Reorganizing Publicly-Funded Drug Abuse Treatment: The Experience of Ten Target Cities Projects

Does centralized intake improve drug abuse treatment outcomes?

“…These goals were met to greater and lesser degrees in San Francisco and in other cities, as planners developed CIUs in their local context (Guydish and Muck, 1999). The San Francisco CIU intervention may have improved treatment access for a more highly disabled population, but clients entering treatment through the CIU did not have better outcomes than those entering treatment directly.…”

Alcohol and drug abuse treatment demonstrations: Developing and testing community interventions.

“…Despite efforts to assure that all stakeholders accepted the project's goals, the need for coordination and standardization was not universally recognized. Autonomous treatment programs were reluctant to relinquish control of intake and assessment processes (Guydish & Muck, 1999a). As a consequence, central intakes were diffi cult to develop and maintain, and cities struggled with the creation and implementation of centralized information systems (Guydish & Muck, 1999a).…”

“…Autonomous treatment programs were reluctant to relinquish control of intake and assessment processes (Guydish & Muck, 1999a). As a consequence, central intakes were diffi cult to develop and maintain, and cities struggled with the creation and implementation of centralized information systems (Guydish & Muck, 1999a). Changing state and local environments, moreover, complicated evaluation efforts, and few results have been reported (Guydish & Muck, 1999a).…”

“…As a consequence, central intakes were diffi cult to develop and maintain, and cities struggled with the creation and implementation of centralized information systems (Guydish & Muck, 1999a). Changing state and local environments, moreover, complicated evaluation efforts, and few results have been reported (Guydish & Muck, 1999a). The primary summary of the Target City Demonstrations noted that system linkages were created and admission processes were enhanced; system reorganization, however, required substantial resources and infrastructure investments, and it was not clear that the benefi ts of the program exceeded the costs of system change (Guydish & Muck, 1999a).…”

“…Changing state and local environments, moreover, complicated evaluation efforts, and few results have been reported (Guydish & Muck, 1999a). The primary summary of the Target City Demonstrations noted that system linkages were created and admission processes were enhanced; system reorganization, however, required substantial resources and infrastructure investments, and it was not clear that the benefi ts of the program exceeded the costs of system change (Guydish & Muck, 1999a). DISCUSSION Room's (1990) refl ective essay on community-based demonstration projects for the prevention of alcohol problems concludes that demonstrations are challenging to implement and evaluate because the combination of change agents, community participants and interests, and investigators is inherently unstable.…”