The American Society of Addiction Medicine (ASAM) recently updated its criteria for assessing and treating substance use disorders. The ASAM Criteria is the most widely used framework for the placement, continued service, and transfer of patients with addiction.
ASAM provides these standards to help promote individualized treatment, helping clinicians and care managers make objective decisions about admission and level of care, as well as continuing care and transitions. It also helps providers determine what services should be available at each level of care.
BestNotes recently held a webinar with Dr. Michael Miller, MD, DFASAM, DLFAPA, to explain some of the key changes in the new, fourth edition of the ASAM Criteria. This information can help behavioral health providers update their practices to the new standards and effectively navigate the evolving landscape of addiction treatment.
How should the ASAM Criteria be used?
This fourth edition update to the ASAM Criteria is meant to improve outcomes and prevent both under- and over-treatment of individuals with addiction. Just like the Third Edition, the Fourth Edition of the ASAM Criteria describes the different intensities of service that should be available in addiction care. For each level of care, there is a description of the services, frequency, and staff. The intensity of treatment should be wholly determined by the severity of the illness.
The criteria are not “one and done,” that is, they should not be applied solely at admission. They should be revisited and used at all stages and levels of care to ensure that a client is still receiving the appropriate treatment.
What has changed in the Fourth Edition?
Different levels of outpatient care now have different, but consistent, numbering and naming, with new subdimensions added. For example, “Readiness to Change” has been removed and is now included in the new “Person-Centered Considerations.” This dimension also includes social determinants of health.
Medication management is a big part of the new edition updates. Medically managed programs at all levels should be able to initiate all FDA-approved medications. Every level of care should be able to support the continuation of these medications. In addition, any client admitted to an addiction treatment plan should receive a physical examination “within a reasonable time frame” by a physician or advanced practice provider experienced in addiction treatment.
Other changes in the fourth edition include:
- Level of care 1.0 has been added, providing ongoing monitoring for clients in stable remission.
- The ability to address co-occurring conditions has been integrated across the care continuum.
- Withdrawal management, cognitive impairment treatment, and harm reduction concepts are now incorporated into all care levels, rather than being separated.
- Assessment dimensions have been modified and reordered.
- Some levels of care have been removed or added compared to the Third Edition, such as the inclusion of recovery residences like sober living facilities.
- The concept of “Risk Ratings” has been removed.
You can find more information on the ASAM website, including the full version of the Fourth Edition of the ASAM Criteria.
Staying up-to-date on industry standards and regulatory changes is a must for addiction treatment providers. BestNotes EHR solutions automatically update to match common federal, state, and county standards, as well as accrediting bodies such as Joint Commission and CARF. Get in touch with us today to learn more, or schedule a free demo!