 27
homeless persons, treatment, 104
ineffective treatments, 10
managed care reimbursement, 27
prevention programs, 102
small research projects, 7, 76, 84, 114
top-down, 64-66
see also Block grants;
Grant review processes;
Incentives, financial
G
Gay Men's Health Crisis, 46-47
Gender factors, 7, 114, 152, 153, 194
see also Men;
Women
Genetic factors, 150, 202, 203, 205, 212
Global Appraisal of Individual Needs, 99-100
Government, see Federal government;
Local government;
State government Grant review processes, 7, 28, 106-107
Group therapy, 22, 164, 175, 195
see also Peer support
H
Harrison Act, 199
Health insurance, 42, 196, 214
consumer participation, 11-12
Mathematica study, vi
Mental Health Parity Act, vi
self-insured employers, 11-12, 119
see also Medicaid;
Medicare
Health maintenance organizations, 19, 101, 135-136, 140, 141, 143
Health Plan Employer Data and Information Set, 63
Heredity, see Genetic factors
Here's Looking at You, 102
adolescents, 239
Alcohol and Drug Services Survey, 193, 194
NIH treatment guidelines, 198-225
see also Methadone
Hispanic persons, 20, 77, 194, 214
Historical perspectives, 1, 21-23, 25, 27, 73, 94, 136, 138, 141-143, 199-200
collaborative research, 90-95
community-based defined, 137, 138, 140
demonstration initiatives, 102
methamphetamine abuse, 230
technology transfer, 48-49, 57, 58
HIV, see Human immunodeficiency virus
HMOs, see Health maintenance organizations
Homeless persons, 74, 102, 103-105, 108, 237
Hospitals, 97, 100, 135, 137-141 passim, 143, 237
Alcohol and Drug Services Survey, 188, 193
historical perspectives, 21-22, 25
outcome monitoring, 150, 159-161, 169
Human immunodeficiency virus, 7, 25, 34-35, 42, 49, 65, 114, 118, 142
advocacy groups, 46
Alcohol and Drug Services Survey, 195
consumer participation in treatment, 11, 105, 108
demonstration projects, 105, 108
NIH heroin addiction treatment guidelines, 200, 201, 204, 209
I
Idaho, 30
Identification of abusers, 36, 235
NIH heroin addiction treatment guidelines, 204
saliva testing, 204
urine testing, 33, 49, 151, 160, 164, 166, 187, 204
see also Outreach;
Referral
Ideology, see Political and ideological factors
Incentives, behavioral, see Behavioral interventions
Incentives, financial, 56, 115, 120, 127
top-down models, 64-66
Information dissemination, 4, 6, 9-11, 18, 19, 21, 45, 49, 58, 76, 84, 95, 116-117, 124, 131, 247
academic/CBO collaboration, 12-13, 20, 35, 68, 111-112, 119, 135, 137
bidirectional, general, 2, 3, 18, 23, 36, 58-59, 66-67, 121, 123, 135-137, 144, 186-197
definitional issues, 58
guidelines, 62-64
NIDA role, 12-15, 28, 48-49, 58, 116-118, 119-120, 136
policymakers, 7-8, 9-11, 19, 31-32, 113
see also Education and training;
Management information systems;
Technology transfer
Infrastructure, 19, 56, 69, 106
CCOP strategy, 5, 101-102, 106, 112-113
DHHS support, 65
state support, 97
Inhalants, 239
Inpatient treatment
Alcohol and Drug Services Study, 188-193 passim
block grants and, 42-43
heroin addiction, NIH treatment statement, 208
outcome monitoring, 149, 150-155 passim, 158, 159-163, 170, 172
see also Residential treatment
Institute of Medicine, v, viii-ix, 1, 4, 17-18, 23, 48, 95, 106
study objectives, 123-124
technology transfer, 57-58, 62-63
Institutional review boards, 78
Insurance, see Health insurance
Internet resources, 226-232
Iowa Consortium for Substance Abuse Research and Evaluation, 95-98, 107
J
Jails, see Prisons and jails
Joint Commission on Accreditation of Healthcare Organizations, 20, 100
K
Kentucky, 22
Knowledge development, see headings beginning ''Research"
Knowledge dissemination/transfer, see Information dissemination;
Technology transfer
L
LAAM, 49, 149, 151, 166, 201, 209, 212
