Slouching toward a systems approach to treatment

Both the health care sector generally and the alcohol and drug field are moving toward a truly systematic approach to treatment, accelerated by the anticipated advent of health care reform. There is considerable reluctance to develop systems. Many are not convinced of their necessity, and systematization inevitably involves a decrement in autonomy for the components of the system. Nor are systems panaceas; they have problems of their own, such as the bottleneck. But only true systems will be able to cope with the expected increase in demand for services that will accompany the universal entitlement of health care reform. Recent work giving the alcohol and drug treatment field an edge in systems development is discussed. Regrettably, the main motivation for deploying systems has become economic. They would more appropriately be justified by their potential for enhancing the efficacy of treatment.