This research studied the function of heroin addiction as a family-learned method of coping with death, separation, and loss across the life cycle. Heroin addicts, psychiatric outpatients, and normal students were given an extensive interview and test battery to determine the incidence of loss of family members and significant others. Because the impact of death is often overcome through religious rituals, this study also investigated the subjects' perception of their families' religious values and orientation to life's meaning and purpose. Results indicate that the incidence of death differs significantly across groups and that addicts have a distinct orientation to death, are more suicidal, and have more premature and bizarre death experiences. During childhood they have more family separations, and they tend to develop a distinct pattern of continuously separating from and returning to their families. They are also less likely to have a clearly defined purpose in life. A subset of parents from each group were also interviewed and tested, and these results support the theory of the intergenerational transmission of behavior.

Drug addiction is a potentially life‐threatening problem with suicidal ramifications. Within the family of the addict, the addiction takes on a special, participatory meaning; the addicted member is treated as one undergoing a slow death. These families attach special significance to death and give it considerable emphasis. This appears to arise from unresolved and premature deaths experienced by the family, particularly the parents. The addict is substituted for the deceased member. Treatment can deal with these issues directly through making the mourning explicit. The death issue can also serve as a vehicle for family change.

The following report describes the results of a national study of the role of family therapy in the drug abuse field. Characteristics of agencies that work with families are described, as well as the demographic characteristics and psychological problems of the clients most apt to be treated in family therapy. The study also looks at the role and structure of family therapy in the ecological system of the treatment institutions. A profile of the family therapists who are responsible for providing services to families is presented. An attempt was made to assess agencies' level of development with regard to family therapy by using an instrument, The Progress Index for Family Therapy Programs. Generally, findings indicated that there is considerable variation in expertise. More extensive training in family therapy techniques was of major concern, particularly among clinics with a heroin addict population.

While partnership approaches have the potential to achieve cost-effective quality health care, several attributes of the current context make partnerships difficult to achieve. This paper provides an analysis of the socio-cultural, structural and human challenges to building partnerships at both personal and organizational levels, together with an empowering interdisciplinary approach for overcoming these barriers. Premised on empirical evidence, 'flexible client-driven care', currently being tested in the home care sector in Canada, encompasses structures and processes that promote relationship-building and conscientious critical application of individual and collective potential for achieving health care. Strategies for implementing empowering partnership-building at both personal and organizational levels are elaborated, together with the challenges encountered. The practical issues addressed afford insights and ideas for others who may be attempting to achieve similar partnership aims.

In September 2005, the Ontario Ministry of Health and Long-Term Care established the Provincial PD Coordinating Committee to make recommendations to increase the use of PD among prevalent dialysis patients in Ontario from the present 18% to 30% by 2010. In the present paper, we describe the process through which the Committee produced its recommendations and we highlight the proposed implementation plan.