U.S. flag

An official website of the Department of Health & Human Services

AHRQ: Agency for Healthcare Research and Quality

Engagement and Retention of Nonabstinent Patients in SUD Treatment – New ASAM Clinical Guidance

Date

The American Society of Addiction Medicine (ASAM) recently released new clinical guidance for the engagement and retention of nonabstinent patients in substance use treatment. This document is intended for addiction treatment providers and adds to ASAM’s growing catalog of Clinical Recommendations which also includes guidance on opioid use disorder in pregnancy, integrating tobacco use disorder interventions in addiction treatment, and buprenorphine treatment for individuals using high-potency synthetic opioids.

Funded by the California Department of Health Care Services, ASAM’s new guidance “offers essential guidance for substance use disorder treatment programs and providers to address the complexities of patient nonabstinence during treatment, reduce administrative discharges, and implement strategies to lower barriers to care and improve engagement and retention of nonabstinent patients in the continuum of care.” They list the following summary of recommendations:

  1. Cultivate patient trust by creating a welcoming, nonjudgmental, and trauma-sensitive environment.
  2. Do not require abstinence as a condition of treatment initiation or retention.
  3. Optimize clinical interventions to promote patient engagement and retention.
  4. Only administratively discharge patients from treatment as a last resort.
  5. Seek to re-engage individuals who disengage from care.
  6. Build connections to people with substance use disorder who are not currently seeking treatment.
  7. Cultivate staff acceptance and support.
  8. Prioritize retention of front-line staff.
  9. Align program policies and procedures with the commitment to improve engagement and retention of all patients, including nonabstinent patients.
  10. Measure progress and strive for continuous improvement of engagement and retention.

For more information on managing substance use treatment, see ASAM's Clinical Guidelines and the ASAM Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions. Also see the AHRQ Academy’s Substance Use Tools & Resources Collection and Literature Collection items on substance use and opioids.