ABSTRACT
According to the National Comorbidity Survey, 1991, an estimated 20 million people in the United States have substance abuse disorders. An additional eight million people are estimated to have substance abuse disorders coexistent with other mental disorders (Kessler, McGonagle, Zhao, & Nelson, 1994). When measured in terms of health, productivity, and crime, the estimated economic cost of substance abuse to the nation is a staggering $166 billion per year (Rouse, 1995). On the other hand, an estimated $7 billion is spent annually for treatment of substance use disorders (U.S. Dept. of Health & Human Services, 1989), thus suggesting that people with substance use disorders do not often receive professional help (Kessler et al., 1994). Reasons that account for this discrepancy include the residual effects of historical stigmatization, societal denial of the problem, and treatment systems that fail to adequately address methods for improving access and retention.
