Most Addiction Treatment Providers Do Not
Adopt Evidence-Based Practices.* Many
addiction treatment providers address addiction
in ways that have not been evaluated or proven
effective. While this is due in part to the
inadequate education and training of treatment
providers in evidence-based practices,^161 the
larger issue is the significant mismatch between
the qualifications that are necessary for
implementing many evidence-based practices
and the qualifications that the majority of the
treatment workforce currently possesses.^162
Because most treatment providers are not
adequately trained, they are not capable of
performing health assessments, prescribing
pharmaceutical medications, treating co-
occurring health conditions or managing a
chronic disease, each of which is an essential
evidence-based addiction treatment practice.^163
Most also are not trained in the scientific method
or clinical research, further impeding their
ability to integrate clinical research findings into
treatment practice.^164
Education and awareness about evidence-based
practices, however, are not sufficient to ensure
proper implementation of those practices;^165
additional steps are necessary to translate
evidence into practice. Although significant
progress has been made in the past decade in
disseminating knowledge about evidence-based
practices and improving attitudes toward them,
less is known about how well such practices are
implemented in treatment facilities and
programs.^166
One study found that treatment programs that
are most likely to adopt clinical and practice
guidelines, including the use of standardized
assessment tools, are those that offer a broad
range of services--medical services, counseling,
pharmaceutical therapy and support services--
- Evidence-based practice involves the use of current
evidence in making decisions about patient care.
Evidence-based practices aim to combine the best
available research and clinical judgment while taking
into account patient characteristics and needs.
and those that receive funding from managed
care organizations.† 167† Programs with managed care involvement were less
likely to be freestanding facilities and more likely to
be associated with multi-service hospital or medical-
based clinics. They also were more likely to have
staff with advanced degrees and less likely to have
staff in recovery. The authors of this study speculate
that programs with managed care contracts might be
likelier than those without such contracts to be
encouraged to have standardized practices.We have entered the world of showing providers
what is evidence based. Now we must show
providers how to implement it... We haven’t
effectively brought practical research results to
individual providers...so they can use it.^168--William H. Janes
Former Director
Florida Office of Drug Control
Office of the GovernorEvidence from research findings is not generally
accessible and understandable to providers;
we’re failing miserably at that.^169--Joseph M. Amico, MDiv
President
National Association of Lesbian and Gay
Addiction Professionals
(now Vice President, and association now called
The Association of Lesbian, Gay, Bisexual,
Transgender Addiction Professionals
and Their Allies)According to the American Psychological
Association, evidence-based practice is the
integration of the best available research and
clinical expertise within the context of patient
characteristics, culture, values and preferences.
Today we have a few places trying to implement
these practices but with major limitations; few
ever implement the practice the way it was
researched.^170--Stephanie Covington, PhD, LCSW
Co-Director
Center for Gender and Justice
Institute for Relational Development