ASAM Consensus Standards for Substance Use Disorder Care Capabilities in Hospitals and Emergency Departments

Area of Science:

• Addiction Medicine
• Hospital Administration
• Public Health

Background:

• Substance use disorder (SUD) presents significant morbidity, mortality, and financial burdens within hospital and emergency department (ED) settings.
• Despite effective treatments, SUD often remains unaddressed during acute care encounters, leading to substantial healthcare costs, estimated at $13 billion in 2017 for hospital and ED care alone.

Purpose of the Study:

• To update and establish consensus standards for general hospital settings to facilitate effective care for patients with SUD.
• To define the essential capabilities hospitals should possess to address SUD comprehensively.

Main Methods:

• The American Society for Addiction Medicine (ASAM) convened an expert Task Force in 2024 to update The ASAM Criteria for hospital-based SUD care.
• The process involved evidence review, synthesis, formal consensus development, field review, and approval by ASAM's Quality Improvement Council.

Main Results:

• Seven core competencies for hospital and ED-based SUD care were defined: patient identification/engagement, intoxication/withdrawal management, overdose care, addiction medication management, co-occurring condition assessment, linkage to ongoing care, and risk reduction.
• These competencies were used to establish consensus standards across service characteristic domains including setting, staff, support systems, assessment, treatment planning, services, and documentation.

Conclusions:

• Growing evidence supports the importance and feasibility of integrating SUD care within hospital systems.
• These newly developed consensus standards provide a unified framework for healthcare facilities to meet the needs of patients with SUD effectively.