Social Workers Are Essential in Treating Addiction — New Standards Are Available to Help

R. Corey Waller, MD, MS, FACEP, DFASAM

The phrase “It’s time to call in the cavalry” often means a need for backup or specialized, targeted assistance during a crisis. In a tough situation, the cavalry is deployed to give the final push needed for a chance at victory. In our national battle against addiction, I see social workers as part of the cavalry.

Collectively, you are a nimble, responsive group of special forces that can quickly assess a situation and implement the proper solutions. Whatever your focus is as a social worker, you are critical to the battle against addiction.

Comprehensive addiction treatment requires a combination of medical treatment, psychotherapy, psychoeducation, and addiction treatment supports to occur. A physician typically oversees only one of these responses, whereas a social worker manages three. Social workers are critical not only to the system at large but also to each individual patient, as they are essential in facilitating treatment retention.

During the last decade, there’s been a significant increase in awareness of the devastation that addiction brings to any community, especially with regard to opioid use disorder and the overdose epidemic that’s the leading cause of death for individuals younger than 50.

It’s time to call in the cavalry.

If social workers are part of the cavalry, The ASAM Criteria®—the most widely used comprehensive set of standards for addiction treatment—is the battle plan everyone must employ.

I have contributed to The ASAM Criteria for the last six years, most recently serving as the editor in chief for the recently released Fourth Edition. The Criteria is suitable for every medical and social specialty responding to addiction, including social workers. I have collaborated with social workers for more than a decade and, recognizing your significant role in addiction treatment, prioritized the presence of social workers on the editorial team that produced the standards.

The ASAM Criteria improves patient outcomes by establishing a continuum of care that reflects the modern understanding of addiction as a chronic disease. As patients’ (or clients’) conditions improve or worsen, they move along the continuum of care to the level most appropriate for their needs. Treatment based on the Criteria is associated with decreased morbidity, improved client functioning, and more efficient service utilization than mismatched treatment.

The Criteria provides a step-by-step process for a full biopsychosocial assessment, guiding users through the components of care that should be delivered to a patient based on the results of that assessment. It significantly decreases the burden of trying to individualize care yourself and allows for that system of care to help guide how much medical, behavioral, and social support a patient may need.

The ASAM Criteria was built to work as an “easy button.” If you open this book and follow it, it should make every aspect of your job easier. And I know from experience that social workers like you are finding this to be true.

As chief medical officer for BrightView Health, a large comprehensive outpatient addiction treatment company, I work with more than 300 social workers and receive a steady stream of feedback from them. What I hear about the Criteria is consistently positive, with users agreeing that it builds a consistent, predictable structure for the work they do.

Shelly Virva, LMSW, explains it this way: “The Fourth Edition of The ASAM Criteria allows me to trust somebody else’s work when I see a patient and allows me to refer a patient to another provider, knowing they can trust my work,” she says.

Jennifer Harrison, PhD, LMSW, CAADC, an ASAM member, is a social worker, chemical addictions counselor, and professor, as well as the interim director for the School of Social Work at Western Michigan University. She believes her fellow social workers will find The ASAM Criteria to be a valuable resource as they serve clients who are battling addiction.

“The ASAM Criteria is a critical competency for social workers because, in any area of social work practice, you are going to be working with individuals, families, and communities that are impacted by addiction,” Harrison says. “As social workers, we have an obligation to be competent in the areas of micro practice and macro practice, and addiction is absolutely one of those areas. The Criteria is the gold standard for competency development for social workers and other professionals in the field of addiction treatment. It should be mandatory reading and mandatory training for all social work students and practitioners.”

Treating addiction is the most rewarding thing I have done in health care, and I have worked as a paramedic, an emergency department physician, a pain doctor, and an outpatient care provider. Without question, this is the most fulfilling version of health care that I have had the privilege to deliver. And it is one in which social workers are of equal or greater value to medical providers. There are no hierarchies in this space, only scope of practice. Too many patients have been wounded by addiction and co-occurring disorders. We need you in this fight. Please answer the call.

— R. Corey Waller, MD, MS, FACEP, DFASAM, is a nationally recognized expert in substance use disorder and serves as editor in chief of The ASAM Criteria, Fourth Edition. Waller is chief medical officer of BrightView Health, where he oversees education, practice standards, and care delivery across the organization. He is board-certified in addiction and emergency medicine.