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Question 1 of 5
This guide is a starting point, not a diagnosis. Nothing you choose is saved or sent anywhere. A licensed provider will do a full assessment before recommending care.
This guide is a starting point, not a diagnosis. Only a licensed professional can recommend a level of care. In an emergency, call 911. For a crisis, call or text 988.
The six things a good assessment looks at
Treatment professionals across the country use The ASAM Criteria, published by the American Society of Addiction Medicine. It sets out how to match a person to the right care. ASAM says people entering treatment should have an assessment covering six dimensions, and that it should weigh strengths and supports as well as problems. In plain words, those areas are:
- Withdrawal and medication. Is your loved one intoxicated or at risk of dangerous withdrawal? Do they need or take medication for addiction?
- Physical health. Are there conditions that need medical care during treatment, such as heart or liver problems or a pregnancy?
- Mental health and thinking. Are depression, anxiety, trauma or memory problems part of the picture? See dual diagnosis treatment.
- Risks tied to use. How likely is your loved one to keep using or to get hurt without closer support?
- Life around them. Is home safe? Are the people nearby helpful, or are they using too? Is there a job, a ride and a place to stay?
- What matters to them. What do they want? What barriers, such as money, childcare or past bad experiences, could get in the way?
The result is a picture of the whole person, and it doesn’t pick a program for you. ASAM also says people should be reassessed regularly, so the level can change as they do.
How those answers tend to point to a level
| What the assessment finds | Where care often starts |
|---|---|
| Danger signs right now: seizure, confusion, chest pain, trouble breathing, recent overdose | Emergency care. Call 911 |
| Daily alcohol, benzodiazepine or opioid use with withdrawal risk | Detox, then treatment |
| Home isn’t safe, or outpatient care hasn’t lasted | Residential care |
| Frequent use with a stable home | PHP or IOP |
| Less frequent use with a stable home | Outpatient care |
What the guide can’t see
A short guide only knows what you tell it. Some things change the answer in ways it can’t catch:
- Mixed substances. Using more than one substance can make withdrawal less predictable. Our substance guides explain the risks of each.
- Fentanyl. If opioids are involved, read about fentanyl and opioids and ask about medication early.
- Hidden use. Families often don’t know how much someone uses. If you are guessing, say so.
- Willingness. A person who agrees to IOP may do better there than in a residential program they walk out of. Their own choice counts.
Who can do the assessment
Most treatment centers offer an assessment by phone or in person, and a primary care doctor or addiction doctor can do one too. Remember that a center may tend to recommend the care it sells. It is fair to ask, “Why this level, and not one lower?” Our page on questions to ask a rehab has more to use on the call.
Keep your eyes open for patient brokering red flags, such as someone who steers you to one center for a hidden fee. We are funded in the open, and our page on how this guide is funded explains how.
After you have a starting point
Read about that level
Our levels of care page explains each one, with what to ask and what to expect.
Check coverage
Ask the plan whether that level is covered and if approval is needed. See checking insurance benefits.
Call two programs
Ask for an assessment and compare the answers. Listings show each center’s own number.
Questions about choosing a level of care
How do I know what level of care I need?
Start with safety, then look at the substance, how often it is used, home life and past treatment. Our guide above walks through those. A licensed professional then makes the actual recommendation.
What are the ASAM levels of care?
ASAM describes a range of care, from outpatient services to residential and hospital-level care. On this site we use the plain names most families hear: detox, residential, PHP, IOP and outpatient.
What if the center and the insurance plan disagree?
It happens. ASAM says plans should use the same criteria as clinicians. Ask the program to help with an appeal, and ask the plan for its decision in writing.
What if I pick the wrong level?
Levels aren’t locked in. People step up or down as they go. If the first choice isn’t working, tell the team, and ask what they suggest changing.
Can I do the guide for someone else?
Yes. Most people who use it are family members. Answer as honestly as you can, and treat the result as a place to start the conversation.