Abstract
Alcohol and drug treatment have separate histories in the United States. The large public treatment systems were established as separate institutions in the early 1970s and have developed separate research traditions and treatment programs. However, as a response to current treatment financing policy and epidemiologic descriptions of combined alcohol and other drug use in the population, the two treatment systems are merging at the state and local levels. This large structural change is taking place without the development and evaluation of treatment methods for combined problems and without discussion of overall health service or policy implications. This paper describes the changes occurring, examines the literature for its contributions in providing direction, and presents treatment method and policy issues which need to be part of the overall discourse.

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