ASAM Levels of Care for Pyramid Healthcare – Maryland: Q&A With Dominic Barone, VP of Operations

Published On: January 24, 2023|Categories: Drug & Alcohol Treament|
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1. What are the relevant levels of care based on ASAM for our Maryland Facilities? 

  • Harford 3.7WM, 3.7, 3.5 (Male and Female)
  • Charlotte Hall/Anchor  3.7WM, 3.7, 3.5 (Male and Female)
  • California Residential & Outpatient 3.5, 3.3, 3.1 (male only), We also currently offer level 1 (outpatient) and are soon to offer 2.1 and 2.5 to both males and females.

2. Break down the ASAM levels of care

Level 1: outpatient treatment consists of treatment for substance use that is less than nine hours a week. Level 1 is appropriate for people with less severe disorders, or as a step-down from more intensive services.

Level 2.1: is intensive outpatient services consisting of at least nine and no more than 20 hours per week of treatment. These programs typically offer medical care 24 hours a day by phone or within 72 hours in person.

Level 2.5: is partial hospitalization, which is at least 20 hours a week but is less than 24-hour care. This level of care provides structure, and daily oversight for people who need daily monitoring, but not 24/7 care.

Level 3.1: is clinically managed low-intensity residential treatment. Residential services at this level consist of a setting, such as a group home, where people live. However, treatment is only required to be five hours per week, which helps people with such topics as relapse management.

Level 3.3: is clinically managed high-intensity and population-specific services. These programs are targeted at providing treatment designed to move at a slower pace, for people with cognitive functioning issues. This includes people with traumatic brain injuries, the elderly, or people with developmental disabilities.

Level 3.5: is clinically managed residential services. These services are designed for people with serious psychological or social issues who need 24-hour oversight and are at risk of imminent harm.

Level 3.7: is medically managed high-intensity inpatient treatment These services are for people who need intensive medical or psychological monitoring in a 24-hour setting but do not need daily physician interaction.

Level 3.7WM: is also medically managed high-intensity inpatient treatment. These services are for people who need withdrawal management or detoxification from various substances in a 24-hour setting.

3. Do these levels of care give Pyramid Healthcare Maryland a competitive edge? 

Yes. The ability to step clients throughout the continuum as needed. Having 24-hour admissions and transportation available affords clients the opportunity to access treatment the moment they’ve decided they want help. We all know the disease of addiction does not only impact us Monday through Friday 9a-5p, having dedicated staff working around the clock every day of the year ensures that our clients get the care and attention they need when they need it.

4. How do I know what ASAM level of care is best/necessary for my loved one?

Anyone can research online and/or find information from local resources such as their primary care physician, or local health department. Our admissions staff is also available to answer questions, or screen clients 24 hours a day, 7 days a week, 365 days a year, and review what options are available to them. If Pyramid Healthcare does not offer the services that are best for the client, we will assist with referrals and getting them connected to a comparable provider who does offer those services.

5. Why is ASAM important for my or a loved one’s treatment? 

ASAM stands for the American Society for Addiction Medicine, which was a society founded in 1954 to help addiction professionals, including physicians and other providers, come together. The ASAM was made for those who wanted to improve the quality of addiction treatment and educate the medical community and the public about addiction. ASAM developed a set of criteria that treatment providers can use in the assessment of a person to help determine the most appropriate level of care.

These guidelines are the result of work that began in the 1980s and are now the most comprehensive and widely-used criteria to determine placement in treatment, as well as patients’ transfer and discharge from treatment programs. The ASAM criteria include a detailed assessment of the person seeking treatment, which entails a thorough exploration of their biological, emotional and social needs.

The ASAM criteria use a multidimensional approach to assess a person’s needs, strengths, resources, social support and various assets. The ASAM criteria help determine the best level of care for the person’s substance use disorder at the time of assessment, accounting for their need for medical oversight and safety. The ASAM criteria can be used at entry into treatment and during transitions to different levels of care on the continuum.

6. What questions should you ask regarding ASAM levels of care?

That really depends on the person seeking treatment and what they want their treatment to look like. There is no “one size fits all” approach to behavioral health. In some instances medication-assisted treatment (MAT) may be the best option, there are various pharmacological therapies that Pyramid Healthcare and other providers offer that may be beneficial to treatment and recovery. Not all providers offer MAT or psychiatric services, treatment should be tailored around the individual, and the individual should not have to tailor their treatment around a provider.

7. Do clients typically progress through different ASAM levels of care in a linear fashion?

Yes, typically clients start in the higher levels of care and work their way down into less intensive levels as they progress through their treatment and recovery. Clients can move back into higher levels of care when/if needed, for instance, if a relapse occurred, or an incident that required more intensive care than the level they are in. Again, treatment should be individualized to meet the need(s) of the individual, there are certain parameters in which we facilitate programming but ultimately treatment decisions are that of the individual, we are simply a conduit to guide them and provide options.


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