A publication by the National Institute on Drug Abuse detailing the nature of addiction and treatment and the principles of drug abuse prevention was met with what some would call "cautious skepticism" when it was released last fall. Even NIDA Director Alan I. Leshner, Ph.D., thought it would be "a loser." Six months after its release, however, the treatment community’s response is proving him wrong.

Putting together the publication, titled "Principles of Drug Addiction Treatment—A Research-Based Guide" (PDAT), was an involved process that evolved over time.

"It was the first time that anyone had put together a science-based review of drug addiction and what to do about it," Leshner told Psychiatric News.

The guide is based on more than 25 years of scientific research and clinical practice and details 13 principles fundamental to the success of drug addiction treatment. In addition, each section of the guide is extensively referenced for further reading. The project was the result of a year-long review of scientific literature and clinical practice to pull together a consensus of what is known to be effective in addiction treatment.

In the six months since its release, more than 250,000 copies have been requested from NIDA, and over 55,000 copies have been downloaded from the NIDA Web site, <www.drugabuse.gov>.

"I don’t know of a treatment program that doesn’t have a copy," said Leshner. The book received some negative feedback initially for the very reason that Leshner originally believed it would fail: its apparent simplicity.

"It is not an incredibly sophisticated document," Leshner said. "Some of the stuff looks very obvious to those in the know; but the problem with anything that appears common sense in science is, if it is so common-sensical, then why aren’t you doing it?"

Richard T. Suchinsky, M.D., vice chair of APA’s Council on Addiction Psychiatry, believes the booklet is a "very useful, if brief, document." Suchinsky told Psychiatric News, "It provides documentation for what people have been doing successfully all along. It’s not a treatment guideline, because it’s not detailed enough, but as a guide, it’s a good resource to help providers organize their thoughts, their plans."

Leshner has heard similar feedback. However, he now believes that the guide sets out some important messages. "First, an extremely important message—not to the therapeutic community, but really to those involved with addiction—is that treatment is effective," said Leshner. "But second, I think, is that the single most important point in the booklet is that drug abuse treatment is very complex, has many different elements, and outcome measures are not just reduced drug use, but to get people back to some form of functioning in society."

Leshner now counts the guide as one of NIDA’s most significant achievements (see page 19).