Lesson 7 Summary

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Topic Progress:

A central question in this lesson was: Are the treatment modalities used in practice consistent with our knowledge and understanding of the causes of substance use disorders? We began by considering the gap between etiology knowledge and the implementation of evidence-based treatment (the knowledge-to-practice gap). In Activity 1, we raised the ideological debate and tension between a disease (biological) model and a population health model and began to generate an understanding of how these models affect substance use policy and treatment resources. In this lesson, we developed a clearer picture of how the ideology of etiology affects the treatment system of care.

Moving from the macro level to the mezzo (agency) level, we examined, in Activity 2, the organizational factors that support or impede the implementation of EBP. We examined studies that indicated that there was a good acceptance and adoption of the ideas about evidence-based practice, but the lag in their implementation needs to be resolved, which Glasner-Edwards & Rawson (2010) suggest is due to the nature of the macro system of care. Last, we considered our own personal (micro) role in implementing evidence-based research into our practice and linked our own individual responsibility to the CCSA competencies.

The next lesson examines in more detail the effectiveness of different interventions. The last study we reviewed (Amodeo et al.,2013) provides a good foundation for moving forward.


Amodeo, M., Lundgren, L., Fernanda-Beltrame, C., Chassler, D., Cohen, A., & D’Ippolito, M. (2013). Facilitating factors in implementing four evidence-based practices: Reports from addiction treatment staff. Substance Use and Misuse, 48, 600–611.

Arria, A. M ., & McLellan, A. T. (2012). Evolution of concept—but not action—in addiction treatment. Substance Use Misuse, 47, 1041–1048.

Cunningham, J. A., & McCambridge, J. (2011). Is alcohol dependence best viewed as a chronic relapsing disorder? Addiction, 107, 6–12.

Garner, B. (2009). Research on the diffusion of evidence-based treatment within substance abuse treatment: A systematic review. Journal of Substance Abuse Treatment, 36, 376–399.

Glasner-Edwards, S., & Rawson, R. (2010). Evidence-based practices in addiction treatment: Review and recommendations for public policy. Health Policy, 97(2-3), 93–104.

Miller, W. R., Sorensen, J. L., Selzer, J. A., Brigham, G. S. (2006). Disseminating evidence-based practices in substance abuse treatment: A review with suggestions. Journal Substance Abuse Treatment, 31, 25–39.

Smith, B. (2013). Substance use treatment counselors’ attitudes toward evidence-based practice: The importance of organizational context. Substance Use and Misuse, 48, 379–390.