The Substance Abuse and Mental Health Services Administration (SAMHSA) began reaching out to faith-based groups during the Clinton administration, and many states have also collaborated with faith groups on community outreach and to provide services. Pointing to the legacy of Bill Wilson, the Big Book and the 12 steps of Alcoholics Anonymous, Phil McCullough of the Wisconsin Bureau of Substance Abuse Services noted, "Our field began with faith-based groups."

McCullough, director of the bureau's Division of Supportive Living, was one of a half-dozen participants in a panel discussion on faith-based programs convened at the annual meeting of the National Association of State Alcohol and Drug Abuse Directors, held last month in New Orleans, La.

Panelists from Wisconsin, Pennsylvania, North Carolina and South Carolina demonstrated that while President Bush's faith-based initiative may be a hot topic in Washington, the issue is nothing new to the addiction community. In Wisconsin, for example, a February 2001 survey revealed that 15 percent of addiction service providers were faith-based. And Joe Powell, director of the Division of Prevention at the Pennsylvania Bureau of Alcohol and Drug Programs -- and himself a church elder -- points out, "We've always worked with faith groups."

In most cases, however, governments have contracted with more "established" faith-oriented organizations, such as Catholic Charities and Lutheran Social Services, which were more likely to be nonsectarian in their approach to treatment and prevention, and also more likely to meet standards for staff training and licensing.

But smaller faith-based groups could also be valuable allies. Storefront churches, for example, can provide irreplaceable outreach to local communities; Powell's agency has worked to establish linkages with small inner-city churches in Philadelphia, gaining valuable insight into who needs services.

To make such relationships work, policymakers need to determine the criteria under which faith groups and public agencies can work together. "We need to get beyond the negative rhetoric and define what a faith-based program is," said McCullough.

The SAMHSA national advisory council, for example, is adamant that faith-based providers must meet the same training, certification, and licensure standards that apply to other providers (these standards vary widely by state, however).

Winifred Mitchell, representing the SAMHSA administrator's office, told the NASADAD conference participants that her agency will need guidance from the White House on the ultimate definition of faith-based groups. But, she added, "We think the administration will see no substantial barriers to faith-based programs participating" in SAMHSA grant programs.

Even if they meet licensing or credentialling standards, however, many smaller faith groups will need assistance if they are to be integrated into the public system. McCullough, for instance, points out that these groups will have many of the same ethnic, gender, and geographic hurdles to overcome that other providers do. And Powell notes that faith groups will need help in translating their methodology into terms that decisionmakers can understand.

"Many of the questions you need to ask are the same as for anyone new coming into the system," Powell added, such as whether the services provided are on the continuum the local government provides.

But faith groups also need to be asked whether the incorporate religious dogma into their programs, "or do they just have a religious or spiritual-sounding name?" says Powell. This question may become especially important now that Congress -- which is still debating Bush's faith-based plan -- appears to moving toward an explicit ban on funding programs that do the former.

Research has shown that youth from religious families are less likely to join peer groups involved in alcohol or other drug use, and religious individuals may respond to faith-based programs better than any other intervention. Many in the addiction field would welcome the help of churches, mosques and synagogues -- under the right conditions.

Some state have already taken the initiative. The North Carolina Faith Community Initiative, for example, brings together a panel of multidenominational leaders under the aegis of the state Division of Mental Health, Developmental Disabilities & Substance Abuse Services. And the South Carolina Department of Alcohol and Other Drug Abuse Services -- whose literature calls the faith community "a largely untapped resource in the fight against alcohol, tobacco, and other drugs" -- has launched a statewide outreach effort called FaithWorks. This initiative not only aims to raise awareness of addiction problems among church leaders and congregations, but also identifies youth mentors, established treatment and prevention referral systems, and has set up an interfaith advisory board on addiction issues.

States would be more likely to roll out the welcome mat if the politicians pushing faith-based treatment backed up their rhetoric with cold, hard cash. In Wisconsin, for instance, McCullough estimates that less than 20 percent of those who need treatment and prevention services get help, "so there's plenty [of need] to go around."

But at the federal level, at least, little new funding has been attached to President Bush's faith-based initiative, leaving addiction advocates to worry that the plan will simply allow thousands more programs to dip into a limited pool of money. "Faith-based programs potentially could be competitors with already flat-funded programs," McCullough noted.