Substance Use Disorders: Matching to the Right Level of Care

Registration deadline: 2/6/2023

Trainer: David Gastfriend M.D., DFASAM                                               

Dr. Gastfriend is an addiction psychiatrist. At Harvard Medical School, he directed addiction research at Massachusetts General Hospital and was an investigator in the NIDA Cocaine Collaborative Study, NIAAA’s COMBINE Study and NIDA’s Clinical Trials Network. As Vice President at Alkermes, Inc., he directed scientific publications on Vivitrol in clinical, criminal justice and health economics research.
His research led most states to endorse the American Society of Addiction Medicine (ASAM) Criteria. His 150 scientific publications include the books The ASAM Criteria and Addiction Treatment Matching. His ASAM CONTINUUM – The ASAM Criteria Decision Engine® and ASAM’s CO-Triage® tools are being adopted nationwide.

In 2016, he co-founded DynamiCare Health, a nationally-scalable technology for Contingency Management and predictive analytics, winning awards from Harvard Business School, the Commonwealth of Massachusetts, the Governor of Ohio, and the New York Times. He has consulted to governments in Belgium, China, Iceland, Israel, Norway, Russia and the U.S.

Description:

The goals of evidence-based standards in assessment and placement criteria in treating substance use disorders include: 1) comprehensive, patient-centric evaluation of patients’ needs, strengths and resources; 2) ensuring reliability through standards across providers and systems; and 3) achieving predictive validity, i.e., obtaining the best outcome for patients using the least intensive and restrictive services and settings.

In the 1980s, the American Society of Addiction Medicine began to define a national set of criteria that provides results-based care in the treatment of addiction. Today, The ASAM Criteria are the most widely used set of standards in the United States for placement, continued stay and transfer/discharge of patients with addiction and co-occurring conditions. Care needs are divided into six areas, called Dimensions; treatment types are parsed into multiple intensities and specialty needs. With a computer-guided structured interview and clinical decision-assistance algorithm, investigators have demonstrated feasibility, inter-rater reliability, and predictive validity. With over 5,000 providers throughout the U.S. having conducted over 225,000 assessments, matching patients to care using standardized, evidence-based assessment and decision criteria appears to be feasible for broad public-sector implementation in routine care.

Agenda:

9:00 am Welcome, Introductions, Learning Objectives
9:15 am Rationale: Why Treatment Matching? Why Now?
9:30 am Guiding Principles of Service Specifications & Multidimensional Assessment
9:45 am Levels of Care & Their Distinctions
10:00 am BREAK – 15 min.
10:15 am Evidence for the Validity of Matching with the ASAM Criteria
10:35 am Using Decision Rules for Objective, Standardized Placement: 2 Cases
11:00 am Tools for Advancing Practice
11:15 am BREAK – 15 min.
11:30 am Some Finer Points of Semi-Structured Interviewing
11:50 am Q&A
12:10 pm Implementation Discussion: What’s the Next Step for Your Program?
12:30 pm Adjourn

Learning Objectives:

Attendees will be able to:

 1. Contrast usual care approaches with the rationale for standardized multidimensional assessment and placement according to evidence-based decision criteria.

2. Describe the six-dimensional model of assessment using the ASAM Criteria.

3. Implement the principles of utilizing the least intensive and restrictive treatment setting that provides effective care for a given patient’s needs and strengths.

3 Credits: NAADAC CU’s are approved

Social Worker CE’s, Allied MH CE’s and Psychologists CE’s pending