Suspected Substance Withdrawal in Adolescents — Outpatient SUD Care — Clinical Pathway: Inpatient

Suspected Substance Withdrawal in Adolescents Clinical Pathway — Inpatient

Outpatient SUD Care

  • Voluntary or court ordered. May be court-ordered by justice system or by parent, depending on state law.
    • Outpatient substance use care is not always available for adolescent patients; key limitations to accessing care include age, gender, insurance, geographic region/location.
    • Pennsylvania and Delaware recommend using the ATLAS Treatment Finder.
    • Resource Connects: The Addiction & Recovery listings fall under the Safety & Mental Wellness category. Results can be filtered by age group, substance dependency, gender, and identity and much more.

Consent

Higher Levels of Care (for SUD)

  • These higher levels of care are specific to substance use disorder; they are determined according to the American Society of Addiction Medicine (ASAM) criteria  
  • All levels of care are not available in this area for adolescent patients
    • Key limitations include age, gender, insurance, geographic region/location
  • Higher levels of care are related to substance use disorder only and are separate from the system for mental health care (an IOP for SUD is not the same as IOP for mood disorders, etc.)
  • Health coverage benefits are specific to substance use disorder.
  • Referral is determined by Behavioral Health recommendations in collaboration with family and medical team.
  • Considerations include enteral feed dependence, co-morbidities, chronicity, family and patient preference.

Referral to Higher Level of Care

  • Social Work coordinates placement and insurance
  • Case management coordinates transport if needed for safety
  • When possible, given geography and insurance, refer teens to pediatric facilities
Inpatient
  • Highest level of care with psychiatric support
  • Provides medical oversight, it is not a medical hospitalization
Residential
  • Not locked
  • Usually longer duration
  • Intensive psychological support
  • Less medical support
Partial Hospitalization 5-6 days/wk, 20 or more hrs/wk
Intensive Outpatient Program Up to 2-3 days/wk, up to 9 hrs/wk

Residential Location Considerations

Pennsylvania
New Jersey Substance use disorder is not grounds for involuntary commitment under state law
Delaware Mental Health - CHAPTER 50. Involuntary Commitment of Persons with Mental Conditions; Discharge; Procedure