9
Treatment
III. Level of Care Determination
A. General Approach
Î Recommendation III.1: Level of care determination should be based
on a patient's current signs and symptoms, level of risk for developing
severe or complicated withdrawal or complications of withdrawal, and
other dimensions such as recovery capital and environment. Alcohol
withdrawal can typically be safely managed in an ambulatory setting
for those patients with limited or mitigated risk factors. Patients with
low levels of psychosocial support or an unsafe environment may
benefit from a more intensive level of care than is otherwise indicated.
Î Recommendation III.2: Patients with active risk of suicide should be
treated in a setting equipped to manage patients at risk of suicide,
which often necessitates admission to an inpatient psychiatric setting
that also provides withdrawal management services.
B. Level of Care Determination Tools
Î Recommendation III.3: The ASAM Criteria Risk Assessment Matrix
and withdrawal severity scales can be helpful for determining the
appropriate level of care for managing patients in alcohol withdrawal.
Most withdrawal severity scales reflect current signs and symptoms
and should not be used alone to determine level of care.
