Clinicians use a level of care assessment for opioid use disorder to find the right fit. They check your health and safety. They also look at your mental health, withdrawal needs, and support system. No single score decides the outcome.
The goal is to line up care with what you need. This can look like outpatient services. It might be residential treatment. At times, hospital-based care is the right call.
This check leads to a care recommendation. It does not say you need inpatient rehab. Nor does it promise insurance coverage. Our guide to opioid rehab options explains the treatment settings. For a closer look at short-term care, our guide to weekend rehab for opioids covers what that schedule involves.
We run a U.S. treatment directory. We do not provide care. If you think someone is overdosing, call 911 now.
How Clinicians Choose Your Opioid Addiction Level of Care
A clinician performs a level-of-care assessment to fit treatment to your needs. Scores or quizzes cannot set your placement. The clinician reviews your health and safety first. Then they recommend a fitting setting for you.
6
dimensions used in the ASAM Criteria for a holistic assessment[1]
The ASAM Criteria use six dimensions to look at your total health.[1] This helps plan your services. Each of these numbers serves a different purpose. A diagnosis names the condition. The assessment selects the right care level.
Clinicians review many factors during an opioid addiction level of care assessment. They examine your physical health and history of overdoses. Withdrawal risks and mental health issues are also checked. Your opioid use patterns, past care, and home life matter. They listen to your goals and wishes.
Assessment, diagnosis, and insurance are three distinct steps. The assessment finds the safest care level. Diagnosis confirms an opioid use disorder. Insurance is a separate check on what your plan pays. Keeping these apart helps you ask good questions at your visit.
Steps in an Opioid Level-of-Care Assessment
An opioid level-of-care assessment involves a health check and a talk. You do not pass or fail it. The main goal is to find the right care for you.
- Tell them why you are here. Share what made you seek help. This could be a recent event or a long struggle.
- Review your history. Talk about your opioid use and health. Clinicians look at the whole picture to plan care.[2]
- Check for safety needs. Discuss risks like overdose or withdrawal. Also talk about your support system and goals.
- Ask about the plan. Ask why they picked this level of care. Ask what other options exist if this does not fit.
Share all details during the chat. A drug test is only one piece of the data. Those results need to match your full health picture. They do not stand alone as the basis for a choice.[3]
What to Share at an Assessment
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Inpatient or Outpatient Opioid Treatment: Key Differences
The choice between inpatient and outpatient care turns on your needs. It also turns on your safety risks and the support you have at home. No single level fits everyone. Your assessment results will point you to the right setting.
Below is a chart that lines up common care settings. Every program has its own terms and services. Call each facility to see what they offer. Also ask which clinical needs they can handle.
| Setting | Where Care Happens | General Structure & Supervision | Typical Purpose |
|---|---|---|---|
| Standard Outpatient | Lives at home; attends visits at a clinic or program | Weekly or bi-weekly visits; low supervision | Maintaining recovery; managing mild symptoms; continuing care after higher levels of treatment. |
| IOP / PHP | Lives at home; attends daytime sessions at a clinic or program | Several hours a day, several days a week; group and individual therapy | Intensive support without leaving home; bridging the gap between residential care and standard outpatient care. See partial hospitalization for opioids or intensive outpatient programs for details. |
| Hospital-Based Inpatient | Lives in a hospital | Round-the-clock medical oversight by clinical staff | For individuals requiring management of serious health issues, severe withdrawal symptoms, or complex medical needs that require constant monitoring. |
Ask each program directly about its protocols when you compare options. Facilities do not always use the same labels or service mixes. Clarifying these details ensures you understand exactly what kind of support you will receive during your stay or visits. Confirm whether the program supports the continuation of prescribed medications for opioid use disorder, such as methadone or buprenorphine, as availability varies by facility. When you are ready to weigh the financial side, our guide to luxury versus standard rehab breaks down the costs and hidden fees.
Opioid Level of Care Assessment and the Place of Level 3.7
The American Society of Addiction Medicine (ASAM) uses levels of care to match service intensity to a person's needs. These levels are not a ranking of program quality.[4] The ASAM Criteria rely on six dimensions for assessment and service planning.[1] The Fourth Edition for adults was published in 2023.[5] Go to ASAM's official site to confirm the current edition.
