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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
1. What risk is associated with the patient's current level of acute intoxication?
2. 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.
3. Are there current signs of withdrawal?
4. Does the patient have supports to assist in ambulatory detoxification, if
medically safe?
Dimension 2.) Bio-Medical Conditions and Complications
1. Are there current physical illnesses, other than withdrawal, that need to be
addressed or that may complicate treatment?
2. Are there chronic conditions that affect treatment?
Dimension 3.) Cognitive, Behavioral, and Emotional Conditions
1. Are there current psychiatric illnesses or psychological, behavioral,
emotional or cognitive problems that need to be addressed because they
create risk or complicate treatment?
2. Are there chronic conditions that affect treatment?
3. Do any emotional, behavioral or cognitive problems appear to be an
expected part of addictive disorder or do they appear to be autonomous?
4. Even if connected to the addiction, are they severe enough to warrant
specific mental health treatment?
5. Is the patient able to manage the activities of daily living?
6. Can he or she cope with any emotional, behavioral or cognitive problems?
Dimension 4.) Readiness / Motivation
1. What is the individual’s emotional and cognitive awareness of the need to
change?
2. What is his or her level of commitment to and readiness for change?
3. What is or has been his or her degree of cooperation with treatment?
4. 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
1. Is the patient in immediate danger of continued severe mental health distress
and or alcohol or drug use?
2. 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?
3. 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
1. Do any family members, significant others, living situations or school or
work situations pose a threat to the patients safety or engagement in
treatment?
2. Does the patient have supportive friendships, financial resources, or
educational/ vocational resources that can increase the likelihood of
successful treatment?
3. Are there legal, vocational, social service agency or criminal justice
mandates that may enhance the patient's motivation for engagement in
treatment?
4. 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).
ASAM SIX DIMENSIONS
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