Severe alcohol and other drug problems typically take a chronic course and often require multiple episodes of intervention before stable recovery is achieved. The conceptualization of addiction as a chronic disorder has critical implications for the design, delivery, evaluation, and funding of addiction treatment. Yet, despite widespread acknowledgement that the nature and long-term course of addiction is similar to other chronic illnesses, such as hypertension and diabetes, it is still treated almost universally as an acute condition. This acute care model has been shaped by a number of influences, including the commercialization of addiction treatment and a system of managed behavioral health care, which have forced treatment into discrete, and ever-briefer, episodes of care. In this chapter, we address the shortfalls of the acute care model and contrast it with a model of sustained recovery management, which aims to remedy the mismatch between the chronic nature of addiction and the approaches designed to treat it. The nature of Recovery Management as a philosophy of organizing addiction treatment and recovery support services to enhance early prerecovery engagement, recovery initiation, long-term recovery maintenance, and the quality of personal/family life in long-term recovery is described. The shift to a model of sustained recovery management includes changes in treatment practices related to the timing of service initiation, service access and engagement, assessment and service planning, service menu, service relationship, locus of service delivery, assertive linkage to indigenous recovery support resources, and the duration of posttreatment monitoring and support.