ASAM Levels of Care:

Criteria for treatment within a medical model

The following chart and levels of care are retrieved from https://www.asam.org/resources/level-of-care-certification

ASAM Levels

Outpatient Services

  • Level 0 – Early Intervention: For individuals at risk of developing a chronic substance-use disorder (DUI programs).
  • Level 1 – Ambulatory Detox without Extended Onsite Monitoring: For those experiencing mild withdrawal and needing daily or less than daily outpatient supervision. The patient is likely to complete detox and to continue in level I intensity treatment and recovery.
  • Level 1 – Outpatient Treatment: For patients requiring less than 9 hours/week of therapy.
  • Level 1 – Opioid Maintenance Therapy: For patients receiving pharmacological interventions (Buprenorphine, Methadone) for opioid use disorder.
  • Level 2 – Ambulatory Detox with Extended Onsite Monitoring: For patients experiencing moderate withdrawal and needing all day detox, support, and supervision. Patient has a supportive family or living situation and is likely to complete detox and to continue level II treatment and recovery.
  • Level 2 – Intensive Outpatient Treatment (IOP): A day or evening program for patients requiring 9 or more hours of therapy/week.
  • Level 2.5 – Partial Hospitalization (PHP): A day program for patients requiring 20 or more hours/week of therapy.

Residential/Inpatient Services

  • Level 3.1 –Clinically-Managed Low-Intensity Residential Treatment: For patients needing 24-hour residential care with trained staff and 4-5 hours of clinical treatment/week (do not require detox). (Includes state-regulated halfway houses and some unregulated recovery residences with in-house Level I services and a structured recovery environment.)
  • Level 3.2 – – Clinically-Managed Residential Detox: For patients experiencing moderate withdrawal and needing 24-hour support to complete detox and to continue treatment and recovery.
  • Level 3.3 – Clinically-Managed Medium-Intensity Residential Treatment: Provides 24-hour residential care in a moderately structured peer environment. Trained counselors deliver group treatment to stabilize multi-dimensional imminent danger, and prepare patients for a lower level of care.
  • Level 3.7 – Medically-Monitored Inpatient Detox / Intensive Inpatient Treatment: For patients experiencing severe withdrawal; provides 24-hour nursing care and physician visits as necessary for patients who are unlikely to complete detox without monitoring. (Patients needing alcohol or benzodiazepine detox (where withdrawal can be fatal) are commonly in a 3.7 – 4.0 level of care.
  • Level 4 – Medically-Managed Inpatient Detox / Intensive Inpatient Treatment: For patients experiencing severe and unstable withdrawal; provides 24-hour nursing care, and daily physician care, in order to modify the detox regimen and manage medical instability; A counselor is available 16-24 hours/day to engage patients in treatment.

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