Pennsylvania’s Client Placement Criteria vs. the ASAM

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Deaths from drug overdose reached an all-time high in 2015. Such deaths have been increasing steadily over the last two decades, but the increase in Pennsylvania of 20.1 percent over the previous year was particularly startling. Health and regulatory authorities are understandably concerned about the increasing figures.

Providing the right kind of help for people with substance use disorders is key to reducing the number of overdose deaths. In Pennsylvania, the Client Placement Criteria (PCPC) is a set of standards that addiction specialists can use to assess the needs of clients seeking treatment.1 The most recent revision of PCPC was released in 2014, and the criteria have come under scrutiny as the death toll from overdoses continues to rise.

Purpose of the Criteria

The criteria are in place to help healthcare professionals decide what treatment options are likely to be most beneficial for clients seeking help. Using the criteria, the healthcare professional will interview a client and recommend the best course of action. The criteria help the professional to decide if a client requires detox, for example, and also things like whether inpatient or outpatient therapy, or other forms of treatment, is the best option.

Some of the options include:

  • Early intervention
  • Intensive outpatient treatment
  • Partial hospitalization
  • Halfway houses
  • Medically monitored detox
  • Short-term residential treatment

Long-term residential treatment

The criteria also help interviewers determine how long treatment should last for. The PCPC can be used to decide if a person with substance use problems who is receiving treatment would benefit from a continued stay. There is also a section covering special populations and considerations that deals with issues like co-existent substance abuse and mental health problems and women with children.

Why Pennsylvania Needs Its Own Client Placement Criteria

Client Placement CriteriaCritics of the PCPC have questioned the need for a state-specific set of criteria. They argue that the American Society of Addiction Medicine (ASAM) criteria have been vetted and found useful, while there is little published data regarding the effectiveness of the latest version of the PCPC.

The Pennsylvania Department of Drug and Alcohol Programs (DDAP) says that the PCPC is essentially a modified version of the ASAM criteria. DDAP points out that ASAM may recommend services that are not widely available in Pennsylvania. ASAM criteria2 are used to make evaluations in a very similar way as the PCPC.

Which is Better?

Many Pennsylvania-based healthcare providers find the PCPC is just as useful as ASAM. They say that perceived faults with the PCPC are often due to the bias of the reviewers rather than any flaw with the actual criteria. That bias is reflected in the high percentage of clients who are referred for long-term treatment.

When interviewers allow personal bias to enter their evaluations, that will happen regardless of which set of criteria are used. While drug abuse and addiction is not unique to Pennsylvania, the fine-tuning of assessment criteria to take into account the types of support services available in the state should help to deliver the best outcome.


References:

  1. http://www.ddap.pa.gov/Manuals/PA%20Client%20Placement%20Criteria%20(PCPC)%20Edition%203%20Manual.pdf
  2. http://www.asam.org/quality-practice/guidelines-and-consensus-documents/the-asam-criteria

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