Language, see Foreign language speakers
Law, see Crime and criminal justice system;
Informed consent;
Regulatory issues
Legislation
federal
ADAMHA Reorganization Act of 1992, 95-96
Harrison Act, 199
Mental Health Parity Act, vi
Narcotic Addict Rehabilitation Act, 22
women's services, 36
state
Length of treatment, see Duration of treatment
Levo-alpha-acetylmethadol/levomethadyl acetate, see LAAM
Licensing and certification, professional, 8, 44, 115, 165, 175
Local factors, see Community-based drug treatment organizations;
Community-level factors, other
Local government, 17, 42, 43, 114
M
Managed care organizations, general, 2, 3, 7, 11, 12, 17, 18, 24, 27, 29, 63, 64, 65-66, 90, 95, 101, 186, 235-236, 248
see also Community-based drug treatment organizations;
Health maintenance organizations
Management information systems, 8, 100, 101, 111, 113, 115, 127
Alcohol and Drug Services Survey, 188-189
TEDIS, 232
training in, 77
see also Databases
Managers, see Administrators and managers
Marijuana, 22, 193, 194, 206, 239
Marital status and therapy, 153, 168, 169
Massachusetts, 22
Mathematica study, vi
Medicaid, 42, 94, 96, 176, 197
Medical education, 12-13, 47-48, 62-63, 210-211, 213
continuing medical education, 8, 12, 15, 48, 62-64
Medical interventions, 24, 31, 56, 94-94, 112, 173
acupuncture, 37-38, 150, 175, 195, 244
Alcohol and Drug Services Survey, 188
Medicaid, 42, 94, 96, 176, 197
NIH heroin addiction treatment guidelines, 204, 206
see also Biopsychological factors;
Detoxification methods and centers;
Hospitals;
Saliva testing;
Urine testing
Mental Health Parity Act, vi
Mental Health Services Administration, see Center for Substance Abuse Treatment
Mental illness, other than alcohol/drug abuse, 16-17, 25, 38-39, 68, 84, 203, 238, 249-250
adolescents, 239
outcome monitoring, 154-155, 157, 160, 170, 171, 172, 173, 175, 176
see also Biopsychological factors;
Psychiatric treatment
Methadone, 22, 30-31, 32-33, 34, 35, 47, 49-50, 58, 62, 80, 149
Alcohol and Drug Services Survey, 188, 192
NIH treatment guidelines, 201-214 passim
nonmethadone treatments vs, 37, 208, 209
outcome monitoring, 151, 154, 155, 158, 164-166, 170-172
withdrawal from, 166, 204, 208
Methamphetamines, 194, 229-230
Methodology, see Research methodology
Minority groups, 7, 47, 91, 101, 114, 139, 142, 152, 153, 194, 214 , 237, 238
adolescents, 239
see also specific groups
"Money with strings," see Incentives, financial
Motivation, see Attitudes;
Behavioral interventions;
Contingency management
Multi-problem addicts, 16-17, 25, 34, 38-39, 46, 168-174, 212, 239 , 250
Multiple substance abusers, 27, 38, 158, 174, 209
Multiple treatment modalities, 17, 30, 31, 34-35, 103, 168-174, 175
Myths of addiction, see Stigma
Naltrexone, 28, 33, 80, 166-168, 201, 207-208
alcohol abuse treatment, 33, 167
Narcotic Addict Rehabilitation Act, 22
Narcotics Anonymous, 140, 162-164, 175
National Acupuncture Detoxification Association, 37
National Advisory Council on Alcohol Abuse and Alcoholism, 95
National AIDS Demonstration Research, 105
National Alliance for the Mentally Ill, 47
National Alliance of Methadone Advocates, 47
National Association of Alcohol and Drug Abuse Counselors, 20
National Association of State Alcohol and Drug Abuse Directors, 65
National Cancer Institute
see also Community Clinical Oncology Program
National Committee on Quality Assurance
see also Health Plan Employer Data and Information Set
National Institute of Mental Health, 94
National Institute on Alcohol Abuse and Alcoholism, 7, 9, 10, 13-15, 74, 94, 95, 100, 102, 104, 108, 116, 117
Project MATCH, 155, 159, 162, 170, 173
National Institute on Drug Abuse, v, vii, 7, 74, 94, 114, 124
