David Gastfriend, MD¹, J. Aaron Johnson, PhD², and Hannah K. Knudsen, PhD². (1) Addiction Research Program, Massachusetts General Hospital Dept. of Psychiatry, 388 Commonwealth Avenue, Boston, MA 02215, 617-585-7483, dgastfriend@partners.org, (2) Center for Research on Behavioral Health and Human Services Delivery, University of Georgia, 101 Barrow Hall, D. W. Brooks Drive, Athens, GA 30602

In the last decade, addiction treatment providers have come under increasing pressure from managed care organizations and other third party payers to demonstrate the use of “evidence-based medicine” in addiction treatment. The use of standardized placement criteria, such as those developed and endorsed by the American Society of Addiction Medicine (ASAM), is an example of a treatment practice that is responsive to the demands of managed care. These criteria assist providers in matching patients to the appropriate level of care, as well as identifying needs for additional wraparound services. Although the ASAM Patient Placement Criteria (PPC) are available to treatment providers, some have questioned the use of these criteria, given the complexities of the patient evaluation process. To date, it is unknown to what extent treatment centers in the US have implemented the ASAM PPC as a means of matching clients to appropriate levels of care. This paper utilizes data from a national sample of 800 public and private treatment programs to assess the use of ASAM PPC and to identify differences in the use of ASAM PPC by program type. The paper also examines indicators of fidelity in use of the criteria, and the organizational correlates of adoption. Results indicate that those programs most likely to use ASAM PPC are not for profit, offer multiple levels of care, and treat dually-diagnosed clients. Implications for treatment providers, patients, and quality of care are discussed. (Supported by the NIDA Clinical Trials Network, and NIDA grants K24-DA00427, R01-DA13110 and R01-DA14482).

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