Sources

Where every clinical claim in the walkthrough comes from.

Each item below is publicly available, free to read, and links to the original source. The walkthrough does not cite any proprietary level-of-care framework.

Independence The AvoidRehab Decision Walkthrough is independent. It is not affiliated with, endorsed by, or derived from the ASAM Criteria, the LOCUS, the CALOCUS-CASII, or any other licensed level-of-care system. The structure, naming, and decision logic are AvoidRehab's own.

SAMHSA Treatment Improvement Protocols (TIPs)

TIP 45: Detoxification and Substance Abuse Treatment. Substance Abuse and Mental Health Services Administration. SMA15-4131. library.samhsa.gov/product/tip-45-detoxification-and-substance-abuse-treatment Used for: alcohol and benzodiazepine withdrawal-risk pathways; the framing that stimulant and cannabis withdrawal do not require medical detox; the medical-detox-as-days-not-weeks frame.
TIP 42: Substance Use Disorder Treatment for Persons With Co-Occurring Disorders. SAMHSA. PEP20-02-01-004. library.samhsa.gov/product/tip-42-substance-use-treatment-persons-co-occurring-disorders Used for: psychiatric crisis flags (active psychosis, mania); environmental and treatment-planning factors; the framing that environment changes which level of care is realistic.
TIP 63: Medications for Opioid Use Disorder. SAMHSA. PEP21-02-01-002. library.samhsa.gov/product/tip-63-medications-opioid-use-disorder Used for: medication-first opioid pathway; pregnancy-with-opioid-use-disorder framing; outpatient framing for buprenorphine and methadone.
TIP 35: Enhancing Motivation for Change in Substance Use Disorder Treatment. SAMHSA. PEP19-02-01-003. library.samhsa.gov/product/tip-35-enhancing-motivation-change-substance-use-disorder-treatment Used for: readiness-to-change question; goal question (abstinence, moderation, harm reduction as legitimate goals); motivational interviewing as evidence-based.

NIDA

Principles of Effective Treatment (research-based guide). National Institute on Drug Abuse. nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition Used for: framing that duration of engagement, not residential intensity, is the strongest predictor of outcome; framing that effective treatment exists on a spectrum.

NIAAA

Rethinking Drinking. National Institute on Alcohol Abuse and Alcoholism. rethinkingdrinking.niaaa.nih.gov Used for: low-risk and heavy-drinking thresholds in the alcohol frequency question; AUDIT-informed framing of the minimal-treatment outcome.

Public-domain or freely licensed clinical instruments

CIWA-Ar. Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM. Assessment of alcohol withdrawal: the revised Clinical Institute Withdrawal Assessment for Alcohol scale. British Journal of Addiction. 1989;84(11):1353-1357. pubmed.ncbi.nlm.nih.gov/2597811 Used for: symptom domains (prior seizure, prior DTs, tremor, sweating) flagged in the alcohol-withdrawal-history question. The walkthrough does not score users.
COWS. Wesson DR, Ling W. The Clinical Opiate Withdrawal Scale (COWS). Journal of Psychoactive Drugs. 2003;35(2):253-259. pubmed.ncbi.nlm.nih.gov/12924748 Used for: background framing of the opioid-withdrawal pathway. Not scored.
AUDIT. Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT). Addiction. 1993;88(6):791-804. World Health Organization. who.int/publications/i/item/audit Used for: self-assessment framing in the minimal-treatment outcome.
DAST-10. Skinner HA. The Drug Abuse Screening Test. Addictive Behaviors. 1982;7(4):363-371. pubmed.ncbi.nlm.nih.gov/7183189 Background reference for non-alcohol substance screening.
PHQ-9. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine. 2001;16(9):606-613. phqscreeners.com Background reference for clinicians who want to follow up on co-occurring mood concerns.
C-SSRS. Posner K, Brown GK, Stanley B, et al. The Columbia-Suicide Severity Rating Scale. American Journal of Psychiatry. 2011;168(12):1266-1277. Columbia Lighthouse Project. cssrs.columbia.edu Used for: the core ideation framing (with vs without plan or intent) in the crisis question. Not scored.
WHO mhGAP Intervention Guide v2.0. World Health Organization. 2016. who.int/publications/i/item/9789241549790 Background reference for crisis routing.

Additional federal guidance

SAMHSA Harm Reduction Framework. samhsa.gov/substance-use/harm-reduction/framework Used for: harm reduction as a recognized evidence-based approach in the minimal-treatment outcome.
SAMHSA Contingency Management Advisory. PEP24-06-001. 2024. library.samhsa.gov/sites/default/files/contingency-management-advisory-pep24-06-001.pdf Used for: contingency management as the most evidence-based intervention for stimulant use disorder.
SAMHSA National Helpline. 1-800-662-HELP (4357). 24/7, free, confidential treatment referral service. samhsa.gov/find-help/national-helpline
988 Suicide and Crisis Lifeline. 988lifeline.org
SAMHSA Find Treatment locator. Includes buprenorphine practitioner and opioid treatment program locators. samhsa.gov/medications-substance-use-disorders/find-treatment

What the walkthrough does not cite

The AvoidRehab Decision Walkthrough does not reference, reproduce, or derive from the ASAM Criteria, the LOCUS, the CALOCUS-CASII, the Continuum, or any other licensed proprietary level-of-care framework. The walkthrough's five-question structure, the wording of each question, and the six-outcome decision logic are AvoidRehab's own work, grounded only in the publicly available federal sources listed above.

Last updated: 2026-05-02. When source documents are revised or new federal guidance is published, this page is updated and the change is noted in the walkthrough's changelog.