Drug treatment in the United States has been fragmented, underfunded, less than comprehensive, and poorly planned and integrated. Significantly increasing the number of drug abusers who receive treatment and the effectiveness of the treatment they receive will require replacing the current fragmented approach with an integrated, coherent drug treatment system. A first step in improving drug treatment is to develop the case-finding capabilities of the health care and criminal justice systems, because these two systems see the largest numbers of drug abusers, often have assessment procedures in place, and have some experience in treatment or referrals. Most researchers and treatment providers would also agree that some level of matching between client and treatment program to improve treatment effectiveness and make better use of treatment resources. A treatment system also needs horizontal linkages to community agencies and other systems and vertical development through the inclusion of a wide range of strategies that include extended care throughout the required period of time. Drug treatment currently lacks the major elements of a system, although national, State, and local developments suggest that it may be moving in this direction. Notes and 70 references