ASAM 4th Edition Development
Over the past year-and-a-half, ASAM has been working to develop the 4th Edition of The ASAM Criteria® for adults using a rigorous methodology for evidence review and formal consensus development under the guidance of an editorial subcommittee led by R. Corey Waller, MD, MS, FACEP, DFASAM.
Summary of Major Changes to The ASAM Criteria 4th Edition
The Editorial Subcommittee is proposing the following major changes in the 4th Edition of The ASAM Criteria to facilitate dissemination and implementation, address known gaps in the quality of addiction treatment, and reflect the evolving needs of the field:
- Update the continuum of care.
- Update the ASAM Criteria Assessment and Treatment planning standards.
- Increase access to addiction pharmacotherapies.
- Promote more integrated care for co-occurring mental health conditions.
- Promote better integration of substance use disorder treatment into general healthcare.
- Incorporate treatment of individuals with cognitive impairments across the continuum.
- Support better communication of medical necessity.
- Discuss how telehealth, mobile treatment services, and digital therapeutics can be incorporated into treatment at each level of care.
- Update the language throughout to reflect evolving terminology in the field.
- Review and update the standards with a focus on diversity, equity, and inclusion.
Core principles of The ASAM Criteria remain the same, including:
- Admission into treatment is based on patient need rather than arbitrary prerequisites (e.g., prior treatment failure).
- Patients receive a multidimensional assessment that addresses the broad biological, psychological, social, and cultural factors that contribute to addiction and recovery.
- Treatment plans are individualized based on a patient’s needs and preferences.
- Care is interdisciplinary, evidence-based, delivered from a place of empathy, and centered on the patient.
- Patients move along a clinical continuum of care based on progress and outcomes.
- Informed consent and shared decision-making accompany all treatment decisions.
In the coming years, ASAM plans to release separate volumes addressing:
- Adolescent and Transition Age Youth
- Addiction Treatment within Jails and Prisons
- Behavioral Addictions (i.e., gambling, internet and gaming addiction, sex addiction)
Public Comment Periods
Public Comment Period #1 – March 2021
ASAM released a survey seeking comments* on what is working well in the implementation of The ASAM Criteria, what barriers or challenges exist, and what can be improved in the next edition. The editors carefully analyzed this feedback, which, along with their knowledge of evolving systems of care, research advances, and clinical experiences with The ASAM Criteria, informed the framework of proposed major changes.
Public Comment Period #2 – December 2021
The proposed major changes were released for public comment and ASAM received responses from 124 individuals and organizations. The feedback received* was instrumental in establishing the updated framework and developing the draft standards and decision rules.
Public Comment Period #3 – NOW through Nov 11th
The draft standards and decision rules are available for public comment until Friday, November 11th. It is important that ASAM receive feedback now to prevent any unintended consequences upon publication in 2023. Feedback must be submitted through the online submission form to be considered. Please note that your comments may be made public.
ASAM has been seeking input from providers, policymakers, payers, patients, and families to ensure the updates are responsive to the needs of addiction treatment systems across the country. Since the release of the 3rd Edition in 2013, there has been widespread adoption of The ASAM Criteria by treatment programs as well as payers and managed care organizations, and states across the country are using these standards as the foundation of efforts to improve their addiction treatment systems. No one person has insight into all these implementations, thus input from diverse stakeholders is needed to inform final decisions.
Corey Waller, MD, MS, FACEP, DFASAM (Editor-in-Chief)
Steven Daviss, MD, DFAPA, FASAM
Ayman M. Fareed, MD, DFAPA
Sandra Gomez-Luna, MD, FASAM
Edward James, III, MSW, ACSW, LMSW, MPM, DSW
Kimberly Johnson, PhD
Navdeep Kang, PsyD, HSP
Whitney Menarcheck, LPC
Wendy Welch, MD, MBA, FASAM