Preface

"Preface." Substance Use & Misuse, 47(5), p. 461

Notes

1 Treatment can be briefly and usefully defined as a unique, planned, goal-directed, temporally structured, multidimensional change process of necessary quality, appropriateness, and conditions (endogenous and exogenous), which is bounded (culture, place, time, etc.) and can be categorized into professional-based, tradition-based, mutual-help based (AA, NA, etc.) and self-help (“natural recovery”) models. There are no unique models or techniques used with substance users of whatever types and heterogeneities, which are not also used with nonsubstance users. Whether or not a treatment technique is indicated or contraindicated, and its selection underpinnings (theory-based, empirically based, “principle of faith”-based, tradition-based, etc.) continues to be a generic and key treatment issue. In the West, with the relatively new ideology of “harm reduction” and the even newer quality of life (QOL) and well-being treatment-driven models, there are now a new set of goals in addition to those derived from/associated with the older tradition of abstinence-driven models. Treatment is implemented in a range of environments, ambulatory as well as within institutions, which can include controlled environments. Treatment includes a spectrum of clinician–caregiver–patient relationships representing various forms of decision-making traditions/models: (1) the hierarchical model in which the clinician-treatment agent makes the decision(s) and the recipient is compliant and relatively passive, (2) shared decision-making, which facilitates the collaboration between the clinician and the patient(s) in which both are active, and (3) the “informed model” in which the patient makes the decision(s). Editor's note.