The American Society of Addiction Medicine (ASAM) standardizes addiction treatment by establishing five levels in a continuum of care (level 0.5 to 4) for substance abuse treatment. The ASAM criteria helps the patient enter the treatment at the level of care that best suits their present condition. Level of care refers to the intensity of services provided- the intensity of care increases with the level number. After receiving a particular level of care, the patient may transition to a step-down or step-up level of care, if needed. The progression may not necessarily be linear, and depend on the response to the ongoing treatment.
Let’s understand these levels of care, as standardized by ASAM.
Early intervention is useful for those adults and adolescents who are on the verge of developing a substance use disorder. It is also recommended for those who have symptoms of a substance use disorder but are not diagnosed with any such disorder yet. Early intervention may take the form of informal counseling or structured therapy. This level of care involves educating about the negative impact of drug misuse.
This involves evaluation, treatment, and recovery follow-up services in a non-residential setting. So, the patients can carry on with their daily routine while undergoing level 1 treatment and regularly meeting treatment professionals. This is the least intensive and least expensive level of care and is suitable for patients with less severe symptoms. As per ASAM criteria, outpatient treatment takes less than 9 hours/week for adults and less than 6 hours/week for adolescents.
At level 2 comes, Intensive outpatient programs (IOP) and partial hospitalization programs (PHP). These services are designed for patients with more complex substance use disorders and co-occurring disorders. These services do not hinder the patient’s daily routine but require meetings with physicians, psychiatrists, and therapists after their work hours. The level 2 care can be in the form of:
Intensive outpatient programs (IOP) offer more resources, thus, more intensive than outpatient programs while still being non-residential. The weekly duration for IOP is about 9-20 hours. Unstable medical and psychological conditions require a more intensive level of care than IOP.
Partial hospitalization programs (PHP) are the most intensive in the non-residential setting. It requires at least 20 hours/week, or a sitting of 6 hours per day. These are also known as day programs.
Both programs may occur at hospitals or behavioral health treatment centers.
In these programs, patients live onsite or in close proximity to the treatment center. These programs are designed for those who have developed some functional deficits and require stability. The patients are looked after by professionals 24X7 and kept engaged with meaningful therapies and medical care activities, leaving them with minimal free time. The duration may range from 30 to 90 days, depending on the patient’s need and recovery pace. It is the step-down level after medical detox.
This level is the highest and most comprehensive of all treatment levels. The level is designed for those who have severe substance use disorders and require medical stabilization. The patients are medically monitored 24X7 by physicians, which consist of medical detox, medication-assisted treatment, and counseling. This treatment prepares the patient for a transfer to less intensive treatment in the continuum of care.
Insurance coverage for the levels above can be complex to comprehend. Physicians can trust medical billing firms for better reimbursements, while they try to assist the patients in their recovery journey.
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