Stages in the Response of the Drug Abuse Treatment System to the AIDS Epidemic in New York City

The acquired immunodeficiency syndrome (AIDS) has profoundly changed the nature of intravenous drug use and of treatment for intravenous drug abuse. Program staff are finding themselves confronted by the need to provide drug abuse treatment to persons who are likely to die, and challenged by the need to reduce the sharing of drug injection equipment and change the sexual behavior of their clients. In responding to these challenges, drug abuse treatment programs in New York City appear to have gone through four stages; denial, panic, coping and potential burnout. The author also presents other possible stages.