PRACTICE GUIDELINES IN THE ADDICTIONS - RECENT DEVELOPMENTS

Consensually established principles of clinical conduct, known various ly as practice guidelines, standards, protocols, or algorithms, have p roliferated throughout medicine over the past decade. Institutional an d disciplinary efforts to develop and promulgate guidelines for the tr eatment of addictive disorders have recently been initiated. We review guideline development activities of the American Psychiatric Associat ion, American Psychological Association, American Society of Addiction Medicine, American Nurses Association, National Association of Social Workers, and Center for Substance Abuse Treatment of the Substance Ab use and Mental Health Services Administration. Medical care performanc e and outcome assessments are discussed with attention to the role the y can play in evaluating and refining guidelines. Potential effects of guidelines, salutary and deleterious, on clinical practice in the add ictions are delineated.