The ASAM Criteria 4th edition was published in December 2023, and California’s Department of Health Care Services (DHCS) will be transitioning California’s Drug Medi-Cal system of care into alignment with ASAM Criteria 4th edition standards. The current system of care is aligned with the ASAM Criteria 3rd Edition (published in 2013).

In preparation for this transition, SAPC provider agencies should take steps now to prepare their staff by reviewing the ASAM Criteria 4th edition implementation tools that include training resources, a downloadable training slide deck, and additional reference materials. SAPC will be updating our treatment network guidance to align with the ASAM Criteria 4th Edition, and related trainings are posted on our SAPC Trainings and Events page.

ASAM Criteria 4th Edition Implementation Site

• ASAM Criteria, Fourth Edition Training Slides (a set of 300+ slides)
• Quick Reference Guides
  • A Patient's Journey Through the Continuum of Care
  • Common Standardized Measures
  • Continuum of Care
  • Core Service Characteristics
  • Dimensions and Subdimensions
  • Fourth Edition Methodology
  • Level of Care Flow Chart
  • Risk Rating Tracker
  • Risk Ratings
  • Where to Treat Matrix
• Speaking the Same Language Toolkit

Overview of the Updates to the ASAM Criteria 4th Edition

• Updated Assessment Standards
  • Level of Care Determined through Dimensional Drivers
• Updated ASAM Criteria Levels of Care
  • Universal Access to Addiction Medications (aka Medications for Addiction Treatment)
  • All levels of care should be co-occurring capable
  • Withdrawal management integrated as a service component into the continuum of care; withdrawal management levels of care eliminated
  • A 3.3 level of care (LOC) from the ASAM Criteria 3rd Edition eliminated; a slower pace of treatment is a patient-centered consideration in ever level of care
  • Outpatient LOC is now labeled 1.5
  • New 1.0 level of care: Long-Term Remission Monitoring
  • New Recovery Residence level of care
• Forthcoming ASAM Criteria Tools and Resources from ASAM
  • New Paper-Based Assessment (anticipated early 2025)
  • Updated Computer-Based Assessment (anticipated early 2025)
  • Adolescent and Transition Age Youth (anticipated early 2026)
  • Correctional Settings and Reentry (anticipated 2027)
  • Behavioral Addictions (i.e., gambling, internet and gaming addiction, sex addiction) (anticipated 2028)

ASAM Criteria 4th Edition Assessment Dimensions and Subdimensions for Adults