Comprehensive services, including employment/vocational interventions,
family therapy, medical care, and case management, have been shown by
the literature to be critical elements of programs that provide effec
tive treatment for substance abusers. Despite clear research findings,
clients are often unable to obtain needed adjunctive services at thei
r clinics. When services are not provided on site, clients typically a
re not effectively placed for services at other agencies. This article
reviews the recent literature on comprehensive services as elements o
f substance abuse treatment, focusing on four areas that the National
Institute on Drug Abuse (NIDA) has established nr priorities for healt
h services research: (a) the effectiveness and outcomes of treatment s
ervices, (b) the organization and management of treatment services, (c
) the actual availability of services to clients, and (d) the impact o
f managed care on the provision of adjunctive treatment services. Reco
mmendations are also made for future research, and policy implications
are discussed.