Progress in addiction treatment: from one-size-fits-all to medications and treatment matching

This paper briefly reviews the development of treatment for substance use disorders over the last 100 years from the perspective of the author, who has participated in treatment outcome studies since the mid-1970s. It includes some personal events that contributed to the author's involvement in addiction treatment and research, and describes the gradual evolution of an approach that began with a focus on detoxification and psychosocial treatment to one that involves blending psychosocial treatments with use of Food and Drug Administration (FDA)-approved medications and adding treatments for psychiatric and medical disorders when necessary based on patient assessments. It ends with comments on the gap between what is known and the degree to which existing knowledge is applied, and how the Affordable Care Act holds promise for bridging that gap.