Sensitivity of the ASAM Criteria to Psychiatric Need
The ASAM Criteria (ASAM) is one of the most widely used placement tools in the addiction field. Its use, however, has focused on placement of individuals into addiction-only or co-occurring addiction and mental health services, not individuals who need primary mental health treatment. This study examined whether the ASAM, particularly dimension 3 (D3), was sensitive to mental health needs of a group of individuals placed into addiction services using the ASAM then followed for 1 year to determine whether they received mental health services. Individuals who received mental health services had D3 scores that were twice as high as those who did not, and individuals with a “Psychotic Disorder” had higher scores than all other diagnostic clusters. At a cutoff of 1, D3 had a sensitivity of .89 and specificity of .44 (C = .73). These results argue for an expanded application of the ASAM across the behavioral health continuum.
KeywordsASAM Co-occurring Placement Addiction Mental health
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev. ed.). Washington, DC: American Psychiatric Association.Google Scholar
- Angarita, G., Reif, S., Pirard, S., Lee, S., Sharon, E., & Gastfriend, D. R. (2007). No-show for treatment in substance abuse patients with comorbid symptomatology: validity results from a controlled trial of the ASAM patient placement criteria. Journal of Addiction Medicine, 1, 79–87. https://doi.org/10.1097/ADM.0b013e3180634c1d.CrossRefPubMedGoogle Scholar
- Caton, C. L. M., Hasin, D. S., Shrout, P. E., Drake, R. E., Dominguez, B., First, M. B., et al. (2007). Stability of early-phase primary psychotic disorders with concurrent substance use and substance-induced psychosis. British Journal of Psychiatry, 190, 105–111. https://doi.org/10.1192/bjp.bp.105.015784.CrossRefPubMedGoogle Scholar
- Center for Behavioral Health Statistics and Quality (2015). Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/data/.
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). New Jersey: Lawrence Erlbaum Associates.Google Scholar
- Dawe, S., Geppert, L., Occhipinti, S., & Kingswell, W. (2011). A comparison of the symptoms and short-term clinical course in inpatients with substance-induced psychosis and primary psychosis. Journal of Substance Abuse Treatment, 40, 95–101. https://doi.org/10.1016/j.jsat.2010.08.002.CrossRefPubMedGoogle Scholar
- Lindamer, L. A., Liu, L., Sommerfeld, D. H., Folsom, D. P., Hawthorn, W., Garcia, P., et al. (2012). Predisposing, enabling, and need factors associated with high service use in a public mental health system. Administration and Policy in Mental Health and Mental Health Services Research, 39(3), 200–2009. https://doi.org/10.1007/s10488-011-0350-3.CrossRefPubMedGoogle Scholar
- Magura, S., Staines, G., Kosanke, N., Rosenblum, A., Foote, J., DeLuca, A., et al. (2003). Predictive validity of the ASAM patient placement criteria for naturalistically matched vs. mismatched patients. The American Journal on Addictions, 12, 386–397. https://doi.org/10.1111/j.1521-0391.2003.tb00482.x.CrossRefPubMedGoogle Scholar
- McGovern, M. P., Xie, H., Acquilano, S., Segal, S. R., Siembab, L., & Drake, R. E. (2007). Addiction treatment services and co-occurring disorders: the ASAM-PPC-2R taxonomy of program dual diagnosis capability. Journal of Addictive Diseases, 26(3), 27–37. https://doi.org/10.1300/J069v26n03_04.CrossRefPubMedGoogle Scholar
- Mee-Lee, D., Shulman, G. D., Fishman, M. J., Gastfriend, D. R., & Miller, M. M. (2013). The ASAM Criteria: treatment criteria for addictive, substance-related, and co-occurring conditions (3rd ed.). Chevy Chase: American Society of Addiction Medicine.Google Scholar
- National Association of State Alcohol and Drug Abuse Directors (2006). Current state AOD Agency practices regarding the use of Patient Placement Criteria (PPC)—an update. Retrieved from http://www.asam.org/docs/publications/survey_of_state_use_of_ppc_nasadad-2006.pdf?Status=Master&sfvrsn=2.
- Reichenberg, A., Harvey, P. D., Bowie, C. R., Mojtabai, R., Rabinowiz, J., Heaton, R. K., et al. (2009). Neuropsychological function and dysfunction in schizophrenia and psychotic affective disorders. Schizophrenia Bulletin, 35(5), 1022–1029. https://doi.org/10.1093/schbul/sbn044.CrossRefPubMedGoogle Scholar
- Stallvik, M, & Clausen, T. (2017). HRQoL and its association with clinical severity and service needs among individuals with a substance use disorder. Journal of Substance Use, 1–7. https://doi.org/10.1080/14659891.2016.1259366.
- Substance Abuse and Mental Health Services Administration (2005). Substance abuse treatment for persons with co-occurring disorders: Treatment Improvement Protocol (TIP) Series, No. 42. Retrieved from http://store.samhsa.gov/shin/content/SMA13-3992/SMA13-3992.pdf.
- Substance Abuse and Mental Health Services Administration (2015). Behavioral Health Barometer: United States, 2015. HHS Publication No. SMA–16–Baro–2015. Retrieved from http://www.samhsa.gov/data/sites/default/files/2015_National_Barometer.pdf.
- Turner, W. M., Turner, K. H., Reif, S., Gutowski, W. E., & Gastfriend, D. R. (1999). Feasibility of multidimensional substance abuse treatment matching: automating the ASAM patient placement criteria. Drug and Alcohol Dependence, 55, 35–43. https://doi.org/10.1016/S0376-8716(98)00178-1.CrossRefPubMedGoogle Scholar