An Argument for Change in Tobacco Treatment Options Guided by the ASAM Criteria for Patient Placement
Open Access
- 1 September 2016
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Addiction Medicine
- Vol. 10 (5), 291-299
- https://doi.org/10.1097/adm.0000000000000239
Abstract
Tobacco use is a major threat to public health in the United States, and the number one cause of preventable death. Although most smokers try to quit unaided, robust data indicate that pairing behavioral support to US Food Drug Administration-approved cessation medications significantly increase cessation rates. Those who do receive assistance in quitting usually receive very low intensity treatment, regardless of the severity of their dependence or their medical and environmental circumstances. This is in stark contrast to how other substance use disorders are treated, where there are varying levels of care depending on addiction severity and biopsychosocial circumstances. The American Society of Addiction Medicine (ASAM) developed a formal algorithm for assessing substance use disorders and determining the optimal level of care. The ASAM Patient Placement Criteria are regularly used to determine the appropriate level of care for all substance use disorders except tobacco. This paper will review key aspects of the ASAM dimensions of care and placement levels, with emphasis on how they apply to tobacco use and present case examples of typical smokers who would benefit from a higher intensity of tobacco dependence treatment. We also present current barriers to reimbursing healthcare providers for these services. We conclude with a commentary and discussion regarding recommendations for improvements in tobacco dependence treatment care.Keywords
This publication has 47 references indexed in Scilit:
- State Quitlines and Cessation Patterns Among Adults With Selected Chronic Diseases in 15 States, 2005–2008Preventing Chronic Disease, 2012
- Interventions to increase smoking cessation at the population level: how much progress has been made in the last two decades?Tobacco Control, 2012
- Socioeconomic status and smoking: a reviewAnnals of the New York Academy of Sciences, 2011
- Residential Treatment Compared With Outpatient Treatment for Tobacco Use and DependenceMayo Clinic Proceedings, 2011
- National survey of U.S. health professionals' smoking prevalence, cessation practices, and beliefsNicotine & Tobacco Research, 2010
- Smoking cessation quitlines: An underrecognized intervention success story.American Psychologist, 2010
- Smoking and mental illness: results from population surveys in Australia and the United StatesBMC Public Health, 2009
- Behavioural interventions for smoking cessation: a meta-analysis of randomized controlled trialsEuropean Heart Journal, 2008
- Why implementation processes vary across the 5A's of the Smoking Cessation Guideline: Administrators' perspectivesNicotine & Tobacco Research, 2008
- Tobacco use among those with serious psychological distress: Results from the national survey of drug use and health, 2002Addictive Behaviors, 2008