Over the past few decades, the American Society of Addiction Medicine (ASAM) has been trying to help define addiction and addiction treatment with the help of the national institutes and agencies (NIAAA, NIDA, CSAT and SAMHSA). Addiction is defined as a brain disease with attendant psycho-social behaviors, that is chronic and deadly if left undiagnosed and untreated. As a result of evidence-based data collection and studies, and the research and development of treatment modalities, ASAM has emerged as the expert in addiction recognition and addiction treatment. This expertise and recommendations have been captured in the ASAM Criteria and the Principles of Addiction Medicine. The information is available for all to see. The relevance comes when the information is recognized and then implemented, as it has been at the Behavioral Health of Palm Beaches (BHOPB).
A Commitment to Quality, Evidence-based Care
BHOPB is a 250-bed facility in North Palm Beach Florida and has treated thousands of patients over the last twenty years. We have always prided ourselves on delivering state-of-the-art addiction treatment to our patients. In its search to provide the best care, BHOPB found the American Society of Addiction Medicine and began to investigate its policies, procedures and treatment recommendations. It became clear very quickly that ASAM\’s recommendations coincided with and were supported by governmental guidelines and recommendations derived from years of research. The BHOPB leadership made a bold decision to incorporate ASAM Criteria and the treatment in Principles of Addiction Medicine.
BHOPB strictly adheres to the ASAM Criteria in making admission and level-of-care decisions. BHOPB strictly adheres to the ASAM Criteria in making admission and level-of-care decisions. It has been invaluable in negotiating with third-party insurers as well as helping to clinically determine patient movement from one level of care to another. The ASAM Criteria have been very helpful as a measure to not only to determine the appropriate level of care for admission into addiction treatment, but also when to transfer patients to lesser levels of care. All of the admission staff and clinical staff have been educated about the ASAM Criteria.
The Implementation and Efficacy of Medication-assisted Treatment
Medication-assisted Therapy (MAT) has arrived in addiction treatment and has proven to be a very helpful adjunct to counseling and rehabilitation. BHOPB recognizes the efficacy of MAT and supports its use in the appropriate settings, at the appropriate times, for patients that require MAT to obtain and sustain their recovery. MAT and utilization of national consensus detoxification guidelines have certainly improved previously very difficult detoxification cases and the medical management of other co-occurring medical problems. It appears that MAT, coupled with CBT, DBT and other counseling modalities, has improved patient outcomes that are followed and reported by our alumni associations. Use of consensus expert detoxification protocols have also tremendously increased the retention of patients in treatment beyond detoxification only.
Continued Education and Research
BHOPB recognized that proper, state-of-the-art education and ongoing clinical training was essential to having great patient treatment outcomes. Therefore, the administration encouraged and supported all of their physicians to minimally become members of ASAM to enhance their continuing medical education addiction and addiction treatment. To date, BHOPB has six doctors who are members of ASAM. BHOPB now has five physicians that are certified in Addiction Medicine (ADM) by the American Board of Addiction Medicine (ABAM). Additionally, BHOPB has encouraged its entire eligible staff to become Associate Members of ASAM since the new membership category began. BHOPB has nine of ASAM Associate Members.
ï»¿A New and Innovative Treatment Approach
When patients are discharged from rehabilitation, great efforts are made to refer them to ADM-certified physicians for chronic care medical follow-up.
The recognition that addiction is a chronic medical illness has caused BHOPB to make several changes in its program and management of cases. BHOPB has stopped the traditional practice of “coining out” patients when they complete detoxification and primary rehabilitation. Instead, early on in treatment, the patients are educated that they suffer from medical illnesses which will require chronic lifelong attention and care. When patients are discharged from rehabilitation, great efforts are made to refer them to ADM-certified physicians for chronic care medical follow-up. As is the standard of care for other chronic medical illnesses, like diabetes, patients with addictions need to be followed for the long-term.
The dedication of ASAM has been long and sustained over the years in terms of accurately defining and now directing specific treatment for addiction and addiction treatment. ASAM has amassed and developed invaluable tools, information, and consensus guidelines to provide expert recommendations to the addiction treatment field and industry. BHOPB has grasped this opportunity to employ ASAM Criteria and Treatment Principles to ensure the best possible treatment outcomes for its patients.