Intoxication,

Withdrawal, Biomedical/ Psychiatric and Recovery Person

Substance
and Medication Physical Health Cognitive Environment Centered
Use Risks
Needs Issues Conditions Interactions Considerations

Stable and Fair and

No or low risk due No acute risks. predictable No active use. appropriate Safe, supportive
Level 1 to lack of Stable physical mental health Committed to coping skills. home
substance use. health status. Mild change. Focused on environment.
symptoms. recovery.

Mental health Unsure or

Possibly Medical problems Some coping skills Job or home life
impacts recovery. reluctant to
intoxicated. No present but stable. use, but may get in the
No danger to self
Level 2 danger to self. Support from
or others.
change. Lower inconsistent. Can way of attending
Moderate risk of home, work, or commitment to manage with treatment
Functions change.
withdrawal. school. reminders consistently.
independently.

Severe Unable to care for

Health is poorly Does not care to Poor use of coping High stress with
intoxication with self. Impulsive,
controlled. Limited change use. skills. Struggles to housing,
Level 3 risk of danger.
coping skills and
risky behaviors.
Passively engaged see risks linked to transportation, or
Severe risk of Need 24-hour
poor self-care. in treatment. substance use. child care.
withdrawal. care and support.

Active, life- Lack of

Severe and Actively rejects No ability to use
Unable to function. threatening transportation
unstable medical treatment and coping skills.
Severe symptoms. symptoms. and other
Level 4 High danger and conditions.
Violent,
need to change. Active substance
resources may
Vomiting, pains, Combative and use. Regularly puts
risk to safety. aggressive, risk to outpatient
risky pregnancy. possibly self and others at
self or others. treatment
dangerous. risk.
Break from reality. impossible

Using the ASAM Level of Care Cheat Sheet:

The clinician will gather information of the client’s health and well-being focusing on the 6 dimension format of the ASAM Criteria. Clinicians can use a less
structured interview or a structured assessment interview. Cross reference levels of care described in the ASAM Level of Care Cheat Sheet. Consider
recommending care based on the highest level met in any dimension as a way to maintain safety and create stability. Frequently reassess to track progress
and move to the most appropriate care level. Article: https://www.icanotes.com/2024/03/20/mastering-asam-levels-of-care-strategies-for-effective-
treatment-planning/
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