Broadening the base of treatment for alcohol problems : report of a study by a committee of the Institute of Medicine, Division of Mental Health and Behavioral Medicine.

Includes bibliographical references.

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Broadening the Base of Treatment for Alcohol Problems -- Copyright -- Contents -- Introduction and Summary -- The Study Process -- A Summary of the Text -- Our Vision -- Some Fundamental Questions -- Aspects of Treatment -- Special Populations in Treatment -- Aspects of Financing -- Guiding the Ongoing Effort -- REFERENCES -- 1 Our Vision -- A Brief History of Treatment -- Broadening the Base -- Toward Treatment Systems -- Advice to the Reader -- REFERENCES -- 2 What Is Being Treated? -- The Alcohol Problems Perspective -- Other Perspectives

AlcoholismAlcohol Dependence Syndrome -- A Terminological “Map� -- The Heterogeneity of Alcohol Problems -- Heterogeneity of Presentation -- Heterogeneity of Course -- Heterogeneity of Etiology -- Implications of Heterogeneity for Treatment -- Summary and Conclusions -- REFERENCES -- 3 What Is Treatment? -- Refining the Definition of Treatment for Alcohol Problems -- Defining the Expanded Continuum of Care -- Defining the Elements of Treatment in the Continuum of Care -- Treatment Philosophy or Orientation -- Treatment Stages

Stage 1: Acute InterventionStage 2: Rehabilitation -- Stage 3: Maintenance -- Treatment Settings -- Treatment Modalities -- Summary and Conclusions -- REFERENCES -- 4 Who Provides Treatment? -- Describing the System to Treat Persons with Alcohol Problems -- Treatment of Alcohol Problems in the Nonspecialist Community Sectors -- Treatment in the Specialist Alcohol Problems Sector -- A State Perspective on Treatment Providers -- A Federal Perspective -- A National Perspective -- Treatment Personnel -- Summary and Conclusions -- REFERENCES

5 Does Treatment Work? Reframing the Question -- Answering the Reframed Question: Methods -- The Randomized Controlled Trial -- The Role of Quality Assurance -- Other Methods -- Answering the Reframed Question: Results -- Summary and Conclusions -- REFERENCES -- 6 Is Treatment Necessary? -- Improvement in Alcohol Problems Without Formal Treatment -- Deterioration in Alcohol Problems with Formal Treatment -- Coerced Treatment for Alcohol Problems -- Implications for Treatment -- Treatment Based on Knowledge of Improvement Without Treatment

Summary and ConclusionsREFERENCES -- 7 Is Treatment Available? -- Distribution of Resources for Alcohol Problems Treatment -- The National Drug and Alcoholism Treatment Unit Survey -- The Distribution of Treatment Capacity -- Expenditure Data -- American Hospital Association Annual Survey of Hospitals -- Relationship Between Treatment Availability and the Prevalence of Alcohol Problems -- Summary and Conclusions -- REFERENCES -- 8 Who Pays for Treatment? -- Who Are the Payers? -- Who Pays for Treatment in Specialty Programs?

And ConclusionsREFERENCES -- 7 Is Treatment Available? -- Distribution of Resources for Alcohol Problems Treatment -- The National Drug and Alcoholism Treatment Unit Survey -- The Distribution of Treatment Capacity -- Expenditure Data -- American Hospital Association Annual Survey of Hospitals -- Relationship Between Treatment Availability and the Prevalence of Alcohol Problems -- Summary and Conclusions -- REFERENCES -- 8 Who Pays for Treatment? -- Who Are the Payers? -- Who Pays for Treatment in Specialty Programs?

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