ASAM Patient Placement Criteria

Description: 
The ASAM Patient Placement Criteria for the Treatment of Substance-Related Disorders, Second Edition-Revised (Mee-Lee et al. 2001) lists the 5 basic levels of care available for adult substance users. These levels of care range from Early Intervention (for at-risk individuals) to Medically Managed Intensive Inpatient Treatment (for patients with severe disorders who require around-the-clock care). The Patient Placement Criteria classifies opioid maintenance therapy as a Level I treatment since it is most often conducted in outpatient settings.


According to the Patient Placement Criteria, the following 6 patient dimensions should be considered when formulating a treatment plan (Mee-Lee et al. 2001):

Dimension Things to Consider
Acute Intoxication and/or Withdrawal Potential Assess whether the patient is currently intoxicated, is at risk of precipitated withdrawal, or is currently in withdrawal.
Biomedical Conditions and Complications Consider the patient's existing medical conditions and/or illnesses and how they might affect treatment.
Emotional, Behavioral, or Cognitive Conditions and Complications Note the patient's psychiatric illnesses and psychological, behavioral, emotional, or cognitive problems, and determine if they are related to or are independent of the substance use disorder.
Readiness to Change Assess the patient's readiness to change, and determine how willing he/she is to begin treatment.
Relapse, Continued Use, or Continued Problem Potential Try to ascertain what the outcome will be if treatment is not successful, and consider if the patient can combat cravings and cues that might lead to relapse.
Recovery/Living Environment Determine if the patient's home and work environments contribute to or detract from treatment efforts and what family and social support is available.

References:

A more thorough explanation of the Patient Placement Criteria is available in the following sources:

Mee-Lee D, Schulman, GD, Fishman M, Gastfriend DR, Griffith JH, eds. ASAM Patient Placement Criteria for the Treatment of Substance-Related Disorders, Second Edition-Revised (ASAM-PPC-2R). Chevy Chase, Md: American Society of Addiction Medicine Inc; 2001.

Mee-Lee D, Schulman GD. The ASAM Placement Criteria and matching patients to treatment. In: Graham AW, Schultz TK, Mayo-Smith MF, Ries RK, Wilford BB, eds. Principles of Addiction Medicine, Third Edition. Chevy Chase, Md: American Society of Addiction Medicine Inc; 2003:453-465.