acupuncture, 37-38
definitional issues, 23
grant review, 106
information development/dissemination, 9, 10, 12-15, 28, 48-49, 58 , 116-118, 119-120, 136
methamphetamine abuse, 229-230
NIH heroin addiction treatment guidelines, 213
prevention demonstrations, 102-103, 108
service delivery approaches, 34, 116
technology transfer, 12-13, 48-49, 58, 119-120, 136
understudied approaches, 37
Web site, 58
National Institutes of Health, v, 15, 101, 106, 107
heroin treatment guidelines, 198-225
methadone maintenance, 32-33
Native Americans, 3, 20, 73-74, 98-99, 194
Navajo Nation, 20, 96, 98-99, 108
New Hampshire, 30
New Jersey, 22
New York, 22
NIDA, see National Institute on Drug Abuse
Non-residential treatment, see Outpatient treatment
Non-traditional interventions, 87, 244
acupuncture, 37-38, 150, 175, 195, 244
relaxation therapy, 175
North Dakota, 30
Not-for-profit organizations, 74, 137, 237
abusers, recovering, 22
Alcohol and Drugs Services Study, 188, 189, 191, 196, 197
HMOs, 140
market forces and, 59
Treatment Episode Data Set, 232
O
Office for Treatment Improvement, 94
Office of National Drug Control Policy, 22, 94, 213
methadone maintenance, 32
Ohio, 31
Opiates, 22, 32-33, 49-50, 194
biopsychological factors, 200-201, 203-204, 212
dependence defined, 204
outcome monitoring, 153, 154, 155, 158
relapse and relapse prevention, 200, 202, 205, 208, 212
treatment guidelines, 61, 198-225
withdrawal from, 151, 166, 207-208, 244
see Buprenorphine;
Heroin;
LAAM;
Methadone;
Naltrexone
Organizational factors, general, 4-5, 9, 40-42, 56, 94, 116, 237
ADAMHA reorganization, 94-95
Alcohol and Drug Services Survey, 188-190
change models, 59-60, 66-69, 82-86, 87
cultural, vii, 5, 27-29, 60, 85-86, 108, 112, 136
funding, 196-197
institutional review boards, 78
learning, 6, 76, 79, 111-112, 113
see also Administrators and managers;
For-profit organizations;
Infrastructure;
Not-for-profit organizations
Orlaam ™, see LAAM
Outcome monitoring, 10-12, 14, 17, 25, 39, 41, 49, 61-64, 93, 95, 96, 99-100, 118
alcohol abusers, 153-160 passim, 167, 168, 169
cocaine users, 153, 155, 159, 160-161, 163, 164, 167-168, 171
consumer participation, 11
crime and criminal justice system, 152, 160, 165, 171, 176, 209
definitional issues, 149, 174-175, 176
employment variables, 157-158, 160, 165, 169, 171, 172, 173
family factors, 158-159, 160, 167, 168, 173, 175, 176
goals, controversy, 38
homeless persons, 103-104
inpatient treatments, 149, 150-155 passim, 158, 159-163, 170, 172
relapse, 154, 157, 158, 159, 163, 164, 170, 171, 172, 195
residential treatment, 150, 155, 159-160, 172
social factors, 158-159, 160, 172
socioeconomic status, 142-143, 152, 203, 239, 243
top-down incentives, 65
see also Evidence-based treatments
Outpatient treatment, 22, 37, 49, 137, 138, 149, 243
Alcohol and Drug Services Survey, 188, 192, 193
outcome monitoring, 150, 159-161, 171, 172
see also Counseling and counselors
Community Reinforcement Approach, 169-170, 240-242
crime and criminal justice system, 239, 243
HIV-infected persons, 105, 114
P
see also Children;
Families
Patient Outcome Research Teams, 63-64
Peer support, 22, 24, 27, 41, 44, 45, 75, 138, 164, 243, 244
Alcoholics Anonymous, 24, 27-29, 85, 138, 140, 160, 162-164, 169, 175
Narcotics Anonymous, 140, 162-164, 175
Synanon, 22
see also Group therapy
Performance Partnership Grants, 65
Pharmacotherapy, see Drugs to treat abusers
see also Medical education
Physicians in Residence program, 48
Policy and policymakers, general, vi, 1-8 passim, 14, 18, 29, 40, 49-51, 56, 90-91, 96, 97, 113, 114-115, 127, 247-248
historical perspectives, 21-23
knowledge development/dissemination, 7-8, 9-11, 19, 31-32, 113
