The AIDS epidemic in New York City probably began in the homosexual population and crossed to the IVDU population through persons with both high risk factors. The first stage in drug treatment program response was denial in which AIDS was seen as a medical problem separate from the functioning of treatment programs. AIDS was seen by treatment staff as undermining the hope an individual needs to overcome drug addiction; the disease also emphasized the difficulty in completely eliminating the addiction in any given treatment episode. During this stage, staff and clients received no special education about AIDS. The panic stage, initiated by outbreaks of AIDS among treatment program clients, was characterized by a search for information on AIDS transmission, symptoms, and medical and social support resources for patients. Drug abuse treatment staff feared casual contact transmission, despite lack of evidence, and there was also a generalized fear of death, even among those not at risk. The coping stage involved incorporating AIDS issues into drug treatment programs including education programs for staff and clients and drug abuse treatment for HIV-infected IVDUs. The overriding goal in this phase is HIV prevention, particularly through IV needle-sharing. The potential fourth stage in this response pattern is burnout, which to date, has been observed in individuals rather than institutions. Realistic objectives, peer counseling, and self-help groups may protect against burnout. Development of a theoretical framework for understanding these stages may provide a basis for designing interventions to improve the operation and success of these programs in response to the AIDS epidemic. 3 notes, 14 references. (Author abstract modified)