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Effective Treatment of Addictive Disorders

Adoption Date:
April 1, 1997

Public Policy Statement on Effective Treatment of Addictive Disorders: a Basis for a Dialogue between the American Society of Addiction Medicine and the American Managed Behavioral Healthcare Association


**Note: This historical policy statement is available as part of ASAM's Policy Archives, but it is no longer considered current ASAM policy. Please contact ASAM's advocacy staff at advocacy@asam.org for questions related to ASAM's position on this topic.

Sharing an interest in the delivery of high quality, cost-effective treatments of addictive disorders, the American Managed Behavioral Healthcare Association (AMBHA) and the American Society of Addiction Medicine (ASAM) have entered into an ongoing dialogue and, as a beginning, make the following observations:

1) Substance related problems span a range from problems associated with use, misuse and addiction. Patients may present requesting care at any time during this spectrum.

2) We accept the need to match the severity of patients' disorders with appropriate interventions for that intensity of problem.

3) Some individuals experience single or isolated episodes of illness; others experience periodic recurrences in their lifetimes; others have severe and persistent addictive disorders. For some persons with addictive disorders, especially those with severe and persistent disorders, there is a need for ongoing management and periodic acute treatment interventions to appropriately respond to situations of relapse.

4) Addictive disorders are primary disorders which require their own unique and specialized treatment. Individuals with addictive disorders may also experience mental illness and may also experience primary health problems.

5) A purpose of managed behavioral health care is to deliver clinically effective and cost-efficient services within the constraints of finite resources. This involves using the least intensive available treatment setting, appropriate to the needs of the patient, while maintaining patient safety. As for all chronic medical conditions, payers/purchasers of addiction services have limited resources. Effectiveness requires provider accountability for clinical outcomes that improve patients' health and provide acceptable consumer satisfaction.

6) The history of addiction expenditures is one characterized by stigma, prejudices, and biases which have led to inadequate treatment resources and a misallocation of resource use.

7) Managed behavioral health care is attempting to build organized and integrated delivery systems targeted to a population-based approach. But treatment must also be individualized and tailored to each individual's unique situation and needs.

8) To successfully assess and treat individuals with addictive disorders, providers must possess a core set of knowledge and experience. There are multiple and many professional providers of addiction services; each must demonstrate that he/she individually possesses a core set of knowledge and experience. AMBHA and ASAM have a shared interest in articulating what a minimum and standardized set of knowledge and experience should be.

9) All providers should deliver treatment that is effective, efficient, and has value. This will require sophisticated screening, assessing and tracking systems for measurement of outcomes and agreement on common screening tools, diagnostic criteria and nomenclature. There is increasing awareness that health plans, networks and individual providers must be more publicly accountable for the clinical outcomes they deliver.

10) Quality should be measured. Standardized data sets, including administrative, clinical, and performance, should be developed. AMBHA and ASAM will strive to articulate possible data set guidelines. AMBHA and ASAM share the goal of seeing that guidelines are produced to oversee the development, articulation and application of data sets and data accumulation processes.