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A Need for Research: The State of Substance Abuse Treatment in Communities

Less than 20 percent of the nation’s 9.4 million drug-addicted and dependent individuals receive treatment each year. In spite of great strides made in research on the science and treatment of addiction, there are still many barriers to linking research findings with policy development and treatment implementation. Critical to improving treatment is closing the gap between community-based treatment organizations and researchers.

Across the country, treatment providers talked with the committee about their needs for improved treatment. Consistently, providers expressed their need for research to help them determine efficacy and cost-effectiveness of treatments. Despite this need, relatively few researchers work closely with community-based treatment organizations, and even fewer providers actively participate in research. This is not to assign blame, but rather to explain why the gap exists and to find ways to bridge it.

The universe of community-based treatment providers is large—there are more than 8,000 such facilities in the United States—and they account for the bulk of drug and alcohol treatment. The broad range of treatment programs includes therapeutic communities, freestanding outpatient clinics and programs based in health departments, hospitals, academic medical centers and managed care organizations. Self-help programs are included in most of these treatment settings.


There is a gap between knowledge gained from clinical experience and knowledge gained from basic science and applied treatment research. The IOM study addresses this gap with the goal of enhancing collaborative relationships between providers and researchers to improve the effectiveness and efficiency of the treatment of addictive disorders in the United States.

Bridging this gap will:

  • facilitate collaborative research to address the needs of community-based treatment organizations;

  • encourage the adoption of proven research findings into treatment practice; and

  • broaden the tools available to community-based treatment organizations by enhancing their ability to develop more targeted interventions. See recommendations, pp. 8–9.


Substance abuse among young women has set new challenges before the treatment community and presents a research opportunity for providers. The rapid development of women’s programs, which has occurred with little systematic evaluation of the processes and outcomes of treatment, provides researchers and clinicians with the chance to study new treatment modalities through all stages of development and implementation. Evidence-based treatment for women presents an opportunity for providers and researchers to set a collaborative research agenda and study new treatment approaches from concept through development and implementation.

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