In October 2017, the opioid epidemic was officially declared a public health emergency, and the data made it clear why. Between 2001 and 2017, nearly 500,000 people died from opioid overdoses and the economic toll of this crisis surpassed $1 trillion. At the time, one study projected another $500 billion in costs by 2020, not to mention the continued death toll. Amid this alarming reality, the emergency designation acted as a catalyst for mobilizing a focused, concerted effort to change the trajectory of the opioid crisis, and several key policy interventions have proven successful in decreasing the number of overdose deaths nationwide. In fact, recent data shows a 24 percent drop from 2023 to 2024.
So, where do we go from here?
Maintaining progress in a changing healthcare landscape
Current shifts in federal policy addressing mental health and substance use disorder have the potential to affect progress. In early 2025, significant workforce cuts to SAMHSA were announced and in July, the One Big Beautiful Bill Act introduced substantial fiscal and coverage implications for Medicaid. These changes, among others, raise concerns about states’ ability to continue to support community-based mental health services – including addiction treatment and prevention programs. Despite the possible setbacks, newly announced initiatives like the Rural Health Transformation (RHT) Program and the STREETS pilot program are emerging to help maintain momentum.
Translating The ASAM Criteria into technology solutions that support person-centered care
At FEI, we’re here to help our state partners monitor trends, navigate changes and continue moving forward. For more than 25 years, we’ve developed and supported technology solutions and services to advance the quality delivery of health and human services. For example, in 2015 we partnered with the American Society of Addiction medicine to develop the ASAM CONTINUUM™ and CO-Triage® electronic assessment tools using The ASAM Criteria to guide treatment and care planning for those with substance use disorders and co-occurring conditions. Over the past decade, our collaboration with ASAM has focused on translating these nationally recognized standards and clinical best practices into technology solutions that support consistent, evidence-based decision-making across treatment settings.
That work continues with the release of the fourth edition of The ASAM Criteria. As providers, payers and state agencies look for ways to improve outcomes, reduce variability and better understand program performance, recent changes to the criteria introduce refinements designed to support more person-centered care and a more consistent approach to determining level-of-care recommendations. Likewise, the subsequent transition to the fourth edition of the ASAM CONTINUUM represents a meaningful step forward.
What’s changing?
The ASAM Criteria includes three core components that work together to guide level of care recommendations. The criteria also define standards for the various levels of care across the continuum, describing the setting, staffing, service intensity and other key elements at each level.
The update to The ASAM Criteria, 4th edition and the corresponding release of the fourth edition of the Continuum and CO-Triage assessments, includes the following enhancements:
| UPDATE | WHAT IT MEANS |
|---|---|
| Updated six dimensions | Integrates readiness to change across all dimensions, adds Dimension 6: Person-Centered Considerations, supporting holistic, biopsychosocial assessment. |
| Newly defined subdimensions | Highlights actionable factors within each dimension for consistent, nuanced clinical evaluation. |
| Refined continuum of care | Four main levels remain; decimal designations clarify gradations of intensity and care type, supporting precise treatment alignment. |
These updates, reflected directly in the fourth edition of the Continuum and Co-Triage assessments, give treatment providers clearer guidance and greater confidence when determining appropriate levels of care.
The fourth edition of the assessments are fully biopsychosocial assessments, aligned with the Joint Commission and Commission on Accreditation of Rehabilitation Facilities (CARF).
Supporting engagement, efficiency and continuity
Electronic assessments grounded in The ASAM Criteria bring greater consistency and efficiency to substance use disorder treatment. By promoting early patient engagement, enabling timely over-the-phone prior authorization and streamlining payer reimbursement approvals, these tools help promptly connect patients to the right level of care. Automated scoring and level of care recommendations strengthen continuity of care, which can contribute to lower drop-out rates and sustained long-term recovery.
With Continuum and Co-Triage, the entire treatment team — from intake specialists to treatment providers — has access to a structured interview platform to determine appropriate levels of care and inform treatment plans for those with substance use disorders and co-occurring conditions. For more information or to request a demo, please contact FEI Systems.
