Recent FDA approval of acamprosate (Campral(r)) and long-acting injectable naltrexone (Vivitrol(r)) has given alcohol treatment providers and their patients'new treatment options in addition to existing pharmacotherapies and psychosocial counseling techniques for the treatment of alcohol dependence. In addition, the evidence base continues to accumulate for a number of counseling techniques such as motivational interviewing and contingency management, and manualized approaches are being developed and disseminated. Coupled with these developments in treatment """"""""technologies"""""""" is an ever-increasing emphasis by states and payers on the use of evidence-based practices. Together, these factors are beginning to influence changes in the content of treatment services. However, there remain significant concerns about the effective dissemination of these evidence-based treatment techniques and the elimination of the """"""""research to practice gap"""""""" that characterizes much of the addiction treatment field. There are few mechanisms to measure the effectiveness of various dissemination strategies, the extent of adoption of evidence-based innovations, and the fidelity with which those techniques are implemented in diverse, real-world treatment settings. Moreover, there is scant research on the organizational, staffing, and environmental factors that facilitate or impede the diffusion, adoption, and implementation of evidence-based behavioral and pharmacological approaches to alcoholism treatment. The economic disincentives to integrating new practices in treatment organizations and counselor repertoires likewise require study. To address these needs, we propose a longitudinal data collection effort with N=400 alcohol treatment centers from which related data were collected in 2001-2006. Longitudinal data in hand provide a valuable baseline against which to monitor future adoption behaviors of existing techniques, diffusion of emerging treatment innovations, and discontinuation of previously-used methods. Because the baseline data include a period of time before the approval of acamprosate and Vivitrol, this study would offer a unique opportunity to monitor past, present, and future adoption of these medications specifically, and related treatment strategies more generally.
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