CONTENTS

About This Course

Table of Contents

1. Introduction to the Issues
2. Understanding Alcohol Abuse
3. Understanding Violence Against Women
4. Alcohol and Domestic Violence
5. Alcohol, Sexual Assault, and Rape
6. Prevention and Early Intervention
7. Screening and Assessment
8. Diagnosis and Treatment
9. Legal and Ethical Issues

Supplements
Fact Sheets
Videos
Resources

Silence Hurts
Alcohol Abuse and Violence Against Women

American Society of Addiction Medicine Patient Placement Criteria (ASAM-PPC-2) Assessment Dimensions

Dimension 1 -- Acute Intoxication and/or Withdrawal Potential

• What risk is associated with the patient's current level of acute intoxication?
• Is there significant risk of severe withdrawal symptoms or seizures, based on the patient's previous withdrawal history, amount, frequency, and recency of discontinuation or significant reduction of alcohol or other drug use?
• Are there current signs of withdrawal?
• Does the patient have supports to assist in ambulatory detoxification, if medically safe?

Dimension 2 -- Biomedical Conditions and Complications

• Are there current physical illnesses, other than withdrawal, that need to be addressed or that may complicate treatment?
• Are there chronic conditions that affect treatment?

Dimension 3 -- Emotional/Behavioral Conditions and Complications

• Are there current psychiatric illnesses or psychological, behavioral, or emotional problems that need to be addressed or that complicate treatment?
• Are there chronic conditions that affect treatment?
• Do any emotional/behavioral problems appear to be an expected part of addiction illness, or do they appear to be autonomous?
• Even if connected to the addiction, are they severe enough to warrant specific mental health treatment?

Dimension 4 -- Treatment Acceptance/Resistance

• Is the patient actively objecting to treatment?
• Does the patient feel coerced into treatment?
• How ready is the patient to change?
• If willing to accept treatment, how strongly does the patient disagree with others' perceptions that he or she has an addiction problem?
• Does the patient appear to be compliant only to avoid a negative consequence, or does he or she appear to be internally distressed in a self-motivated way about his or her alcohol/other drug use problems?

Dimension 5 -- Relapse/Continued Use Potential

• Is the patient in immediate danger of continued severe distress and drinking/drug-taking behavior?
• Does the patient have any recognition of, understanding of, or skills with which to cope with his or her addiction problems in order to prevent relapse or continued use?
• What severity of problems and further distress will potentially continue or reappear if the patient is not successfully engaged in treatment at this time?
• How aware is the patient of relapse triggers and ways to cope with cravings?

Dimension 6 -- Recovery Environment

• Are there any dangerous family members, significant others, living situations, or school/working situations that pose a threat to treatment engagement and success?
• Does the patient have supportive friendships, financial resources, or education/vocational resources that can increase the likelihood of successful treatment?
• Are there legal, vocational, social service agency, or criminal justice mandates that may enhance the patient's motivation for engagement in treatment?

Source: American Society of Addiction Medicine, 1996.