The ASAM framework lines up care on a continuum of intensity. It goes from low-intensity outpatient services to high-acuity medically managed inpatient care. Service details can vary a bit by edition, but the general progression includes:
- Outpatient Services: These levels let people live at home while getting structured treatment. They cover basic counseling up to intensive outpatient programs (IOP) and partial hospitalization programs (PHP).
- Residential/Inpatient Services: People live at the treatment facility during these levels. The settings range from less intense residential care to more intense medically monitored environments.
ASAM has a specific level called Level 3.7.[6] The ASAM Criteria define it as Medically Monitored Intensive Inpatient Services. This is different from Level 4, known as Medically Managed Intensive Inpatient Services.[7] This name comes from the cited materials. The Fourth Edition may use newer terms, so check the exact title with the program or ASAM. A level name does not reveal the setting or services at a specific program. Ask the program if care is residential or hospital-based and what it offers.
Questions if a Referral Says Level 3.7
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Ways to Treat Opioid Use Disorder in Different Settings
The place where you get care is one choice. The way you get treated is a second choice. You may pick outpatient, residential, or hospital-based care. That choice does not decide if you use medication treatment for opioid use disorder. They are two separate parts of your plan.
The FDA has approved three drugs for opioid use disorder: methadone, buprenorphine, and naltrexone.[8] Your care team can go over which one fits you. You can get medication treatment for opioid use disorder in outpatient settings.[9] This means you can live at home while getting medication support. You can also take part in other services at the same time.
The mix of options changes based on the setting. In outpatient care, such as intensive outpatient programs or partial hospitalization for opioids, you usually get therapy and meds while living at home. Buprenorphine is often the most accessible med there. Methadone access may be limited to certain clinics or programs due to rules. Naltrexone is generally available in outpatient care but needs a period of opioid-free time before you start. In residential or hospital-based care, all three meds may be available. This allows for more flexible management during transitions. Requirements and availability can differ by location and program. Your placement level does not automatically decide which med you get. Your provider will help you find the right mix for your needs.
Getting through withdrawal is only the start. NIDA notes that medically supervised detoxification is rarely enough alone.[10] It helps with acute physical symptoms. But it does not fix long-term addiction. You need ongoing care in a full plan to stay well. To see how long the first phase takes, read about opioid detox duration. Our guide to opioid detox duration breaks down the typical timeline so you know what to expect in that first phase.
Changes in Your Level of Care
Your level of care is not a permanent label. Needs may shift as time passes. You might move to a setting with more or less intensity. Safety, health, and support drive this choice. No one set treatment length fits every person with a substance use disorder.[11]
You can view this process as a set of checks. It does not follow a fixed calendar. This is how it often looks:
Initial assessment
You and the team check your needs. You agree on a recommended level of care.
Treatment begins
You start in the chosen setting. You set specific goals and a support plan.
Progress reviews
The team checks your progress often. They watch how your needs shift over time.
Care adjustments
You and the team talk about next steps. You may stay, step down, or get more support.
Transition planning
If you move settings, the team makes a plan. This ensures ongoing care and follow-up.
Treatment moves at different paces for different people. This timeline shows how reassessment works. It makes no promises about a set order or time.[11] Ask what signs lead to a placement review. Also ask how care gets coordinated when you change settings. Knowing how treatment placement is assessed helps you feel in control.
Do not give up if you use opioids again after treatment ends. Reach out to your care team instead. Discuss what occurred and ways to change your plan. Opioid treatment levels of care are flexible. They are designed to help you through various recovery phases. For details on finding safe housing and ongoing support, see our guide to sober living after opioid rehab.
Important safety note: If you have gone a while without opioids, your body may react more strongly to the drug. Carry naloxone with you at all times.[12] If you suspect an overdose—signs include slowed or stopped breathing, inability to wake, and blue or gray lips or skin—call 911 immediately.[13]
Possible Opioid Overdose: Get Emergency Help
Spotting these signs in someone right now means a medical emergency. Possible opioid overdose signs include slowed or stopped breathing, inability to wake, and blue or gray lips or skin.[13] Do not wait to see if they get worse.
- Call 911 immediately. Tell the dispatcher that you suspect an opioid overdose.
