Treatment criteria for addictive, substancerelated and cooccurring conditions. The criteria were developed by the american society of addiction medicine asam. Past president, american society of addiction medicine past president, wisconsin society of addiction medicine director, american board of addiction medicine and the addiction medicine foundation managing editor, the asam criteria 20 former clinical adjunct professor pending clinical instructor. In addition to aligning benefits coverage with nationally accepted guidelines, states can also assess their program standards to ensure that sud service provision adheres to the industry standards. Examining residential substance use disorder treatment and. Treatment criteria for addictive, substancerelated and cooccurring conditions, third edition 20 by david meelee, gerald shulman, marc fishman, david.
Understanding the new asam criteria misti storie, ms, ncc. This document is to be utilized in applying the american society of addiction medicine asam criteria, 20 within pennsylvanias treatment system when conducting a level of care assessment for initial referral into services or for continued stay and discharge considerations after treatment engagement. An introduction to the asam criteria for patients and families. Pdf the asam criteria and matching patients to treatment.
These programs include an asam level of care certification program delivered by carf, a robust training program on the asam criteria, and ongoing enhancements to the asam continuum software a clinical decision support tool used to assist in treatment planning for individuals with addiction. The asam criteria is a collection of objective guidelines that give clinicians a way to standardize treatment planning and where patients are placed in treatment, as well as how to provide continuing, integrated care and ongoing service planning. Asam quick reference 32015 the american society of addiction medicine asam criteria is an evidencebased template to determine the appropriate level of substance use disorder intervention for an individual. The american society of addiction medicine asam criteria is an evidencebased template to determine the appropriate level of substance use disorder. Asam level of care loc determination guidelines 1 of 2 as emergency needs come first, the highest severity problem with specific attention to dimensions 1, 2 and 3 should guide the clients entry point into the treatment continuum. Asi, it measures biopsychosocial conditions to match patients to an optimal level of. Eventually, asam and naatp opted to merge and unify the placement criteria and came up in 1991 with the second asam placement criteria. Utilized by clinicians and payers across all care settings, the use of the asam criteria is required in more than 30 states.
Think of mat as being medication in addiction treatment just like medications in diabetes or depression treatment where medication is one tool in the clinical toolkit. Asam and carf reshape addiction care with landmark. Asam level of care loc determination guidelines 1 of 2. Treatment criteria for addictive, substancerelated, and cooccurring conditions addresses a wide range of special populations and includes the latest addiction science. Overview of substance use disorder care clinical guidelines. In addition to the criteria developed by asam, states and other agencies and groups may have. May be delivered in an office setting, healthcare or addiction treatment facility or in a patients home. Relapse, continued use or continued problem potential needs an understanding of, or skills to change, current alcohol, tobacco, other drug, or medication use patterns andor high risk behavior at high risk of relapse or continued use without otp and structured therapy to promote tx progress. The oklahoma department of mental health and substance abuse services odmhsas mandates. Asam has a responsibility to providers, payers, regulators, patients and their families to ensure the asam criteria continues to be equated with highquality care proven to be effective in addiction. The pipmag project was generously funded by the substance abuse and mental health services. Tips to get your clinical authorization approved by the ime. The american society of addiction medicine asam criteria software is a computerassisted structured interview and clinical decision support program. Licensees use and interpretation of the american society of addiction medicine s asam criteria for addictive, substancerelated, and co occurring conditions does not imply that the american society of addiction medicine has either participated in or concurs with the disposition of a claim for benefits.
The asam standards of care for the addiction specialist. A strong probability that certain behaviors such as continued alcohol or other drug use or addictive behavior relapse will occur always present for referral to residential treatment. In 1989, naatp joined forces with the american society of addiction medicine asam. As used in the asam criteria, an individual receiving alcohol, tobacco, andor other drug or addictive disorder treatment. Based on the asam criteria 3rd edition multidimensional assessment. The american society of addiction medicine asam criteria, formerly known as the asam patient placement criteria, have become the most comprehensive and widely used set of guidelines for placement, continued stay, and transferdischarge of clients with addiction or cooccurring conditions. These levels of care provide a standard nomenclature for describing the continuum of recoveryoriented addiction services. Asam patient placement criteriaa teaching tool states create their own criteria casam, masam, nysam, asam in major us mco.
The new asam criteria for the treatment of addictive. The asam criteria supports individualized, personcentered treatment that is responsive to specific needs and the patients progress in treatment. The goal was to uniformly identify placement and treatment options for patients presenting for care. The pyramid depicts the five levels of detoxification care that asam has identified. The criteria also provide levels of care that help manage particular treatment. Within the five broad levels of care, decimal numbers are used to further express gradations of intensity of services. About the asam criteria the asam criteria is the nations most widely used and comprehensive set of guidelines for placement, continued stay, and transferdischarge of patients with addiction and cooccurring conditions. A resource for states developing sud delivery system reforms. Treatment criteria for addictive, substancerelated, and cooccurring conditions, third edition. The information provided here will help you best implement asams criteria. The american society of addiction medicine has provided a thorough, evidencebased model to guide the level of care designation for those suffering from substance use disorder and or a cooccurring disorder.
Today the criteria have become the most widely used and. The american society of addiction medicine asam criteria is an evidence based template to determine the appropriate level of substance use disorder. The asam criteria views treatment length as a unique factorone that depends on the individuals progress and changing needs. Asam levels of care in the 1980s, it was determined that there should be one national set of guidelines for care in the treatment of addiction. May, 2015 the asam criteria text describes treatment as a continuum marked by four broad levels of service and an early intervention level. Treatment criteria for addictive, substance related, and co occurring conditions. Asam criteria retain at the present level of care if. The asam criteria and addiction treatment matching naadac.
