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Different Levels of Care for Treating Addiction

Being anxious is common in patients who are looking to begin a drug abuse treatment. The cause of this can be different from person to person, and an add-on to this anxiety is not knowing the treatment options available that would suit the current needs.

7 Minute Read | Published Jan 24 2024 | Updated Apr 05 2024 Expert Verified
Wayne P. Brown
Reviewed by
Wayne P. Brown
Reviewed by

Statistics indicate that in the US, half of people who are 12 years of age and older have used drugs at least once in their lives. Due to this, having a significant number of people having concerns about the treatment process is normal, and all the concerns might or might not be answered. However, it is beneficial to explain and make sure patients understand the different levels of care that are there to approach addiction treatment for oneself or a family member.

Apart from gaining a clearer picture of the therapeutic field, people can discover a lot about themselves and their requirements by reading through the continuum of care. The treatment institution typically performs evaluations to individualize treatments. Self-education is the perfect way to relax fears and help decrease anxiety. Accepting that this feeling is normal can also bring relief. 

If you or someone you love is having a hard time with substance abuse or addiction, the following document will help you learn the various stages of therapy, why they are different, and how to get help.

What is ASAM and What are its Dimensions?

ASAM, which stands for the American Society for Addiction Medicine, uses a broad approach to defining a proper level of care. For this, they have an assessment that tries to evaluate different areas of someone’s life, embracing different aspects and situations.

ASAM evaluates different dimensions to determine the right level of care. These dimensions are:

Dimension 1: 

Is used only to assess acute intoxication and withdrawal risk. This is done by reviewing both current and past substance use and withdrawal history.

Dimension 2: 

It looks into other medical aspects of a person's life and history.

Dimension 3: 

It is used to treat emotional issues, behavioral or cognitive disorders, and conditions and complications that could be co-occurring.

Dimension 4: 

It is used to measure how ready an individual is to change. Addiction treatment relies a lot on the person's willingness to change and face what drove their consumption patterns.

Dimension 5: 

This dimension is used to contemplate the chances of relapse.

Dimension 6: 

It is used to assess one’s living conditions to see if the environment will foster or restrict recovery efforts.

What are ASAM's Five Levels of Care?

ASAM has specified five levels of care, all of which have sublevels for specific needs. It should be noted that the care rendered to adults differs from that provided to adolescents. Within the adult framework, the levels are categorized as follows:

Level .5 Prevention/Early Intervention: 

This is the level of care type that is a class of service for people who are either identified as being at risk of acquiring substance-related problems for a known reason or a service for those for whom there is yet enough information to diagnose a substance use disorder. Services could include:

  • One-on-one counseling.
  • Drug-free workplace initiatives.
  • SBIRT: Screening, Brief Intervention, and Referral to Treatment.
  • Employee Assistance Programs.

Level 1. Outpatient Services: 

This level of care typically entails under 9 hours of service/week for adults or under 6 hours/week for adolescents. Services could include:

  • Psychotherapy for individuals and groups.
  • Psychoeducational services.
  • Family and adjunctive therapies.
  • Nursing services.
  • Ambulatory services.
  • Medication Management.
  • Medicated Assisted Treatment.
  • Laboratory/Toxicology Services.

Level 1.5 Outpatient Services: 

Based on behavioral outpatient treatment.

Level 1.7 Outpatient Services:

BAsed on medically-managed outpatient treatments.

Level 2. Crisis Stabilization/ Intensive Outpatient: 

Level 2 covers services that can address the unique needs of individuals with addiction and any other type of co-occurring conditions. It is structured as an outpatient program, in which treatment services are provided during the day.

Level 2.1 Intensive Outpatient Services: 

This is known as a Referred Intensive Outpatient Treatment for Adolescents and Adults. This level of care is defined as administering at least 9 hours per week for adults and at least 6 hours for adolescents. The key is that care is provided while treating multidimensional instability

Level 2.5 High-Intensity Outpatient (HIOP): 

The key is that care is provided while treating multidimensional instability, which does not need 24-hour attention.

