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 for the opioid pathway. The walkthrough does not score users on COWS.
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. Published by the World Health Organization. who.int/publications/i/item/WHO-MSD-MSB-01.6a Used for: self-assessment framing referenced in the minimal-treatment outcome. The walkthrough does not administer AUDIT.
DAST-10. Skinner HA. The Drug Abuse Screening Test. Addictive Behaviors. 1982;7(4):363-371. pubmed.ncbi.nlm.nih.gov/7183189 Used for: background reference for non-alcohol substance screening. The walkthrough does not administer DAST-10.
PHQ-9. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine. 2001;16(9):606-613. pubmed.ncbi.nlm.nih.gov/11556941 Used for: source-library reference for clinicians who want to follow up on co-occurring mood concerns. Not directly administered by the walkthrough.
Columbia C-SSRS. Posner K, Brown GK, Stanley B, et al. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings. American Journal of Psychiatry. 2011;168(12):1266-1277. Made freely available by the Columbia Lighthouse Project. cssrs.columbia.edu Used for: the core ideation framing (with vs without plan or intent) in the crisis question. The walkthrough uses only the framing and does not score users on C-SSRS.
WHO mhGAP Intervention Guide v2.0. World Health Organization. Mental Health Gap Action Programme. who.int/publications/i/item/9789241549790 Used for: background reference for crisis routing across psychiatric, medical, and substance-use emergencies.

Public-health and harm-reduction references

SAMHSA Harm Reduction Framework. Substance Abuse and Mental Health Services Administration. samhsa.gov/substance-use/harm-reduction/framework Used for: explicit federal recognition of harm reduction and reduced-use as legitimate clinical goals.
SAMHSA Contingency Management Advisory. SAMHSA. PEP24-06-001. 2024. library.samhsa.gov/sites/default/files/contingency-management-advisory-pep24-06-001.pdf Used for: framing contingency management as the most evidence-based intervention for stimulant use disorder; referenced in the stimulant-pathway "why this matters" explanation.
SAMHSA Find Treatment. Treatment locator and the National Helpline. samhsa.gov/medications-substance-use-disorders/find-treatment Used for: the practitioner-locator link in the withdrawal-management and outpatient outcomes; the National Helpline at 1-800-662-HELP in the emergency outcome.

What is deliberately not cited The walkthrough does not cite the ASAM Criteria, the LOCUS, the CALOCUS-CASII, or any proprietary level-of-care framework. The structure, naming, and decision logic are AvoidRehab's own. The clinical claims behind individual questions and outcomes all trace back to the public sources above.

If you spot a source that is missing, mis-cited, or out of date, email the editorial team at the contact address in the footer.