Posted: November 13th, 2015

Assessment of Substance Abuse

Assessment of Substance Abuse

The following are the six dimensions of ASAM, and how they are defined by the American Society of Addiction Medicine, (ASAM PPC-2R, ASAM Patient Placement Criteria for the Treatment of Substance Related Disorders, 2nd Edition – Revised, David Mee Lee, M.D. Editor, 2001).

ASAM Dimension  1.) Acute Intoxication and Withdrawal
What risk is associated with the patient’s current level of acute intoxication?
Is there significant risk of severe withdrawal symptoms or seizures, based on the patients previous withdrawal history, amount, frequency, chronicity and recency of discontinuation or significant reduction of alcohol or other drug use.
Are there current signs of withdrawal?
Does the patient have supports to assist in ambulatory detoxification, if medically safe?

Dimension   2.) Bio-Medical Conditions and Complications

Are there current physical illnesses, other than withdrawal, that need to be addressed or that may complicate treatment?
Are there chronic conditions that affect treatment?

Dimension   3.) Cognitive, Behavioral, and Emotional Conditions
Are there current psychiatric illnesses or psychological, behavioral, emotional or cognitive problems that need to be addressed because they create risk or complicate treatment?
Are there chronic conditions that affect treatment?
Do any emotional, behavioral or cognitive problems appear to be an expected part of addictive disorder or do they appear to be autonomous?
Even if connected to the addiction, are they severe enough to warrant specific mental health treatment?
Is the patient able to manage the activities of daily living?
Can he or she cope with any emotional, behavioral or cognitive problems?

Dimension   4.) Readiness / Motivation
What is the individual’s emotional and cognitive awareness of the need to change?
What is his or her level of commitment to and readiness for change?
What is or has been his or her degree of cooperation with treatment?
What is his or her awareness of the relationship of alcohol of other drug use to negative consequences?

Dimension  5.) Relapse, Continued Use, Continued Problem

Is the patient in immediate danger of continued severe mental health distress and or alcohol or drug use?
Does the patient have any recognition of, understanding of, or skills with which to cope with his or her addictive or mental disorder in order to prevent relapse, continued use or continued problems such as suicidal behavior?
How severe are the problems and further distress that may continue or reappear if the patient is not successfully engaged in treatment at this time?
How aware is the patient of relapse triggers, ways to cope with cravings to use, and skills to control impulses to use or impulses to harm self or others?

Dimension 6.) Recovery Environment
Do any family members, significant others, living situations or school or work situations pose a threat to the patients safety or engagement in treatment?
Does the patient have supportive friendships, financial resources, or educational/ vocational resources that can increase the likelihood of successful treatment?
Are there legal, vocational, social service agency or criminal justice mandates that may enhance the patient’s motivation for engagement in treatment?
Are there transportation, child care, housing or employment issues that need to be clarified and addressed?

(ASAM PPC-2R, ASAM Patient Placement Criteria for the Treatment of Substance Related Disorders, 2nd Edition – Revised, David Mee Lee, M.D. Editor, 2001).

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