Linkages between practice and research and program participation in research can enhance staff pride and esteem and foster consumer empowerment. Staff take satisfaction in their organization's contribution to building practice knowledge as well as improving treatment. For the treatment consumers, a program's participation in research symbolizes its effort to provide the most current treatments. Consumers can also take pride in the opportunity to participate in research initiatives when the research is viewed as relevant to improving their treatment—and when research recruitment is conducted within established guidelines for the protection of research subjects (Code of Federal Regulations, Title 45, Part 46, 1991). Under these federal guidelines, drug abusers are considered a vulnerable population and thus the informed consent process and content are carefully examined by the institutional review board (IRB) with jurisdiction. The knowledgeable and respectful explanation of the study and obtaining of true informed consent can form an important bond between participant and the program. There are a number of ways in which research participation may motivate consumers to participate more actively in the treatment process. However, the most enduring potential benefit to the CBO of a linkage with research may be assistance in building or enhancing a culture of learning, which loosens the grip of dogmatic approaches that are sometimes barriers to adopting demonstrated best practices and bringing new ideas into an organization.

Linkages between treatment providers and research teams can assume many forms, ranging from simply providing access to subjects to becoming full collaborators in the development of research proposals, implementation of protocols, interpretation of data, and publication of results. Collaboration may eventually result in some CBOs developing free-standing research programs, as happened at Arapahoe House.

Examples abound of treatment programs that have simply ''hosted" a particular study. Researchers arrive with a funded research protocol and IRB approval, needing only the subjects. For the clinical site, such experiences can be good or bad, depending substantially on the quality of the communication and consideration shown them in the course of the study. The committee heard examples where both communication and consideration failed, even in the context of established relationships, usually because of the failure to understand and appreciate each other's perspective.

Few examples were cited of investigations where the research questions start as clinical conundrums brought forward by treatment providers, where treatment staff have roles as co-investigators, and where the goal is the