Comprehensive Approach to Drug and Alcohol Dependence Isn't Effective

Because of the prevalence and adverse effects of drug and alcohol dependence, alternative treatment options are being explored. Boston researchers randomized 563 adults (mean age, 38) who were recruited mainly from a residential detoxification facility to a chronic-care management (CCM) model of comprehensive services or to usual primary care. Most participants were homeless men who were dependent on both alcohol and drugs, including heroin or cocaine. The CCM multidisciplinary team involved a nurse care manager, a social worker, specially trained internists, and a psychiatrist; the team provided intensive medical and psychiatric care, motivational-enhancement therapy, relapse-prevention counseling, personal escorts, and telephone follow-up…