The public health care needs of the USA have been steadily shifting from acute, episodic care to treatment for chronic conditions. Chronic conditions are now the leading causes of illness, disability, and death, affecting almost half of the USA population and accounting for the majority of health-care expenditures (Hoffman, Rice, & Sung, 1996). Today, few clinical programs have the infrastructure required to provide the full complement of services needed by people with common chronic conditions (Wagner, Austin, & Korff, 1996). The fact that more than 40% of people with chronic conditions have more than one condition argues for a more sophisticated mechanism to communicate and coordinate care (Robert Wood Johnson Foundation, 1996; Institute of Medicine, 2001).

The treatment of drug abuse, one of the most pervasive chronic conditions and one that often coexists with mental illness and other health problems, similarly lacks the support of an adequate infrastructure for service delivery. The services infrastructure and access to and availability of such services for adolescent drug abusers are even more limited than those for their adult counterparts. Indeed, the actual number of treatment programs serving adolescents with drug abuse problems (mental health as well) has been shrinking in the last few decades (Etheridge et al., 2001). The majority of the programs that do exist are oriented to treat short acute episodes, not taking into account the need to have treatment protocols that follow the treatment career of adolescents and deal with the chronic nature of the disease.