Protocol for Individualized Substance Use Disorder Treatment

Diagnosing

The Oasis Renewal Center uses the Diagnostic and Statistical Manual of Mental Disorders in assessments to designate a Substance Use Disorder diagnosis.  In general, the DSM diagnostic categories dictate that meeting 2-3 of the criteria indicates a mild substance use disorder; meeting 4-5 indicates moderate disorder, and meeting 6-7 indicates severe disorder (APA, 2013).  Regardless of the length of time a person has been sober, the substance use disorder diagnosis will continue to be listed.  However, a specifier exists in which the assessor is to note when applicable 1) partial sustained remission (no use in the past 6 months) or 2) full sustained remission (no use in the past 12 months).  Either of these specifiers should include if the remission occurred while the person was in a controlled environment (e.g. incarcerated).  If a specifier is present, the treatment recommendations should be tailored to the current needs of the client.

Placement Recommendations

The American Society of Addiction Medicine (ASAM) criteria is used in making placement recommendations.  ASAM recommends placement is in the least restrictive environment.  Individuals are recommended for residential treatment if they carry a severe substance use disorder diagnosis and have been determined to be unable to discontinue using in an outpatient setting.   Otherwise, placement recommendations are for outpatient services with intensity and duration dependent upon the severity noted on the diagnosis.  For example, a person with a severe diagnosis might be recommended to residential treatment rather than outpatient services.  If that occurs, then the process of titrating down the intensity of services would be appropriate following discharge from residential.