Levels of Care in Addiction Treatment

Depending upon the severity of an addiction, an individual’s treatment needs will vary. A medical professional can assess what is necessary for a given patient and determine the appropriate type or level of care. From Alcohol Detox to drug rehab, desert rose recovery offers the full continuum of care focused each clients your individual needs.

The American Society of Addiction Medicine (ASAM) has developed five broad levels of care in order to standardize the protocol and help insurance companies decide how much patient coverage to offer. Each includes different tiers of treatments and services offered to patients. Matching addicts with the necessary level of care through these tiers has become the most widely used method of placement for a patient. Levels were established in the 1980s in an effort to formalize outcome-oriented treatment for addiction.

ASAM’s Broad Levels of Care

Prior to assigning a patient to a level that is most appropriate for them, a multi-dimensional assessment takes place by a medical professional. These dimensions help a provider create a tailored treatment plan for the patient.

Here are the different dimensions that a medical professional will evaluate.

1. Acute Intoxication and/or Withdrawal Potential

2. Biomedical conditions and complications

3. Emotional, behavioral or cognitive conditions and complications

4. Readiness to change

5. Relapse, continued use or continued problem potential

6. Recovery/living environment

Once this process is complete, a level of care will be determined. Here are the five levels of care:

Level 0.5 – Early Intervention

This details a level of care that is identified for an individual who is at risk of developing a substance use problem. There is a focus on education and resources and intervention may occur through informal or formal counseling.

Level 1 – Outpatient Services

Professional treatment is provided either daily or weekly at a facility for less than 9 hours a week for adults and less than 6 hours a week for adolescents. When the patient is not engaged in treatment, they have the flexibility to return home.

Level 2 – Intensive Outpatient/Partial Hospitalization

This is a level of care that offers professional treatment but more intensely, from 9-20 hours a week, still giving patients the ability to return home when they are not being treated. This is offered to not only help treat addictions but to also assist with any co-occurring disorders.

Level 3 – Residential Inpatient Services (Clinically Managed)

This level differs in that an individual is required to live on-site in order to take advantage of 24 hour a day care from a facility. It is best suited for someone with an extreme addiction who could be a danger to themselves and/or someone else.

Level 4 – Medically Managed Intensive Inpatient Services

This is even more extreme than Level 3 as it is designed for someone who is severely unstable and an imminent danger to themselves and/or someone else. Medical staff and nursing care provide support 24 hours a day, with daily physician care and counseling available. Medically Supervised Detox.

While levels of care can be delineated into specific categories, they should be viewed as part of a continuum. For example, a medical professional might initially match an individual with an intense level of care. However, after seeing an extreme improvement it is up to the discretion of the medical professional to potentially consider reassigning their patient to a more moderate level of treatment allowing more flexibility and freedom. The reverse situation is also possible as a patient might be matched with a milder level of care initially but then relapse, requiring more intense treatment and services.

Benefits of the ASAM Criteria

This criteria is helpful because treatment is selected based on a well-rounded view of a patient, rather than with a focus on a specific addiction or psychological disorder.

Patients benefit from the approach because:

• They are given the opportunity to take an active role in their treatment plan

• Patients can develop a better understanding of the types of treatment that are available as well as the correct protocols

• Individuals are provided with more detail on how their strengths and weaknesses, skills and resources, work together or against maintaining a healthy lifestyle

Providers benefit from the approach because it:

• Helps them guide a patient from the initial assessment through the completion of treatment

• Assists the patient in establishing goals as well as identifying the means the achieve their goals

• Identifies the severity of the patient’s addiction and determines the most appropriate level of care

• Determines the appropriate tailored plan for treatment within the guidelines of the criteria

Here is a helpful chart detailing the various levels of care along a continuum: