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Front Matter -- Preface -- Acknowledgments -- Contents -- Acronyms -- Executive Summary -- 1 Introduction -- 2 The Gaps Between Research, Treatment, and Policy -- 3 Approaches to Closing the Gaps -- 4 Benefits and Challenges of Research Collaboration for Community-Based Treatment Providers -- 5 Benefits and Challenges of Community-Based Collaboration for Researchers -- 6 Findings and Recommendations -- A Statement of Task -- B Workshops and Roundtable: Agendas and Participants -- C Drug Treatment Programs and Research: The Challenge of Bidirectionality -- D The Treatment of Addiction: What Can Research Offer Practice? -- E The Substance Abuse Treatment System: What Does It Look Like and Whom Does It Serve? -- F National Institutes of Health Consensus Development Statement on Effective Medical Treatment of Heroin Addiction -- G Useful Internet Resources-Examples -- H List of Currently Available CSAT Treatment Improvement Protocols (TIPs) -- I Opportunities for Collaboration -- J Summary of Interviews with Minnesota State Alcoholism-Addiction Leaders -- Index.

Intro -- MEDICAID AND TREATMENT FOR PEOPLE WITH SUBSTANCE ABUSE PROBLEMS -- MEDICAID AND TREATMENT FOR PEOPLE WITH SUBSTANCE ABUSE PROBLEMS -- CONTENTS -- PREFACE -- Chapter 1 INTRODUCTION: MEDICAID AND MEDICAID COVERAGE FOR TREATMENT OF ALCOHOL AND DRUG DISORDERS -- ACKNOWLEDGEMENT -- REFERENCES -- Chapter 2 OVERVIEW OF MEDICAID AND SUBSTANCE ABUSE TREATMENT -- ABSTRACT -- INTRODUCTION -- MEDICAID REHABILITATION OPTION -- Medicaid Clinic Option -- Early and Periodic Screening, Diagnosis and Treatment (EPSDT) -- Blended/Braided Funding -- Temporary Assistance to Needy Families (TANF) -- Medicaid Waivers Under Social Security Act Section 1115 and Section 1915(B) -- Health Insurance Flexibility and Accountability (HIFA) Demonstration Waiver -- CONCLUSION -- ACKNOWLEDGEMENTS -- REFERENCES -- Chapter 3 INSURANCE INSTABILITY: REPLACEMENT OF AID TO FAMILIES WITH DEPENDENT CHILDREN BY TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND IMPACT ON MEDICAID CLIENTS WITH SUBSTANCE ABUSE PROBLEMS -- ABSTRACT -- INTRODUCTION -- BACKGROUND -- Instability in Medicaid -- CHAPTER QUESTIONS -- Insurance and Access to Care -- METHODS -- Overview -- Study Site -- Sample -- Baseline Sample -- Follow-Up Procedures -- Sample Characteristics -- Measures -- Data Analysis -- Methodological Limitations -- RESULTS -- Instability in Insurance Coverage -- Instability of Insurance Coverage and Access to Treatment -- Treatment Access among Medicaid Recipients -- CONCLUSION -- Policy Implications -- ACKNOWLEDGEMENTS -- REFERENCES -- Chapter 4 HISTORY OF MEDICAID MANAGED CARE AND SUBSTANCE ABUSE TREATMENT -- ABSTRACT -- INTRODUCTION -- SERVICES AND THEIR VALUE FOR PEOPLE WITH SUBSTANCE ABUSE PROBLEMS -- MANAGED CARE AND ITS IMPACT ON SUBSTANCE ABUSE TREATMENT -- PUBLIC SECTOR MANAGED CARE FOR SUBSTANCE ABUSE TREATMENT.

Implementing specific evidence-based practices (EBPs) across a set of addiction treatment providers have been a persistent challenge. In the Advancing Recovery(AR) demonstration project, single state agencies, the entities that distribute federal funds for substance use disorder prevention and treatment services, worked in partnership with providers to increase the use of EBPs in the treatment of addiction. The project supported two cohorts of six 2-year awards. Field observations from the first year of implementation guided development of a multilevel framework (the Advancing Recovery Framework). Government entities and other payers can use the framework as a guide for implementing evidence-based clinical practices within treatment networks. The Advancing Recover Framework calls for a combination of policy and organizational changes at both the payer (government agency) and provider levels. Using the Advancing Recovery Framework, 11 of the 12 AR payer/provider partnerships increased use of clinical EPBs. This article identifies key payer policy changes applied during different phases of EBP program implementation. The public health benefit of the demonstration project was broader use of medication–assisted therapy and continuing care in addiction treatment services.

Movement toward legalization of cannabis grows in the United States yet little is known about long‐term use effects. This study was an initial step in the instrument development of a patient registry questionnaire of cannabis users who will be followed over time. Cannabis‐using patients (12 females, 10 males) aged 20–64, were sampled from a Portland, Oregon primary care health center. Respondents completed semi­structured qualitative interviews describing methods of cannabis use, motivations for use, and perceptions of risks and benefits. Qualitative analysis used a content analysis approach to assess and extract salient themes. Patients smoked, inhaled, ingested, and applied a wide variety of cannabis products. All participants but one reported using cannabis for perceived physiological or psychological pain and several used cannabis to alleviate cravings for opioid medications. Other motivations included relief from suicidal thoughts and depression, anxiety, migraines, and neuropathic pain. Relatively few perceived risks as compared to benefits were reported. This study provides relevant insight into how and why these primary care patients use cannabis. Results will be used to construct a quantitative questionnaire for a patient registry that can provide critical information about long‐term use effects.

Health services research is a multidisciplinary field that examines ways to organize, manage, finance, and deliver high-quality care. This specialty within substance abuse research developed from policy analyses and needs assessments that shaped federal policy and promoted system development in the 1970s. After the authorization of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA), patient information systems supported studies of treatment processes and outcomes. Health services research grew substantially in the 1990s when NIAAA and NIDA moved into the National Institutes of Health and legislation allocated 15% of their research portfolio to services research. The next decade will emphasize research on quality of care, adoption and use of evidence-based practices (including medication), financing reforms and integration of substance abuse treatment with primary care and mental health services.

Health services research is a multidisciplinary field that examines ways to organize, manage, finance, and deliver high-quality care. This specialty within substance abuse research developed from policy analyses and needs assessments that shaped federal policy and promoted system development in the 1970s. After the authorization of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA), patient information systems supported studies of treatment processes and outcomes. Health services research grew substantially in the 1990s when NIAAA and NIDA moved into the National Institutes of Health and legislation allocated 15% of their research portfolio to services research. The next decade will emphasize research on quality of care, adoption and use of evidence-based practices (including medication), financing reforms and integration of substance abuse treatment with primary care and mental health services.