Bridging the Gap between Substance Abuse Practice and Research: The National Treatment Plan Initiative
Clark, H. Westley, Journal of Drug Issues
BRIDGING THE GAP BETWEEN SUBSTANCE ABUSE PRACTICE AND RESEARCH: THE NATIONAL TREATMENT PLAN INITIATIVE
The abuse of alcohol and other drugs leads to serious health problems, criminal activity, automobile crashes, and lost productivity in the workplace. As we advocate treatment for those who suffer from alcohol or drug addiction, we must advocate treatment that is proven effective for the drug and populace involved. However, due to background, cultural, and language differences between substance abuse researchers, treatment providers, and policy makers, empirically tested treatments are not being put into widespread practice. To bridge this gap, the Center for Substance Abuse Treatment sponsored the National Treatment Plan Initiative, a two-year effort to listen to multiple segments of the treatment field. This led to the formation of the Practice Improvement Collaborative (PIC) Program, whose purpose is to foster community-based partnerships that are committed to the identification, adoption, and evaluation of evidence-based practices that address locally defined needs. The PIC and the overall goals of the National Treatment Plan are discussed.
The 2000 National Household Survey released by the Substance Abuse and Mental Health Services Administration (SAMHSA, 2001) shows that almost 10% of youths aged 12-17 reported current illicit drug use in 2000. In the 18-20 age group, that figure jumps to almost 20%.
There is no question that more needs to be done to reach our youth with the message that use of ecstasy, methamphetamine, marijuana, or heroin is not a benign thrill. But we also cannot abandon those who do not heed this message. Abuse of alcohol or drugs leads to serious health problems, criminal activity, automobile crashes, and lost productivity in the workplace.
As we advocate treatment for those who suffer from alcohol or drug addiction, we must advocate treatment that is proven effective for the drug and populace involved. During the past decade, there has been an unprecedented growth in support for substance abuse research. As a result, a wealth of promising research leads and preliminary findings are being reported at an accelerating pace across a broad range of areas, particularly neuroscience, pharmacology, clinical management, and health services delivery.
However, the practitioner in the field has neither the time nor the magic compass it would take to track the progress of validation studies or the application of clinically tested findings that prove sound in real world clinical practice. At a time when our practitioners are stretched to the limit to provide critically needed services to clients, they are now also challenged with the task of integrating a continuous stream of evidence-based practices into their clinical settings. Managed care constraints, public sector regulations and policies, limited resources, underpaid staff, and a reimbursement system that calls for quality care with fewer client contact hours are just some of the difficult conditions our providers face. The overburdened clinician winds up perplexed by demands that treatment methods have proof of effectiveness and concerned that the new approaches being touted are really fads. This conflict reflects the background, cultural, and language differences between researchers, providers, and policy makers that, among other factors, help create a gap between substance abuse research and practice.
The need to bridge this gap was first voiced by the Institute of Medicine (IOM) in 1998 in the report Bridging the Gap Between Practice and Research: Forging Partnerships with Community-based Drug and Alcohol Treatment. The Center for Substance Abuse Treatment (CSAT) and the National Institute on Drug Abuse sponsored this study, which highlighted the importance of finding solutions that can bring down the barriers between research and clinical practice. The IOM noted that there have been few incentives to encourage researchers to examine the application and sustainability of their research findings in a real world clinical setting. …