Toward a client-centered understanding of drug treatment.

This article reports some of the results of a study of the content of drug treatment in New York City that is being conducted by Health/PAC's Drug Treatment Policy Project and funded by the Robert Wood Johnson Foundation. The research is led by a steering committee made up of clients of drug treatment services, providers and administrators of drug treatment programs, and legal and financial advocates for drug users. This article reflects 20 months of meetings and discussions by the steering committee; over 50 interviews with drug users, advocates, drug treatment providers, and program administrators about the experience, structure, and policies of drug treatment in New York City; and an analysis of the major evaluations of drug treatment services in New York City, supplemented by informal telephone surveys of facilities by staff. The Drug Treatment Policy Project has found services in New York City as a whole to be less than enlightened or adequate. But, in the course of the research, many programs were found to be both helpful and effective, mostly as a result of the efforts and personal risks taken by individuals who filled in gaps or by programs that, because they were community based, went to extraordinary efforts on behalf of their clients to make sure that a variety of options and services were available. We hope to outline these successes in another article.