Addiction Professional interviewed ASAM Criteria Chief Editor David Mee-Lee, MD, in July on key topics surrounding the new edition of the criteria. Mee-Lee of The Change Companies will deliver a plenary address on The ASAM Criteria, the DSM-5 and healthcare reform at the National Conference on Addiction Disorders in Anaheim, Calif., on Sept. 23 at 8:15 a.m.
Q: What has been your impression of how the criteria have guided addiction treatment services up to now?
A: A lot of organizations say they use the ASAM Criteria, but the word “use” means a lot of different things. There are some people who approach this as something they have to do. The goal is to really guide a more holistic, person-centered treatment approach across the continuum of care. Part of me can be very grateful for what I see has changed. I’ll hear from someone in a state that has gone with the spirit of the criteria, and they’ll say, “We now don’t have people just saying that everything should be residential treatment.” On the other side, when I hear people still using the term “graduating,” I think we haven’t had any impact.
Q: Does the new edition reflect significant changes from the existing criteria?
A: The actual criteria are not significantly changing. But there are some slight modifications in certain areas, such as the criteria for withdrawal management services. Clinicians “manage withdrawal,” and thus we have made the name change from “detox.”
Q: The new edition will include special sections for four distinct populations (older adults; professionals in safety-sensitive occupations; pregnant and parenting women; and persons in the criminal justice system). Why were these specific populations selected?
A: Over the years, people from the field have given us feedback. Some said, for example, that the present criteria don’t apply to older adults; because of cognitive issues in the population, the levels of care don’t fit. In safety-sensitive professions, there are models for longer-term residential treatment with closer monitoring, so there are special considerations in that group that don’t apply to others.