Implementation of Evidence-Based Practices for Treatment of Alcohol and Drug Disorders: The Role of the State Authority

The current climate of increasing performance expectations and diminishing resources, along with innovations in evidence-based practices (EBPs), creates new dilemmas for substance abuse treatment providers, policymakers, funders, and the service delivery system. This paper describes findings from baseline interviews with representatives from 49 state substance abuse authorities (SSAs). Interviews assessed efforts aimed at facilitating EBP adoption in each state and the District of Columbia. Results suggested that SSAs are concentrating more effort on EBP implementation strategies such as education, training, and infrastructure development, and less effort on financial mechanisms, regulations, and accreditation. The majority of SSAs use EBPs as a criterion in their contracts with providers, and just over half reported that EBP use is tied to state funding. To date, Oregon remains the only state with legislation that mandates treatment expenditures for EBPs; North Carolina follows suit with legislation that requires EBP promotion within current resources.

Empowering Interactions. Political Cultures and the Emergence of the State. in Europe 1300-1900

The emergence of the state in Europe is a topic that has engaged historians since the establishment of the discipline of history. Yet the primary focus of has nearly always been to take a top-down approach, whereby the formation and consolidation of public institutions is viewed as the outcome of activities by princes and other social elites. Yet, as the essays in this collection show, such an approach does not provide a complete picture. By investigating the importance of local and individual initiatives that contributed to state building from the late middle ages through to the nineteenth century, this volume shows how popular pressure could influence those in power to develop new institutional structures. By not privileging the role of warfare and of elite coercion for state building, it is possible to question the traditional top-down model and explore the degree to which central agencies might have been more important for state representation than for state practice. The studies included in this collection treat many parts of Europe and deal with different phases in the period between the late middle ages and the nineteenth century. Beginning with a critical review of state historiography, the introduction then sets out the concept of 'empowering interactions' which is then explored in the subsequent case studies and a number of historiographical, methodological and theoretical essays. Taken as a whole this collection provides a fascinating platform to reconsider the relationships between top-down and bottom-up processes in the history of the European state.