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Sci Pract Perspect. 2003 August; 2(1): 3.
PMCID: PMC2851039

Innovation, Adaptation, Integration, Conversation

In Science & Practice Perspectives, researchers and service providers present and respond to each other’s ideas and insights on important practical topics pertaining to drug abuse. All share the goal of improving treatment and prevention and the conviction that dialogue and collaboration among professional groups are essential for success.

This issue of Perspectives covers topics ranging from one of the first and still the most common of drug abuse interventions—12-step recovery programs, to one of the most innovative—antinicotine treatment with mandatory abstinence in a substance abuse treatment setting. Our five articles and our roundtable responses contain well-grounded recommendations ranging from best clinical practices to the need for system-wide adaptation and integration.

  • Greg Brigham draws attention to commonalities in the ways 12-step programs and science-based drug abuse treatments promote recovery. He submits that more research attention to 12-step programs can deepen our understanding of these processes in ways that strengthen both types of interventions. Researcher-respondents Robert Forman, Keith Humphreys, and Scott Tonigan summarize the empirical evidence on preparing patients in drug abuse therapy for successful engagement in 12-step programs after they leave treatment.
  • Lawyer and drug abuse researcher Douglas Marlowe urges closer integration of the criminal justice and drug abuse treatment systems. He cites evidence that for drug-involved offenders in treatment after incarceration, a combined criminal justice-drug abuse assessment can determine the best division of labor between criminal justice supervisors and drug treatment counselors. In response, Allan Cohen, Jennifer Mankey, and William Wendt describe aspects of the public safety-public health interfaces in their own communities and their efforts to increase coordination through cross-training, blended funding, and other means.
  • Paula Riggs reviews what researchers have learned about treating adolescents for substance use and comorbid psychiatric disorders and concludes that while many key issues require further investigation, current data are enough to guide a basic set of best treatment practices. Building on her review and original research, Dr. Riggs makes a strong case against the common practice of withholding psychiatric treatment for youthful patients until they have achieved a period of sustained abstinence. Respondents Patricia Chandler, Franklin Ingram, and Joseph Richard highlight the specific best practice recommendations they intend to incorporate in their own clinical work.
  • James Sharp and coauthors describe how they incorporated antinicotine treatment with zero tolerance for tobacco possession or use into three State-funded residential addiction treatment centers. Researchers Lirio Covey, Anne Joseph, and Steven Shoptaw praise the authors’ “groundbreaking” initiative and agree that the rationale is strong for treating nicotine addiction no differently from the other addictions. However, they also judge that data are needed to answer many questions concerning which clinical antinicotine policies and interventions can yield the best overall benefits for patients during and after treatment for other addictions.
  • Nancy Petry and Michael Bohn relate their experiences using low-cost incentives that reinforce drug abuse patients’ motivation to succeed in treatment. Dr. Petry describes what she has learned from her formal research on the practice, and Dr. Bohn tells about implementing affordable incentives in his community-based clinic.

As we would expect from practitioners of two professions oriented toward a single great goal, our article authors and respondents widely concur. Not surprisingly, however, given researchers’ and clinicians’ different training and roles, their views occasionally diverge. Airing and examining such differences is an indispensable and creative part of effective collaboration. The Perspectives peer review process ensures that the information and interpretations presented here are of high quality, even when consensus has yet to emerge.


Articles from Science & Practice Perspectives are provided here courtesy of National Institute on Drug Abuse