Bridging the Gap Between Practice and Research Forging Partnerships with Community-Based Drug and Alcohol Treatment (1998) / Chapter Skim
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1 Introduction
1 Introduction
Pages 16-26
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From page 16... ...
In fact, almost 80 percent go untreated, a figure that has changed little in the 1990s while the number needing treatment has increased (Epstein and Gfroerer, 1998~. The stigma of drug abuse and the political and financial barriers encountered at all levels impede efforts to increase treatment.
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From page 17... ...
The absence of an evidence-based approach to addiction treatment, coupled with a lack of valid and reliable measures of treatment outcome, has induced skepticism on the part of purchasers of care, policymakers, and consumers as to the value of treatment for drug and alcohol abuse and dependence. Skepticism and the stigma attached to these disorders, which are perceived by many as volitional and suggestive of moral weakness, has further led to discrimination in benefit design and reluctance by payers and managed care organizations to allocate resources to the care of such patients.
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From page 18... ...
Thus, the audience for this report is quite broad and includes federal, state, and local policymakers, drug treatment researchers, community-based treatment providers (including their professional organizations) , and consumers, as well as sponsors of research and treatment programs.
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Policy panelists stated that federal and state policymakers needed to know what worked, and that Congress wanted evidence to support community-based treatment organizations as the front line of prevention and treatment. Researchers and providers spoke of financial and political barriers to .
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This meeting provided an opportunity to obtain an overview of community-based drug treatment in a richly multicultural and mostly rural state containing a very large Hispanic population and 26 Indian nations. In addition to researchers from CASAA, participants included representatives of the state substance abuse agency, the state legislature, the city of Albuquerque, Albuquerque public schools, New Mexico drug courts, the Navajo Nation, and the regional representative of the National Association of Alcohol and Drug Abuse Counselors.
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From page 21... ...
These topics included: diffusion of innovation and dissemination; models of collaboration; research agenda building; drug services survey data; requirements of federal and state policy; and, finally, the implications of the current research grant review process for efforts to form and maintain research collaborations with community-based treatment organizations. Four additional activities completed the major data gathering phase of the study: 1.
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From page 22... ...
Stimulated by federal initiatives, such alternatives accompanied the trend to Reinstitutionalize the mentally ill from state mental hospitals, develop community mental health centers, and fund alcoholism and drug abuse treatment programs (Besteman, 1992; IOM, 1990a,b)
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From page 23... ...
While the committee focused its data collection primarily on drug abuse treatment and research, it recognized that alcohol is also a drug and one that plays a large part in community-based drug treatment. Hence recommendations are included for the National Institute on Alcohol Abuse and Addiction (NIAAA)
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From page 24... ...
Likewise, the committee was cautious not to exclude, a priori, any significant programs of interest by a determination tnat tney were not "community-based." Thus, the public workshops included representatives from a diverse group of treatment programs, ranging from small programs who would be considered communitybased by the most restrictive definition, to large and complex programs sponsored by larger entities, such as the Department of Veterans Affairs, academic medical centers, state court systems, and managed care organizations. One of the important cultural elements that differentiates among community-based treatment programs is the set of beliefs that each uses to define the knowledge base about how to deliver effective drug treatment.
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From page 25... ...
To do this they must have new tools, new skills, new incentives, and new partnerships. SUMMARY Community-based services for drug and alcohol addiction developed in response to many factors: poor care in state mental hospitals, discrimination and prejudice in general hospitals and private facilities, inhumane conditions in "drunk tanks," the expense of providing institutional services, and the need to rapidly expand the nation's capacity to provide treatment for drug abuse and alcoholism.
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From page 26... ...
1991. NIDA Research Monograph 113: Economic Costs, Cost-Effectiveness, Financing, and Community-Based Drug Treatment.
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