Admission criteria

Before a clinically managed medium-intensity residential care program may admit a client, the client must: 1. Meet diagnostic criteria for a substance-related disorder of the DSM; and 2. Meet admission criteria for clinically managed medium-intensity residential services also known as ASAM level III.5 in each of the six ASAM dimensions. Specifically, the client: a. Is at risk of or is experiencing subacute intoxication or withdrawal with mild to moderate symptoms and needs containment and increased treatment intensity without frequent access to medical or nursing services to support engagement in treatment, ability to tolerate withdrawal, and prevention of immediate continued use; b. Does not have a physical condition or complication impacting immediate safety and well-being, requiring twenty-four- hour medical or nursing interventions but biomedical conditions distract from recovery efforts and require residential supervision or continued substance use would place a the client at risk for serious damage to physical health because of a co-occurring biomedical condition and the resident is capable of self-administering any prescribed medications; c. Does not have an emotional, behavioral, or cognitive condition or complication impacting immediate safety or well-being requiring twenty-four-hour medical or nursing interventions unless in a dual diagnosis program but does have problems in the areas of dangerousness or lethality; interference with addiction recovery efforts; social functioning; ability for self-care; or course of illness; d. Has a low readiness to change as evidenced by a lack of awareness of the need for treatment characterized by active or passive resistance to treatment; marked difficulty understanding the relationship between the substance use and life problems; the client requires a structured therapy and a twenty-four-hour programmatic milieu to promote treatment progress and recovery; or the client requires repeated, structured motivational interventions delivered in a twenty-four-hour milieu; e. Has a readiness to change but issues in other dimensions impair the ability to translate this into treatment progress and recovery; f. Has a high relapse, continued use, or continued problem potential as evidenced by the lack of recognition of relapse triggers or the lack of commitment to continuing care; the inability to control use of alcohol or other drugs or antisocial behavior with the attendant probability of harm to self or others; symptoms such as drug craving; difficulty postponing immediate gratification and other drug-seeking behaviors; or imminent danger of relapse with dangerous emotional, behavioral, or cognitive consequences because of a crisis situation; or g. Has a chaotic home environment that makes recovery goals assessed as unachievable at a less-intensive level of care as evidenced by a moderately high risk of physical, sexual, or emotional abuse; substance use so endemic that the client is assessed as unable to achieve or maintain recovery; a social network of regular users of alcohol or other drugs; living with a family or other household member who is a regular user, abuser, or dealer of alcohol or other drugs; neglect or lack of supervision; the inability to cope, even for limited periods of time, outside of twenty-four-hour care; a living environment characterized by criminal behavior, victimization, and other antisocial norms and values; or the need for staff monitoring before safe transfer to a less-intensive setting.