ASAM Criteria and Levels of Care in Addiction Treatment
What are the ASAM Criteria?
ASAM stands for the American Society for Addiction Medicine, which was a society founded in 1954 to help addiction professionals, including physicians and other providers, come together. The ASAM was made for those who wanted to improve the quality of addiction treatment and educate the medical community and the public about addiction.1 ASAM developed a set of criteria that treatment providers can use in the assessment of a person to help determine the most appropriate level of care.2
These guidelines are the result of work that began in the 1980s and are now the most comprehensive and widely-used criteria to determine placement in treatment, as well as patients’ transfer and discharge from treatment programs.2 The ASAM criteria includes a detailed assessment of the person seeking treatment, which entails a thorough exploration of their biological, emotional, and social needs.2
What are the ASAM Criteria Used For?
The ASAM criteria use a multidimensional approach to assess a person’s needs, strengths, resources, social support, and various assets. The ASAM criteria help determine the best level of care for the person’s substance use disorder at the time of assessment, accounting for their need for medical oversight and safety.2 The ASAM criteria can be used at entry into treatment and during transitions to different levels of care on the continuum.2
The ASAM dimensions are comprehensive and take in all aspects of the person’s life. The use of these dimensions helps to determine the intensity of services needed.3 They are:3
- Dimension 1: Acute intoxication and/or withdrawal potential. Exploring and assessing the current and past use of substances, as well as the history of withdrawal
- Dimension 2: Biomedical dimension, which explores a person’s medical needs and health history
- Dimension 3: Emotional, behavioral, or cognitive conditions and complications
- Dimension 4: Readiness to change. Determining a person’s willingness and readiness to change their substance use
- Dimension 5: Relapse, continued use, or continued problem potential. Assessing a person’s individual needs that can influence their potential to relapse
- Dimension 6: Recovering/living environment. Assessing how a person’s living situation can help or hinder their efforts at recovery
ASAM Levels of Care
ASAM outlines various levels of care based on the outcome of the 6 ASAM dimensions assessment.3 These levels of care are on a scale ranging from 0.5 to 4, with 4 being the most intensive.3
Again, with the ASAM dimensions taking into account a person’s needs, strengths, and support system, among other variables, the assessment informs the clinician as to which of these levels is the most appropriate at the time for a person’s treatment needs.3
How Do Rehab Centers Qualify for ASAM Certification?
Currently, a rehab center can get certification as a Level 3.1, 3.5, or 3.7 provider.4 This certification involves an assessment of the program’s ability to provide services consistent with the needs of the people in need of treatment at these levels.4 If a program is seeking an ASAM certification, they go through an application with an organization known as CARF, which provides an independent assessment of a treatment program.4
When a program obtains ASAM certification, it tells patients that they can be assured that the program can provide evidence-based treatment that can meet a person’s specific needs.4