In October 2023, the American Society of Addiction Medicine (ASAM) released the ASAM Criteria 4th Edition, a significant update designed to improve the quality of care in addiction treatment. These new standards reflect the evolving needs of patients and provide behavioral health clinicians with tools for more equitable, person-centered care.
Importantly, as of July 1, 2025, Illinois has required providers to adopt the ASAM 4th Edition for substance use disorder treatment. Clinicians and treatment organizations in Illinois, and nationwide, should familiarize themselves with the new framework and integrate it into daily practice.
The ASAM Criteria Assessment is the most widely used guideline for evaluating and treating individuals with substance use disorders and co-occurring mental health conditions. It helps clinicians determine the right treatment approach by looking at the whole person—not just the addiction.
Traditionally, the assessment focused on six core dimensions:
The ASAM 4th Edition dimensions were expanded to include “person-centered considerations.” This new dimension encourages providers to consider social determinants of health (SDOH), barriers to care, and cultural context when building treatment plans.
The Fourth Edition of the ASAM Criteria is being released in four volumes. The first volume, now in use, provides the updated foundation for assessment and treatment planning. Upcoming volumes will address the unique needs of adolescents and transition-age youth, justice-involved patients, and the treatment of behavioral addictions such as gambling, internet, and gaming.
The ASAM 4th Edition uses a rigorous methodology for evidence review and formal consensus building to ensure accuracy and clinical relevance. This approach ensures the criteria remain the gold standard for addiction medicine.
The addition of “Person-Centered Considerations,” the sixth dimension to the fourth edition of the ASAM Criteria, considers a client’s social determinants of health and other barriers to healthcare.
The fourth edition emphasizes equity by assessing factors such as:
This shift highlights populations often overlooked in treatment planning, including incarcerated individuals, adolescents, and people with cognitive impairments.
The ASAM 4th Edition includes addiction and co-occurring disorders. This change helps clinicians better understand a client's health and gives a clearer picture of their overall well-being. The second part of the ASAM Criteria standards determines whether the client requires medical care. Clinicians can adjust the treatment plan to include physical health services if necessary.
Examples of co-occurring conditions could include:
The goal is to determine if the client needs additional physical health services. Clinicians can consider the client's current medical treatment to create a custom treatment plan.
Being physically sick can negatively affect clients' ability to heal mentally. This dimension should involve clinicians communicating effectively between providers, labs, HIEs, and other health organizations to provide optimal care.
The ASAM criteria recognizes that access remains a challenge and encourages telehealth, mobile services, and digital care options. This is especially important for rural patients or those without reliable transportation.
The ASAM criteria, 4th edition, intentionally uses more inclusive language, supporting treatment that respects each patient’s cultural background and lived experience.
One of the most important aspects of the criteria is how they define and standardize the ASAM 4th Edition levels of care. These levels help clinicians match individuals with the appropriate intensity of services, ranging from:
By refining these levels, the fourth edition promotes smoother transitions between programs, minimizing gaps in care and improving patient outcomes.
With the ASAM 4th Edition now required in Illinois, behavioral health clinicians across the country must be prepared to implement these changes in practice. This means becoming familiar with the updated ASAM 4th Edition dimensions and applying them during assessments, while also aligning treatment plans with the newly defined levels of care.
Clinicians are encouraged to incorporate telehealth and person-centered approaches into recovery programs to improve accessibility and engagement. In addition, leveraging technology (such as an integrated EHR system) will be essential for documenting assessments and ensuring seamless communication across care teams.
The ASAM criteria 4th edition marks a significant step forward in addiction treatment, providing clinicians with a framework that is more holistic, inclusive, and adaptable to patient needs. By embracing these updates, providers can improve patient engagement, strengthen care coordination, and deliver more equitable treatment.
With an EHR, Practice Management, and Billing system integrated with the updated ASAM Criteria, clinicians can improve the quality of care with a seamless recovery journey (with features like patient referral orders and interoperability with outside providers). Patagonia Health's behavioral health solutions include the ASAM Criteria, 4th edition. Together, let's continue to pave the way for improved client outcomes and the overall quality of addiction treatment.