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This document includes:
• ASAM criteria for adolescents
• ASAM criteria for adults
Licensee's use and interpretation of the American Society of Addiction
Medicine’s ASAM Criteria for Addictive, Substance-Related, and Co-
Occurring Conditions does not imply that the American Society of
Addiction Medicine has either participated in or concurs with the
disposition of a claim for benefits.
This excerpt is provided for use in connection with the review of a
claim for benefits and may not be reproduced or used for any other
purpose.
The ASAM Criteria
Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions
Third Edition
The Change Companies
David Mee-Lee, MD
Chief Editor
Gerald D. Shulman, MA, FACATA
Marc J. Fishman, MD FASAM
David Gastfriend, MD
Deputy Editors
Michael M. Miller, MD, FASAM
Managing Editor
Scott M. Provence, MA, MFA
Publication Editor
American Society of Addiction Medicine Inc.
Chevy Chase, MD 20815
2013
ASAM Criteria - Adolescent Levels of Care
Adult Levels of Care DIMENSION 1 DIMENSION 2 DIMENSION 3 DIMENSION 4 DIMENSION 5 DIMENSION 6
Acute Intoxication Biomedical Conditions Emotional, Behavioral or Readiness to change Relapse, Continued Use Recovery/Living
and/or Withdrawal and Complications Cognitive Conditions and Or Continued Problem Environment
Potential Complications A) Potential
Dangerousness/Lethality,
B) Interference with
Addiction and/or Mental
Health Recovery Efforts,
C) Social Functioning, D)
Ability for Self-Care, E)
Course of Illness
Level 0.5 No withdrawal risk None or very stable None or very stable. Any Willingness to explore Needs an Adolescents risk of
Early Intervention Dimension 3 issues are how current alcohol, understanding of, or initiation of or
being addressed through tobacco, medication, skills to change current progression in
concurrent mental health other drug use, and/or alcohol, tobacco, other substance use and/or
services and do not high-risk behaviors drug or medication use high-risk behaviors is
interfere with early may affect achievement patterns, and/or high- increased by substance
intervention addiction of personal goals risk behaviors use or values about use.
treatment services High-risk behaviors of
family, peers, or others
in adolescent’s social
support system
Level 1 No withdrawal risk None or very stable, or The adolescents status in Willing to engage in Able to maintain Family and
Outpatient Services is receiving concurrent dimension 3 features one treatment, and is at abstinence or control environment can
medical services of more of the following: least contemplating use and pursue support recovery with
A) the adolescents is not change, but needs recovery or limited assistance
at risk of harm, B) There motivating and motivational goals with
is minimal interference, monitoring strategies minimal support
C) Minimal to mild
impairment, D) the
adolescent is
experiencing mild to
moderate difficulties
with activities of daily
living, but there is
significant risk of
deterioration E) The
adolescent is at minimal
imminent risk, which
predicts a need for some
monitoring or
interventions
Level 2.1 Experiencing minimal None are stable or The adolescents status in Requires close Significant risks of Adolescent
Intensive Outpatient Services withdrawal distracting from dimension 3 features one monitoring or support relapse or continued environment is
Experiencing mild treatment at a less of more of the following: several times a week to use or continued impeding his or her
withdrawal, or is at risk intensive level of carte. a) the adolescents is at promote progress problems and recovery, and
of withdrawal Such problems are low risk of harm, and he through the stages of deterioration in level of adolescent requires
manageable at Level 2.5 or she is safe between change because of functioning. Has poor close monitoring or
sessions, b) mild variable treatment prevention skills and support to overcome
interference requires the engagement, or no needs monitoring or that barrier
intensity of this level of interest in getting support
care to support assistance
treatment engagement, c)
mild to moderate
impairment but her can
sustain responsibilities)
the adolescent is
experiencing moderate
difficulties with activities
of daily living and
requires near/daily
monitoring or
interventions, e) the
adolescent history
(combined with the
present situation)
predicts the need for
near daily monitoring or
interventions
LEVEL 2.5 Experiencing mild None are stable or The adolescents status in Requires a near daily High risk of relapse or Adolescent’s
Partial Hospitalization withdrawal, or is at risk distracting from Dimension 3 features one structured program to continued use comma environment renders
Services of withdrawal treatment at a less of more of the following: promote progress or continued problems recovery unlikely
intensive level of carte. A) The adolescents is at through the stages of in deterioration in level without near/daily
Such problems are low risk of harm, and he change because of little of functioning. Has monitoring or support,
manageable at Level 2.5 or she is safe overnight, treatment engagement minimal prevention or frequent relief from
B) Moderate interference or escalating use or skills and needs near his or her home
requires the intensity of impairment, or no daily monitoring and environment
this level of care to awareness of the role of support
support treatment alcohol, tobacco and/or
engagement, C) Moderate other drugs play in
impairment but can his/her present
sustain responsibilities, problems
D) The adolescent is
experiencing moderate
difficulties with activities
of daily living and
requires near/daily
monitoring or
interventions, E) The
adolescent’s history
(combined with the
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