report at hand, panelists, 126
war on drugs, 22
see also Funding;
Legislation
Political and ideological factors, vi, 16, 19-20, 51-52, 94
see also Cultural factors;
Religious factors
Practice-based research networks, 6, 12, 57, 69, 79, 119
see also Community Clinical Oncology Program
Practice guidelines, 61-64, 75, 248
heroin addiction treatment, NIH guidelines, 198-225
see Clinical protocols
Pregnancy, 36, 49, 65, 153, 195, 207, 239
Preventive interventions, 87, 91, 95, 96, 97, 102-104, 108, 249
academic research, 102-103
school-based, 73-74, 97, 102-103, 240
see also Followup treatment;
Identification of abusers;
Outreach
cocaine abusers, 249
cost-effectiveness, 49
historical perspectives, 22, 25
opiate offense incarceration, 200
Professional education, 2, 4, 6, 12-13, 15, 69-70, 76, 97, 107, 119 -120
counselors, 84
Internet sites, 228
licensing/certification, 8, 44, 115, 165, 175
practice-based research networks, 6, 12, 57, 69, 79, 119
see also Academic programs and research;
Medical education
Program of Assertive Community Treatment, 67-68
Project MATCH, 155, 159, 162, 170, 173
Psychiatric treatment, 16, 25, 61, 150, 152, 154, 170, 172, 203
Psychological factors, see Biopsychological factors
Public education, 4, 6, 14, 113, 118
school-based preventive interventions, 73-74, 97, 102-103, 240
see also Mass media
Puerto Ricans, 139
Q
Quality control, 39, 76, 93, 99
see also Evaluation methodology;
Standards
R
Racial factors, see Minority groups;
White persons
Alcohol and Drug Services Survey, 191
clinical protocols, 6, 96, 100, 161
Regulatory issues, 6, 19, 21, 24, 90-91, 113, 138, 141, 211-212
state barriers, 40
see also Legislation;
Standards
Relapse and relapse prevention, 16, 30, 33, 34, 58, 100, 236
opiates, NIH statement, 200, 202, 205, 208, 212
outcome monitoring, 154, 157, 158, 159, 163, 164, 170, 171, 172, 195
Relaxation therapy, 175
Religious factors, 24, 85-86, 138, 140, 244
Research, general, vii, 2, 4-11, 14, 56, 111-114, 116
academic/CBO collaboration, 12-13, 76, 79, 87, 96, 98-99, 102-103, 140, 141, 144
agenda building, 21
clinical settings, researchers in, 6, 12, 57, 69, 79, 89-110, 119
cost of practice linkages, 4, 76-77, 111-112
cultural factors, vii, 24, 77, 96
direct CBO contributions to, 73-88
Internet sites, 228
CBOs as researchers, 5-6, 58-70, 83, 85, 123-124, 131
researchers as such, 5-6, 95-105, 123-124
NIH heroin addiction treatment guidelines, 212-214
practice-based research networks, 6, 12, 57, 69, 79, 119
small projects, 7, 76, 84, 114, 148
social factors, vii, 92-93, 94, 158-159
training strategies, 12-13, 15
understudied approaches, 35-40
underutilized, 32-34, 116-117, 135-136, 147-176
see also Academic programs and research;
Data collection;
Information dissemination;
Outcome monitoring;
Technology transfer;
Theory
Research methodology, 80-82, 90, 91-92, 94, 95
Alcohol and Drug Services Study, 187-188
applied social science, 91-92
clinical trials, 32, 37, 38, 62, 68, 79, 86, 90, 100-101, 106, 148 , 152, 174
detoxification, literature review, 148-176
evidence-based treatments, 10-11, 14, 17, 56, 59-60, 63-64, 118
homeless persons, 103-104
longitudinal studies, 249
NIH heroin addiction treatment guidelines, 199
report at hand, v-vii, 20-21, 123-134
participants, 128-130, 132-134
see also Evaluation methodology
Research recommendations, 1, 18, 123-124, 247-250
CSAT role, 10, 13-15, 18, 74, 94, 100, 117-118, 120
implementation of research, vii, 4-7, 111-114, 148
NIDA role, 9, 10, 12-15, 28, 48-49, 58, 116-118, 119-120, 136
small research projects, 7, 76, 84, 114, 148
technology transfer, 12-13, 48-49, 58, 119-120, 136
treatment facilities placement, 38
