Standards of Care
Detoxification can usually be accomplished within 3-10 days or until the patient’s signs and symptoms can be managed at a less intensive level of care. Length of detoxification depends on a number of factors including withdrawal risk, substance(s) used, medical status, and severity of withdrawal symptoms. (ASAM Criteria, 2013; CMS NCD Manual, Section 130.1)
Once determination for the appropriate level of care is determined an admission is completed.
Upon admission, the patient will have a complete history and physical completed by a licensed healthcare provider. The information will be collected in order to identify the needs of each patient. A physical examination and other necessary diagnostic evaluations should be completed to the extent possible and as indicated by the member’s clinical presentation to rule out other causes of symptomatology (CMS LCD, 2017).
The results from the evaluation should determine the member’s diagnosis, level of risk, treatment setting and treatment planning goals (ASAM Criteria, 2013).
Once diagnosed withdrawal management/detoxification medications are used to treat intoxication and withdrawal. Detox protocols will be determined by several factors and determined by the physician.
The substances used, route of administration, the dose, the time since the last dose, and whether the level of intoxication is waxing or waning all needs to be ascertained. When multiple substances have been used, the effects of each substance should be considered.
When monitoring withdrawal Experience Recovery will use The Clinical Institute Withdrawal Assessment (CIWA) and the Clinical Opiate Withdrawal Scale (COWS)