Psychosocial treatment for drug abuse. Selected review and recommendations for national health care.

Substance abuse and dependence remains an important public health concern because of health-related and other costs to our society. We review selected articles that address questions about the psychosocial treatment of substance abuse disorders; these articles could aid in setting the parameters of a national health care insurance. Data from major program evaluation studies of existing substance abuse treatment programs are presented, followed by reviews of controlled studies of opiate, cocaine, and marijuana abuse and dependence; particular attention is given to studies that have standardized treatment through the use of treatment manuals. Articles about the treatment of substance abuse in adolescents are also reviewed. The existing data suggest that substance abuse treatment should be intensive and should probably involve multiple modalities targeted to various problems encountered in patients with substance use disorders, including comorbid psychiatric problems. However, only a few well-controlled studies have been performed to date; therefore, substantial research is needed before a system truly informed by research can be designed. Suggestions for future research directions are provided.