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Case management for substance abusers. More issues than answers.

Although case management has been successfully used in medical settings, its use for the delivery of multiple services for the substance abuser is questioned. An overview of the research suggests that low client-to-worker ratios, frequent and intense contacts, and chronic client relapse often contradict the emphasis on cost-containment, cost-effectiveness, and "successful" outcomes. The implementation of case management programs for substance abusers should proceed with caution. More emphasis should be placed on a community systems advocacy approach.