THE NEED FOR MORE EFFECTIVE TREATMENT APPROACHES REGARDING ALCOHOLISM AND SUBSTANCE ABUSE HAS BECOME INCREASINGLY APPARENT. THE DIRECTION OF THERAPEUTIC APPROACHES AND THEIR EFFECTIVENESS REMAINS UNCLEAR BECAUSE OF SEVERAL FACTORS. FIRST, EPIDEMIOLOGIC STUDIES USE EITHER AGGREGATE DATA FROM MULTIPLE SOURCES OR DATA RELATING TO SPECIFIC, WELL-DEFINED POPULATION GROUPS. REVIEW OF SUCH STUDIES, THEREFORE, RESULTS IN MARKEDLY DIFFERENT FIGURES. FOR EXAMPLE, WITH RESPECT TO CONCOMITANT USE OF ALCOHOL AND HEROIN, ANYWHERE FROM 25 TO 80 PERCENT OF HEROIN ADDICTS ARE FOUND TO CONSUME LARGE QUANTITIES OF ALCOHOL REGULARLY; DEFINITIONS FOR 'PROBLEM DRINKING' AND 'ALCOHOLISM' VARY CONSIDERABLY. ACCURATE STUDIES, HOWEVER, ARE ESSENTIAL TO MODIFICATION OF EXISTING TREATMENT MODALITIES WHICH ARE STRUCTURED BY A 'SINGLE SUBSTANCE' APPROACH. SECOND, CONSIDERABLE DISAGREEMENT EXISTS WITH RESPECT TO THE PSYCHODYNAMICS OF DRUG ABUSE. MOST STUDIES EMPHASIZE PSYCHOSOCIAL FACTORS, WHILE OVERLOOKING THE IMPORTANCE OF PSYCHOLOGICAL AND SOCIOLOGICAL FACTORS. THIRD, THE THERAPEUTIC MODEL, USING AN ABSTINENCE-ORIENTED APPROACH, IS DIFFICULT TO ACHIEVE. EVIDENCE HAS APPEARED IN LITERATURE SUPPORTING THE POSSIBILITY OF CONTROLLED DRINKING COMBINED WITH BEHAVIORAL MODIFICATION AS SUCCESSFUL APPROACH TO CHRONIC ALCOHOLISM. FINALLY, A COMBINED PROGRAM FOR SIMULTANEOUS TREATMENT OF ALCOHOLISM AND NARCOTIC ABUSE MIGHT OFFER MUTUAL ADVANTAGES TO THE PASSIVE-AGGRESSIVE, DEPRESSED ALCOHOLIC, AND THE AGRESSIVE HEROIN ADDICT. THE FOLLOWING ISSUES SHOULD BE ADDRESSED IN DETERMINING THE EFFECTIVENESS OF EXISTING THERAPY APPROACHES: (1) DEFINING THE ACTUAL PREVALENCE OF DEPENDENCY TO TWO OR MORE MOOD-ALTERING SUBSTANCES, WITH CAREFUL RESEARCH FOCUSED ON POPULATION GROUPS AND DATA COLLECTION; (2) ESTABLISHING FUNDING FOR ALCOHOLIC-NARCOTIC INTERACTIONS ON A BIOLOGICAL LEVEL; (3) ESTABLISHING ADEQUATE EVALUATIVE MECHANISMS FOR EXISTING THERAPY STRUCTURES; (4) ENCOURAGING INNOVATIVE APPROACHES, SUCH AS CONTROLLED DRINKING; AND (5) SUPPORTING FEASIBILITY STUDIES FOR COMBINED TREATMENT OF ALCOHOLISM AND NARCOTIC DEPENDENCY. REFERENCES ARE INCLUDED. (LWM)