Residential treatment, 27-28, 80, 86, 137, 138, 141
Alcohol and Drug Services Survey, 188, 189, 192, 193
outcome monitoring, 150, 155, 159-160, 172
see also Detoxification methods and centers;
Halfway houses;
Hospitals
Revia™, see Naltrexone
Runaways, 239
S
Saliva testing, 204
SAMHSA, see Substance Abuse and Mental Health Services Administration
Screening, see Identification of abusers
Self-help, see Peer support
Severity of addiction, 154, 168, 170, 173-174, 206, 236, 249
Addiction Severity Index, 103, 155-156, 172
duration of abuse, 153
Social factors, general, 20, 80, 87, 97, 139, 142-143
community defined, 136-137
outcome monitoring, 158-159, 160, 172
research, vii, 92-93, 94, 158-159
see also Community-level factors;
Cultural factors;
Socioeconomic status
Social support and services, 20, 31, 34, 86, 97, 116-117, 137, 140 , 141
Alcohol and Drug Services Survey, 187-197
Medicaid, 42, 94, 96, 176, 197
see also Children;
Families;
Group therapy;
Parents;
Stakeholders
Socioeconomic status, 142-143, 152, 203, 239, 243
see also Homeless persons
South Dakota, 30
Special Action Office for Drug Abuse Prevention, 22
Stakeholders, general, 3, 9, 19, 20, 57, 70, 93, 100, 116, 151
clinical, 6, 12, 96, 100, 161, 233-234
consumer participation, 8, 12, 119
data collection, 104
funding and, 141
level of care, 100
practice guidelines, 61-64, 75, 198-225, 248
licensing/certification, 8, 44, 115, 165, 175
State government, vii, 2, 8, 14, 114, 115, 118
AIDS, 105
consumer participation, 12
professional licensing/certification, 8, 44, 115, 165, 175
service delivery monitoring, 9, 116
see also Block grants
State-level actions, 22-23, 95-86
service delivery approaches, 35
see also District of Columbia;
State government;
specific states
Statistics, 93
access to treatment, 16
addiction and dependency, national figures, 1, 16, 200, 205-206
Alcohol and Drug Services Survey, 187-188
cancer treatment, 68
counselor training, 44
naltrexone treatment, 33
outpatient treatment, 37
see also Databases;
Data collection;
Management information systems
STEP ONE, 89-90
Stigma, 9, 11, 16, 17, 25, 32, 46-48, 49-50, 116, 153, 205, 210, 213
Structural factors, see Infrastructure;
Organizational factors
Substance Abuse Prevention and Treatment Block Grant, 7, 114
Substance Abuse and Mental Health Services Administration, v, vi, 17-18, 68, 94-95, 106, 138, 187, 232
Synanon, 22
T
Technical assistance, 31, 42, 49, 58, 77, 104, 250
Technology transfer, 4, 9, 18, 21, 48-49, 116, 117, 123-124
bidirectional, general, 2, 3, 18, 23, 36, 58-59, 66-68, 121, 123, 135-137, 144, 186-197
CSAT role, 58, 59-60, 115, 120, 136
definitional issues, 57-58
NIDA role, 12-13, 48-49, 58, 119-120, 136
trust-building and, xv, 3, 5, 56, 57, 66-70, 74, 98, 112
see also Medical education
Telephone contacts, 248
Television, 10
counseling, 80
etiology of drug addiction, 1, 16, 31, 150, 202-204
Therapeutic community, see Synanon
Time factors
community defined, 137
duration of abuse, 153;
see also Severity of addiction
duration of treatment, 35, 147, 149, 150, 151, 154, 161-162, 166, 181, 207, 209, 248
research/implementation lag, 19, 29, 31, 250
state implementation of federal requirements, 19
Tobacco, 148
Training, see Education and training
Transportation services, 49, 195, 247
Treatment Assistance Publication Series, 58-59
Treatment Episode Data Set, 232
Treatment Improvement Exchange, 59
Trust building, xv, 3, 5, 56, 57, 66-70, 74, 98, 112
U
University-based programs, see Academic programs and research
University of Rhode Island Change Assessment, 157
Urine testing, 33, 49, 151, 160, 164, 166, 187, 204
V
Vermont, 30
Videotapes, 58
W
Washington, D.C., see District of Columbia
Washington State, 20