Level 2.7 Medically Managed Intensive Outpatients: 

Based on medically managed intensive outpatient therapy that does not need 24-hour monitoring.

Level 3. Residential/Inpatient Services: 

Covers residential services and comorbidities that are co-occurring. These services are provided by mental health specialists, addiction treatment specialists, and medical staff who render a continuum of care in a 24-hour life support setting.

Level 3.1 Clinically Managed Low-Intensity Residential Services: 

Services in this category include a variety of therapeutic interventions, for instance, individual and group psychotherapy, psychoeducational services, family and adjunctive therapies, nursing services, medication management, medicated assisted treatment, laboratory/toxicology services, and housing and community resource building.

Level 3.5 Clinically Managed High-Intensity Residential Services: 

This level of care is called Clinically Managed Medium-Intensity Residential Services for adolescents and Clinically Managed High-Intensity Residential Services for adults and provides 24-hour medical care and support from trained counselors. 

This aims to stabilize people threatened by multidimensional imminent danger and prepare them for outpatient care. The expansive services offered include individual and group psychotherapy, psychoeducational services, family and adjunctive therapies, nursing services, medication management, and help with housing and community resources.

Level 3.7 Medically Monitored High-Intensity Inpatient Services: 

This type of care is called Medically Monitored High-Intensity Inpatient Services for adolescents and Medically Monitored Intensive Inpatient Services Withdrawal Management for adults and provides 24/7 nursing monitoring with physicians available to address significant issues in Dimensions 1, 2, or 3.
It provides the right environment for patients with subacute biomedical and psycho-behavioral or psycho-cognitive challenges that are severe enough to require inpatient care.
Services rendered are a multitude of interventions and include individual and group psychotherapy, psychoeducational services, family and adjunctive therapies, nursing services, medication management, medicated assisted treatment, and laboratory/toxicology services.

Level 4. Medically Managed Intensive Inpatient Services: 

Level 4 programs are staffed with a team of licensed and certified professionals who provide continuous medical management by physicians, primary nursing care, observation, and professional counseling services for 16 hours daily.

Transition from one of these numbered levels to another is possible, and the referral may be in the upper or lower direction as required and determined by the specialist. This systematic model emphasizes ASAM's dedication to offering personalized treatment programs to help patients in their recovery process.

Why is it Necessary to Have Different Levels of Care?

The treatment that turned out to be effective for everyone doesn't exist. Each person does not come with a single set of needs; therefore, physical, psychological, medical conditions, social involvement, and many other areas are of interest when deciding on therapy. 

The right therapy should have a comprehensive, individualized approach for each individual and the condition or conditions that should be treated.

The American Society of Addiction Medicine (ASAM) uses systematic criteria to determine the placement, continuation, transfer, or release of treatment for each patient. Some treatment centers have developed a proven way to provide specific or different levels of care following ASAM’s guidelines, enabling addicts to receive the treatment that best matches their needs and increasing their chances of recovery success.

Where to Find the Right Level of Care for Me?

Making the best choice for rehabilitation care could seem like a blank spot at the beginning, but you don’t have to figure it out on your own. You can confidently start the process with the backing of doctors or addiction experts. These experts have special skills to address the unique needs of every individual looking for addiction treatment.

The recovery process begins with a series of tasks to determine the best initial treatment and set the path for a process that will indeed have a multitude of evaluations and assessments during its length. Finding the proper assistance and tools means you will make your journey to recovery with the aid of a talented counselor. You can use our Treatment Centers Finder to get information about the nearest place where you can go for assistance.


bullet National Center for Drug Abuse Statistics
"Drug Abuse Statistics"
Retrieved on March 21, 2024
bullet American Society of Addiction Treatment
"About The ASAM Criteria"
Retrieved on March 21, 2024
bullet National Library of Medicine
"The Continuing Care Model of Substance Use Treatment: What Works, and When Is “Enough,” “Enough?”"
Retrieved on March 21, 2024
bullet Journal of Addiction Medicine
"Initiatives to Support the Transition of Patients With Substance Use Disorders From Acute Care to Community-based Services Among a National Sample of Nonprofit Hospitals"
Retrieved on March 21, 2024

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