About the asam criteria american society of addiction. An introduction to the asam criteria for patients and families aetna. Improved outcomes, managed care reform and the unification of the field the asam criteria and addiction treatment matching. With the evolution of addiction treatment and its increasing integration with general medical care, the task force recommended asam adopt general medical terminology to describe addiction treatment. The role and current status of patent placement criteria. Treatment criteria for addictive, substancerelated, and cooccurring conditions addresses a wide range of special populations and includes the latest addiction. The asam criteria the asam criteria is the nations most widely used and comprehensive set of guidelines for placement, continued stay, and transferdischarge of patients with addiction and cooccurring conditions. Overview of substance use disorder sud care clinical guidelines. A level of care can refer to the intensity of treatment you might receive, such as the difference between a walkin clinic and a 24hour hospital stay. Asam and carf reshape addiction care with landmark treatment. Asam criteria for adolescents asam criteria for adults. However, when the asam criteria is not fully implemented or used with fidelity, it can undermine patient care and compromise recovery.
Research shows that treatment based on the asam criteria is associated with less morbidity, better client function and more efficient service utilization than mismatched treatment. Some people need medication for good outcomes, some dont. For the past two years, the medicaid innovation accelerator program iap has been providing a broad group of state medicaid and behavioral health agencies with a variety of technical support. The point is that addiction treatment should be individualized to a persons specific needsand thats where the asam levels of care come into play. Understanding and using asam criteria in substance use. The likelihood that such behaviors will present a significant. The asam criteria maintains and builds on asam s previous efforts to respond to ongoing changes and needs within the special field of addiction treatment. Licensees use and interpretation of the american society of addiction medicine s asam criteria for addictive, substancerelated, and cooccurring conditions does not imply that the american society of addiction medicine has either participated in or concurs with the. Asam level of care loc determination guidelines 1 of 2 as. Asam and carf reshape addiction care with landmark treatment delivery certification. The asam standards of care for the addiction specialist physician. The asam criteria text describes treatment as a continuum marked by four broad levels of service and an early intervention level. With the asam criteria, managed care organizations can easily work with treatment providers to ensure plan participants are receiving the treatment that best fits their needs and that resources are wisely used. Some programs use the same treatment timeline for all of their patients such as putting everyone in a 28day program.
Medicines asam criteria for addictive, substancerelated, and co. The asam criteria are the most intensively studied set of addiction placement criteria, having undergone numerous evaluations and studies of effectiveness. Regarding the criteria, asam says, asam s criteria, formerly known as the asam patient placement criteria, is the result of a collaboration that began in the 1980s to define one national set of criteria for providing outcomeorientated and resultsbased care in the treatment of addiction. The asam criteria provides one common language for assessing patient need and describes the continuum of addiction care treatment settings. The asam criteria american society of addiction medicine. Therefore, asam recommends using the term medication to refer to any fdaapproved medication used to treat addiction. In accordance with the disclosure policies of the american society of addiction medicine asam and the accreditation council for continuing medical education accme, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all educational activities. Licensees use and interpretation of the american society of addiction. About asam asam, founded in 1954, is a professional medical society representing over 6,000 physicians, clinicians and associated professionals in the field of addiction medicine. Nonstandard, intuitive, then find out the rest later managed care wants more data. Guiding principles of the asam criteria 20 the asam criteria 20, pp 311 moving from onedimensional to multidimensional assessment the asam criteria continues to encourage moving away from treatment based on diagnosis alone i. Outcomes research in addiction treatment has not provided a scientific basis for determining precise lengths of stay or intensity of treatment. Continued treatment at present level of care necessary to permit patient to continue to work toward his or her treatment goals. For full details, please consult the american society of addiction medicine s publication, the asam criteria.
This confidential information is provided to you in accord with state and federal laws. The asam criteria maintains and builds on asams previous efforts to respond to ongoing changes and needs within the special field of addiction treatment. Outcomes research in addiction treatment has not provided a scientific basis for determining precise lengths of stay or intensity of treatment for optimum results. According to asam, the placement criteria provide a guideline for placing people in treatment, as well as for creating a treatment plan that guides an individual through the most appropriate levels of treatment for that persons needs. Level id ambulatory detoxification without extended onsite monitoring 1.
A resource for states developing sud delivery system reforms april 2017. Treatment criteria for addictive, substancerelated, and cooccurring conditions. The asam criteria textbook is the primary source for treatment providers who are applying the criteria in a clinical setting. Making progress, but not yet achieved goals articulated in individualized treatment plan. Criteria textbook american society of addiction medicine. Adult asam placement criteria crosswalk dimension 5. Society of addiction medicine asam criteria see appendix one. The asam criteria is the nations most widely used and comprehensive set of guidelines for placement, continued stay, and transferdischarge of patients with addiction and cooccurring conditions. First addiction treatment programs achieve asam level of care. Guiding principles of asam criteria moving away from treatment failure as a prerequisite for admission moving toward multidisciplinary teambased care clarifying physician role in care focusing on treatment outcomes fees, t. It also recognizes that with health reform, more services to persons with addiction will be delivered outside of a separate and separately funded. Asam elearning american society of addiction medicine. Indiana s levels of care are based off of asam criteria, however, asam does not speak to certain specifics which will differ across states.
1067 592 1084 1068 337 15 895 335 1571 216 722 898 560 1023 1496 436 719 1133 263 862 334 1303 167 737 1480 138 639 469 1304 862 1245 1355 818 234 1052