- Give naloxone if you have it. Naloxone can reverse the effects of an opioid overdose.[12] Follow the product directions on the package and the 911 dispatcher’s instructions.
- Support breathing and stay with the person. If the person is not breathing or is only gasping, keep them on their back and follow the 911 dispatcher’s instructions for rescue breathing or CPR. If the person is breathing normally, place them on their side if possible. Stay until emergency responders arrive.
Call 911 even if naloxone appears to help, and stay with the person until emergency responders arrive. If you are unsure whether someone is overdosing, call 911 anyway. Being safe is always the better choice.
Getting Set for the Road Ahead
Six dimensions make up the ASAM Criteria. They guide a biopsychosocial check to help plan care across levels of care and services.[1] A level name points to the type and intensity of help that fits your needs. It does not rank how good a program is.[4] Ask how the pick matches your assessed needs, what services it holds, and how the plan gets rechecked if your needs shift.[14]
Take these questions to a conversation with a qualified provider. Keep in mind they do not diagnose you. They also do not assign a level of care.
Questions to Prepare for Your Next Step
This self-check is for information only and isn't a diagnosis.
This self-check is not meant for emergencies. If you or someone else has any danger signs described above, call 911 or go to the nearest emergency room now. For suicidal thoughts, call or text 988.
Frequently Asked Questions
What are the 5 levels of care for substance abuse?
There is not one universal five-level system used by all programs. The ASAM Criteria, Fourth Edition for adults, organizes assessment using six dimensions to create a holistic, biopsychosocial assessment for service planning and treatment across all services and levels of care.[1] These numbered levels describe types and intensity of services matched to assessed needs, not a simple ranking of program quality.[4]
Broad settings such as outpatient, residential, and hospital care are distinct from these specific ASAM level designations.
What is a 3.7 level of care?
Level 3.7 is an ASAM term for Medically Monitored Intensive Inpatient Services.[7] It is different from Level 4, which offers Medically Managed Intensive Inpatient Services.[7] This number shows the type of medical care, not how sick a person is. Ask your provider to explain the difference between Level 3.7 and Level 4.
Does opioid addiction treatment always require inpatient rehab?
No, you do not always need inpatient rehab. The right setting depends on your needs and safety at home. For some people, intensive outpatient treatment works well instead of inpatient care. Your assessment will help pick the best fit for you.
Can my level of care change during treatment?
Yes, your level of care can change over time. NIDA says plans should be checked often as needs change.[14] Talk to your team if your situation shifts. They may keep you at the same level or move you to more or less support.
What does a 7 opioid risk score mean?
Different tools measure different risks or pain histories, and the meaning of a specific number depends entirely on the instrument used. Identify the specific tool your clinician used and ask them directly what a score of 7 means in that context. A pain score does not set your level of care for addiction treatment.
What is considered a high MME?
MME compares prescribed pain-medication doses and is not a measure of opioid concentration in the body. The CDC advises clinicians to carefully reassess evidence of individual benefits and risks when considering opioid dosages of 50 MME per day or more.[15] This is a pain-prescribing caution, not a universal safe-dose cutoff or a threshold for addiction treatment placement. If you have trouble breathing or are very sleepy now, call 911 or go to the ER right away.
What are the 5 C’s of addiction?
The "5 C’s" is an educational shorthand often used to describe characteristics of substance use disorders, typically including Compulsion, Consequences, Craving, Control loss, and Continuation despite harm. These are not a diagnostic or placement tool. Diagnosis relies on clinical criteria, such as those in the DSM-5.[16]
What are the three classifications of opioids?
Opioids are generally classified as natural (such as morphine), semi-synthetic (such as oxycodone), or synthetic (such as fentanyl). This classification describes the drug’s origin and potency, not a person’s level of care. Classification does not determine treatment placement.
What are "opioid levels"?
The phrase "opioid levels" is ambiguous. It can refer to the class or potency of a specific opioid medication, or it can refer to the concentration of opioids measured in the body through toxicology testing. If you are asking about a lab result, remember that test results should be interpreted in clinical context rather than used as the sole basis for a decision.[3] If you suspect an overdose, look for signs like slowed or stopped breathing, inability to wake, or blue or gray lips or skin, and call 911 immediately.[13]
