Practitioners and policymakers requested more research on treatment effectiveness and studies that help programs operate more effectively and identify interventions that serve clients more effectively. The complexity of the contemporary economic and policy environment increases the importance of health services research and the dependence of policymakers on the data and results from research investigations.

The committee's findings suggest that expanding the range of studied treatment settings, treatment modalities, and treatment populations may result in more broadly applicable treatment research findings. These observations led the committee to make two specific recommendations in this area.

RECOMMENDATION 5. CSAT and NIDA should develop mechanisms to enable state policymakers to monitor service delivery in community-based treatment programs and to determine if consumers receive services empirically demonstrated as effective and to ascertain if the treatment dosage and intensity are sufficient to be effective.

RECOMMENDATION 6. NIDA and NIAAA should continue to support "real world" services research and cost-effectiveness studies and include the development of services research in their strategic plans.

The committee found at least four factors that inhibit diffusion of drug abuse treatment knowledge: (1) the structure of treatment delivery systems; (2) the diversity of the clients, providers, and other stakeholders; (3) the stigmatization of people who are dependent on alcohol and other drugs; and (4) an inadequate base of knowledge about technology transfer specific to the field. Differences in perspective among consumers, clinicians, researchers, and policymakers also inhibit knowledge dissemination and use.

Because providers and payers are often unaware of the latest research, the committee found a pressing need to create consensus in the field about which treatments have been proven to be effective and which have been proven to be ineffective. Further, the research agendas of the federal agencies should continue to be fueled by agreement in the field on which models have not received adequate study. The fruits of this consensus process should be widely distributed.