Cognitive Conditions and Complications

Assessment Dimensions Related to Level of Care Assessment often occurs in relationship to a client’s treatment stage and level of care placement. The ASAM criteria are the most widely used and thorough set of guidelines for assessment, service planning, placement, continued stay, and discharge planning of patients with addictive disorders (Mee-Lee, 2013). Mee-Lee (2013) developed and detailed six dimensions to assess and create a holistic and bio-psycho-social assessment for assessing substance abuse clients. Each of the six dimensions is outlined in the following with corresponding questions to include in the assessment. Dimension 1: Acute Intoxication and Withdrawal Potential (For example, detox and withdrawal management.) What are the current amounts and types of alcohol and/ or drugs currently being taken? If any alcohol or any benzodiazepine (sedative) is reported, a thorough question about amounts and types is especially needed to assess for a medical detox referral. Many clients will need education surrounding the lethality potential from alcohol and sedative withdrawal when attempting to quit or cut down. Reminding the client that the info is needed to check for lethality and not judgment can help gain more accurate numbers. Many people with addiction are riddled with shame and fear of judgment, often prompting the underreporting of substance abuse issues. People of any age can die from withdrawal from alcohol/sedatives if not monitored or stabilized by a medical provider. Dimension 2: Biomedical Conditions and Complications (Physical health conditions and their impact on addiction.) What are any other medical and/or physical problems? High blood pressure? Broken leg? Asthma? Diabetes? Is the client taking any medications for any other ailments? If so, are these ailments recurring or temporary? If recurring, are they well controlled? Or in need of care? There may be a need for referrals to treat physical issues that are not stable or not being adequately treated at this time. Dimension 3: Emotional, Behavioral, and Cognitive Conditions and Complications (Co-occurring mental health disorders, cognitive/brain disorders or impairments.) Does the client have any current mental health diagnoses? If any, how long has the client had the diagnosis? How long does the client believe he or she has struggled? How long has client been on medication? If so, is the client compliant with medication? Was this mental health diagnosis made while the client was still drinking and/or using drugs regularly (or any mind-altering substance)? Many mental health disorders are mimicked when under the chemical influence of alcohol and drugs.