The criteria for selecting the first three waves of research protocols developed by NIDA's National Drug Abuse Treatment Clinical Trials Network (CTN) reflect the growing sophistication of CTN participants as they gain experience in conducting research studies in clinical settings:

• The first wave of protocols is being tested now in the CTN's community treatment programs (CTPs). These protocols were based on scientific evidence of effectiveness and the ease with which they could be implemented across the network and transferred into practice, said Dr. Betty Tai, director of NIDA's CTN office. They include pharmacological studies of the effectiveness of buprenorphine/naloxone (BUP/NX) in facilitating opiate withdrawal and studies testing the effectiveness of motivational enhancement therapy and offering prizes as incentives in keeping patients drug free.
  
  
• The second wave of protocols now getting underway in the CTPs is designed to complement and build on the first set of protocols. One study will define current CTP practices and staff attitudes to establish a baseline for assessing whether and how innovative practices and treatments are adopted. Two new BUP/NX studies will extend clinical research on that medication by assessing the effect of tapering doses over time and its effectiveness with adolescents who abuse heroin. Other protocols will study infectious diseases and drug abuse and smoking cessation treatment in substance abuse programs.
  
  
• The third wave of approved treatment research concepts is now being shaped into protocols for implementation. Unlike earlier research concepts, which were selected primarily by the CTN's Steering Committee, this third wave of concepts was generated and refined by researchers and practitioners working together in CTN nodes across the network. The concepts continue to broaden the research focus by addressing drug abuse-related treatment issues such as HIV prevention and treatment, and also the treatment needs of special populations, such as substance-abusing pregnant women, women with trauma histories, and adolescents.