Substance abuse treatment has been a topic of ongoing debate in the United States since at least the 1960s, when the country witnessed the development of several promising new treatment approaches. Although costs to society in connection with substance abuse point to a continuing need for an effective treatment system, there is only a general understanding of the field. Several factors make it difficult to comprehend the treatment structure: the field is comprised of a sprawling combination of public and private facilities, it strives to treat many types of addicts, and it employs a variety of treatment approaches. While there are general studies that attempt to describe the system and its components, few inquiries probe the inside of specific treatment facilities to discern their evolution, mission, and effectiveness. This article, which examines the Antelope Valley Rehabilitation Centers (AVRCs), is one such analysis. Located in rural areas sixty miles from downtown Los Angeles, the AVRCs are Los Angeles County's only directly operated treatment centers. The two centers, at Acton and Warm Springs, are not only the first and fourth largest substance abuse hospitals in the country, but they serve a population larger than that of forty-two states, making them an excellent lens through which to view a portion of the substance abuse treatment system.
Performance-Based Contracting Within a State Substance Abuse Treatment System: A Preliminary Exploration of Differences in Client Access and Client Outcomes
