Standards of Care for the Addiction Specialist Physician Document Released

by Beth Haynes | February 17, 2014

Image of front of Standards document

The Practice Improvement and Performance Measurement Action Group (PIPMAG) has published Standards of Care for the Addiction Specialist Physician. A dissemination plan is currently being developed which includes working with Substance and Mental Health Services Administration (SAMHSA) to inform important stakeholders about these newly released standards.

Dr. Margaret Jarvis, ASAM Secretary and Chair of the PIPMAG Expert Panel which developed the standards document, will be presenting the standards to SAMHSA’s liaison group on February 20th. This group, encompassing representatives of all the addiction field organizations as well as multiple federal agencies, meets monthly to share information on issues and projects of mutual interest.

PIPMAG is an ASAM activity with participating Steering Committee representatives from other professional societies and addiction-related federal agencies, in addition to individuals with significant experience in medical quality activities, performance standards development, and performance measurement.

ASAM Past President Michael M. Miller, MD, FASAM, serves as the Steering Committee’s chair, and the PIPMAG Expert Panel regarding performance measures for addiction specialist physicians has already begun its work reviewing existing physician performance measures and drafting its own report. After the standards document was presented to the ASAM Board and approved last October, ASAM received feedback leading the Steering Committee to expand the document further and clarify some of its language.

The issue of whether these standards should apply only to specialists and not to generalist physicians was discussed at multiple points in the PIPMAG process. The latest revisions, presented to the ASAM Board this January included revised language in the introduction to the standards, which now clearly states that the standards apply to any physician assuming the responsibility for caring for patients with addiction and acting in this capacity even if such a physician does not hold addiction specialty certification.

According to Dr. Miller, “It was very important for us to revise the document to make clear that these standards apply to all physicians caring for patients with addiction and not just to specialty physicians. All physicians should face similar accountabilities in order to assure that patients are receiving the highest quality of care.”

Dr. Miller also added that “In all areas of medicine, specially trained and certified specialists develop the standards of best practice for patient care in a specialized area, but primary care and other physicians must practice in accordance with these established standards. It should be no different when the condition is addiction or a substance-related disorder.”

As work started with the Performance Measures Expert Panel within PIPMAG, it was evident that more clarity was needed regarding pharmacotherapies and psychosocial treatments for addiction. As a result, the recent revisions include more specific language to the treatment planning and treatment management standards.

Final reports of PIPMAG will be released in October 2014, including Performance Measures currently being developed by the PIPMAG Expert Panel. During a component session at ASAM’s Annual Medical-Scientific Conference this coming April titled “Quality Improvement: Improving Patient Care with Standards, Performance Measures and Guidelines,” Drs. Michael Miller, Margaret Jarvis and Corey Waller, Chair of the Expert Panel on Measures, will discuss the standards and the development of performance measures. PIPMAG is part of a broader initiative at ASAM to improve the quality of care for patients with addiction.

Learn more about PIPMAG and the newly releasing standards by watching the below video. 


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  1. John Chapdelaine,LADC,CAC ,M.Ed. Jan 05, 2016 - 09:45 AM

    John Edwards you are ill informed about addiction and the treatment that the patient (keyword) plays in recovery. First the Medical provider in Shelly's case as she laid it out is the responsible person providing care and the medicine . Any MD that provides opiates for longer than 2-4 weeks knows that after a certain set of regular doses physical dependency results. That is fact . These fact should and are of utmost importance to be shared with all patients. When the provider passes medicines onto a patient the provider is liable and is forever linked to the outcomes of said patient. To avoid a role and responsibility in the outcome is an irresponsible and a lethal stance to the patient and the families. In Shelly's case it is clear cut as she paints her story of a gross negligence on the providers part. 

    Ken Freedman MD are you the same that went to Tufts and practiced in Hartford,CT with the HCV population?  If so ..Hello!

  2. John Edwards Apr 11, 2015 - 01:21 AM

    @rburns, You are right, this was an incredibly arrogant move, and it represents an attempt to set an agenda favorable to those pricey but ineffective treatment centers that the membership of ASAM tries to push on the public as effective treatment. The addiction/rehab industry is about to crash and burn, too many people realize what is actually behind these pronouncements.

  3. John Edwards Apr 11, 2015 - 01:16 AM

    @shelly, since you clearly realized the addiction potential of your husband's medication, it is your responsibility, not the doctor's - why try to offload your failure?

  4. Carol Rogala Sep 24, 2014 - 05:51 PM

    I agree with Dr. Burns; referring to this as "Standards of Care" especially  when coming from ASAM is handing malpractice lawyers all they need to know.  If there are ever any lawsuits, you will be asked about these Standards in a deposition.  Also, primary care and other doctors will be held to them if they provide controlled substances to assist in withdrawal.  

  5. TLC May 03, 2014 - 03:24 PM

    Perhaps a certain amount of educational standards for the physicians prescribing these often abused meds is necessary.

    If physicians receive pertinent information regarding prescription meds and are able to educate their patients instead of simply writing a prescription, ignoring the potential that they set up for their patients by ignorantly assigning a med, we might save some lives.

  6. RBurns, MD Apr 20, 2014 - 03:30 PM
    Although I am sure this document will contribute to improved addiction care, if followed, I would like to know who "charged" ASAM to produce Standards of Care, as opposed to guidelines. Violating a guideline is no big deal as long as you have good medical reasoning for doing so. Violating a Standard of Care implies malpractice has been committed.   As you can see from the 25-Mar post, someone is already interested in jumping on the malpractice bandwagon. If ASAM charged itself with creating Standards for an entire field of medicine, I would say that would be somewhat arrogant and potentially wrought with legal liability.
  7. Shelley Conte Mar 25, 2014 - 08:17 AM

    Would this apply towards my husbands MD? In short, my husband was treated for muscle spasms in 2012 w/Oxycodon. Then apparently was taking to many & running out. But his MD kept on filling them, even switched it up and gave him a generic script for Vicodin. I found out, went to the MD w/my husband. He(MD) claims he didn't realize Steven had a problem? Here we are 2014 I am thinking the scripts stopped, he's not taking those Opiates. I found out 2 wks ago he never stopped! Am I wrong but isn't my husband, Steven's MD accountable for this? Knowing he has a problem & was informed of it!!?? 

  8. Ken Freedman, MD Feb 22, 2014 - 05:52 PM
    Excellent prelude to what promises to be an important contribution to clinical addiction medicine and our ongoing evidence-based practice improvement.
  9. John Tanner Feb 21, 2014 - 06:37 PM

    Great job!  Thanks for all the work and preparation for this to Margaret Jarvis, Mike Miller and everyone who served on the committee and ASAM Staff.  

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