Addiction Medicine: Closing the Gap between Science and Practice

(lu) #1

a treatment plan, including appropriate support
services.


Require all non-physician health professionals
providing psychosocial addiction treatment
services to have graduate-level clinical training
in delivering these services.


Require that all pharmaceutical treatments for
addiction be provided only by a physician or in
accordance with a treatment plan managed by a
physician.


Develop Improved Screening and


Assessment Instruments


Screening instruments should be adjusted or
developed to coincide with appropriate
definitions of risky substance use, and
assessment instruments should be adjusted or
developed to mirror diagnostic criteria for
addiction. Both screening and assessment
instruments should address all types of addictive
substances.


Establish National Accreditation Standards


for All Addiction Treatment Facilities and


Programs that Reflect Evidence-Based


Care


As a condition of accreditation, accrediting
organizations should stipulate requirements for
all facilities and programs providing addiction
treatment with regard to professional staffing,
intervention and treatment services and quality
assurance:


 Professional Staffing. All facilities and
programs providing addiction treatment
should be required to have a full-time
certified addiction physician specialist on
staff to serve as medical director, oversee
patient care and be responsible for all
treatment services. All individual providers
of patient care in these facilities and
programs should be required to be licensed
in their field of practice and demonstrate
mastery of the core clinical competencies.
Professionals who are in the process of


becoming licensed must be supervised at all
times by a licensed professional.

 Intervention and Treatment Services. All
facilities and programs providing addiction
treatment should be required to provide
comprehensive assessment and evidence-
based treatment for addiction involving all
substances that is tailored to the stage and
severity of the disease, co-occurring
conditions and patient characteristics.*

 Quality Assurance. All facilities and
programs providing addiction treatment
should be required to collect and report
comprehensive quality assessment data,
including process and outcome
measurements related to screening,
intervention, treatment and disease
management, in accordance with established
guidelines developed in collaboration with
the American Board of Addiction Medicine.

Standardize Language Used to Describe


the Full Spectrum of Substance Use and


Addiction


Recognize addiction as a medical disease and
standardize the language related to the spectrum
of substance use severity in current and
forthcoming diagnostic instruments. Develop a
classification system based both on observable
behavior and neurobiological measures that
underlie different manifestations of addiction
and related conditions which currently are
classified and addressed as distinct conditions.

* Currently, the provision of such services frequently
is optional. For example, the Joint Commission
currently has voluntary performance measures for
hospitals that choose to provide these addiction-
related services. However, hospitals are required to
choose four out of 14 possible core performance
measurements sets and may completely avoid those
related to addiction care (see Chapter X).
Free download pdf