AMONG THE MORE PROMINENT TREATMENT APPROACHES USED IN THE U.S. ARE (1) MAINTENANCE ON MORPHINE OR HEROIN, ALTHOUGH THIS METHOD WAS SHORT-LIVED; (2) HOSPITALIZATION IN ABSTINENCE-ORIENTED, LARGE REGIONAL HOSPITALS; (3) CIVIL COMMITTMENT PROGRAMS SUCH AS THE CALIFORNIA CIVIL ADDICT PROGRAM; (4) TREATMENT AS PART OF A GENERAL SERVICE WITHIN HOSPITALS; (5) THERAPEUTIC COMMUNITIES SUCH AS SYNANON; (6) INPATIENT, SHORT-TERM DETOXIFICATION, PROBABLY THE MOST COMMON TREATMENT MODE; AND (7) HALFWAY HOUSES. WITH THE ADVENT OF FEDERAL FUNDING IN THE LATE 1960S, FOUR MODALITIES OR GENERALIZED CLASSES OF TREATMENT EVOLVED: METHADONE MAINTENANCE (MM), THERAPEUTIC COMMUNITY PROGRAMS (TC), OUTPATIENT DRUG-FREE PROGRAMS (DF), AND SHORT-TERM DETOXIFICATION (DT). MM PROGRAMS HAVE GENERALLY OPERATED ON AN OUTPATIENT BASIS AND INVOLVE DEPENDENCE ON METHADONE, AN ADDICTIVE OPIATE WITHOUT HEROIN'S DISTURBING PSYCHOLOGICAL EFFECTS. TC'S ARE TYPICALLY RESIDENTIAL PROGRAMS THAT EMPHASIZE USE OF GROUP PRESSURE TO PERSUADE ABUSERS THAT THEIR BEHAVIOR IS INAPPROPRIATE AND DESTRUCTIVE. DF PROGRAMS ARE BOTH OUTPATIENT AND DRUG-FREE, AND ARE OFFERED MAINLY FOR NONOPIATE USERS; RETENTION OF PATIENTS HAS BEEN A PROBLEM IN DF PROGRAMS. DT PROGRAMS ARE USUALLY SHORT-TERM, NOT OVER 21 DAYS, AND MAY OR MAY NOT BE FOLLOWED BY OTHER FORMS OF TREATMENT. WITHIN ALL MODALITIES, CONSIDERABLE VARIATION HAS BEEN OBSERVED WITH RESPECT TO TREATMENT GOALS, PROCESSES, STAFFING, FACILITIES, AND CLIENT SUCCESS. WITH REGARD TO EVALUATION RESULTS, SEVERAL STUDIES HAVE BEEN CONDUCTED INVOLVING FEDERAL NARCOTIC TREATMENT HOSPITALS, DETOXIFICATION FROM METHADONE MAINTENANCE, THE CALIFORNIA CIVIL ADDICT PROGRAM, THERAPEUTIC COMMUNITIES, HALFWAY HOUSES, DETOXIFICATION PROGRAMS, MULTIMODALITY STUDIES, AND OTHERS. THE OUTCOMES FOR MM, TC, AND DF APPEAR MOST FAVORABLE. REFERENCES AND TABULAR DATA INCLUDED. (LWM)