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 (e.g., requiring them 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), intervention and
treatment services (e.g., requiring them 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), and quality assurance (e.g.,
requiring them to collect and report
comprehensive quality assessment data,
including process and outcome
measurements).
Standardize language used to describe the
full spectrum of substance use and
addiction. Recognize addiction as a
primary 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.
Use the Leverage of Public Policy to Speed Reform in Health Care Practice ............
Condition grants and contracts for
addiction services on the provision of
quality care. Federal, state and local
governments should require--as a condition
of receipt of public funds--that grants,
contracts and non-insurance reimbursement
for addiction treatment services utilize
evidence-based prevention and treatment
approaches, including pharmaceutical
therapies (provided or managed by a
physician demonstrating the core
competencies of addiction medicine or
addiction psychiatry) and psychosocial
therapies (provided by medical professionals
or graduate-level clinical mental health
professionals trained and licensed in the core
competencies of addiction treatment), as
indicated; involve other health professionals,
individuals providing auxiliary services and
those providing peer support, working in a
multidisciplinary team; and generate
positive and measurable long-term patient
outcomes. Educate non-health professionals about
risky substance use and addiction.
Require that the topic of risky substance use
and addiction be included in the education
and training of government-funded
professionals who do not provide direct
addiction-related services but who come into
contact with significant numbers of
individuals who engage in risky substance
use or who may have addiction. These
include, but are not limited to law
enforcement and other criminal justice
personnel, legal staff, child welfare and
other social service workers and educators. Identify patients at risk in government
programs and services where costs of
risky use and addiction are high. Federal,
state and local governments should require
that routine screening and brief interventions
be provided by trained professionals in all
educational, mental health, developmental
disabilities, child welfare, housing, juvenile