In 2004, over 23 million Americans age 12 and older needed speciality treatment for alcohol or illicit drug problems. Of those in need, only 10 percent received treatment at a speciality facility. There are a number of factors that contribute to low treatment participation rates. One of the most fundamental is the lack of an adequate human infrastructure to support current and future demands for treatment. The addictions treatment field is facing a workforce crisis. Worker shortages, inadequate compensation and stigma currently challenge the field. Increasingly, treatment and recovery support providers also struggle with issues related to recruitment, retention and professional development of staff. The ability to provide quality addictions treatment and recovery support services is severely hampered by these conditions. Without investment in human infrastructure, this critical public health function will not be equipped to respond effectively to the overwhelming need for services. This book includes a discussion of both long-term and emergent issues impacting the addictions treatment workforce and provides a context for understanding the challenges facing the addictions treatment workforce and a background for the recommendations that follow.