Substance Use Disorder Criteria
Intake & Admission Protocol
Methadone
& Buprenorphine
Outpatient &
IOP
Harm Reduction
100

These two criteria relate to physical dependence.

What are tolerance and withdrawal?

100

When a client has completed initial steps and is ready to begin evaluation, clinicians should wait for this sound. 

What is the Intake Specialist's page?

100

This document ensures that positive toxicology results were addressed with appropriate counseling and harm reduction education.

What is a Positive UA Assessment?

100

Clients admitted to IOP are expected to attend treatment during these specific days and hours.

What is Mondays, Wednesdays, and Fridays 8:30–11:30?

100

This medication reverses opioid overdose

What is naloxone?

200

Criteria must be met within this certain period of time.

What is a 12-month period of Substance use?

200

A client reports increased heroin use over the past 3 months, two recent overdoses, and loss of employment. This information belongs in this section.

What is the History of Presenting Illness (HPI)?

200

Taking this medication too soon after recent opioid use can cause precipitated withdrawal

What is Buprenorphine?

200

These required documents must be completed before a client can officially begin Intensive Outpatient treatment.

What are the IOP Authorization Form, Initial Treatment Plan (and Treatment Plan Review), and Physical?

200

A client who does not see their substance use as a problem is in this stage.

What is precontemplation?

300

Continued use despite persistent social or interpersonal problems falls under this DSM domain

What is social impairment?

300

This screening tool helps determine level of care using multidimensional assessment.

What is the ASAM Criteria?

300

This document evaluates stability factors such as attendance, toxicology results, and safety before granting doses.

What is a Take Home Medication Request?

300

Before a client joins group, staff verify participation status using this document. 

What is the check-in sheet?

300

This counseling style is most aligned with harm reduction and stages of change.

What is Motivational Interviewing?

400

This criterion refers to using in situations where it is physically dangerous.

What is hazardous use?

400

A client with severe OUD, daily IV use, history of overdose, unstable housing, and moderate withdrawal presents for intake. Based on ASAM, what level of care is most appropriate?

What is OTP with methadone OR higher level of care depending on ASAM dimension severity

400

This medication is a full opioid agonist

What is Methadone?

400

This ASAM dimension most directly evaluates relapse potential.

What is Dimension 5 (Relapse, Continued Use, or Continued Problem Potential)?

400

This duo in Rover ensures both clinical documentation and accountability for distributed supplies.

What is the Rover Intake Screen & Rover Supply Form?

500

Severity is determined by this.

What is the number of criteria met (mild 2–3, moderate 4–5, severe 6+)?

500

After clinical recommendations are made, this step closes the evaluation loop and triggers the formal admission process.

What is informing the Intake Specialist of the disposition (evaluation outcome)?

500

A community member calls the clinic reporting that a client may be selling their take-home medication bottles. This protocol is our first intervention.

What is Bottle Recall?

500

A client does not require detox, has moderate mental health symptoms, high relapse risk, and an unstable recovery environment but can remain safely in the community. According to ASAM, this level of care is indicated.

What is ASAM Level 2.1 – Intensive Outpatient Treatment?

500

This stage is often misconstrued because the client may be gathering resources and making small steps but behavior change has not yet fully begun.

What is Preparation?

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