The first specialized collection of treatment standards and hospitalization criteria for young people with Substance Use Disorder (SUD) has been developed. This significant work – “The ASAM Criteria: Adolescents and Transitional-Age Youth” – constitutes a part of the fourth edition of the American Society of Addiction Medicine (ASAM). Published by the Hazelden Betty Ford Foundation, the manual encompasses adolescents under the age of 18 and transitional-age youth (16–25 years).
Since SUD is fundamentally a disease that begins during the pediatric years, the importance of this document is critical. Research confirms that 80% of adults with addiction began using substances before the age of 18. Among those who begin use before age 15, the risk of developing the disease is 6.5 times higher than in cases of starting after age 21. The presented manual fundamentally changes addiction medicine, placing emphasis on interventions tailored to the critical phase of brain growth.
The Evolution of ASAM Criteria
Since its appearance in 1991, the ASAM criteria have represented the recognized “gold standard” in the field of substance dependence treatment. It offers a multidimensional framework for making individual decisions regarding patient admission, treatment continuation, and the transition between different levels of service.
Although adolescent standards were integrated into adult manuals in the 2013 third edition, growing research regarding the neurodevelopment of young people made the creation of a separate volume in the fourth edition necessary. This new collection, which was announced on March 25, 2026, in Rockville (Maryland) and Center City (Minnesota), has already been available on digital platforms since March 31, 2026, while the print version will be published in the month of June.
The work was presented at the “Joint Meeting on Youth Prevention, Treatment, and Rehabilitation.” The document directly addresses the specific vulnerability of the adolescent brain, which continues formation until the mid-20s. This long process of development strengthens the probability of the formation of addiction. Consequently, it leads to the worsening of health status and the hindrance of fundamental stages of development.
Dr. Corey Waller, who is the editor-in-chief of this volume, highlights the special developmental needs of young people. He considers that the system of addiction treatment must be oriented toward precisely these unique requirements. The new standards unite a full spectrum of services, ensuring the prevention of disease exacerbation and effective therapy. The mentioned approach facilitates the successful reintegration of the young person into adulthood. Furthermore, the document envisions the reformation of infrastructure and payment models so that assistance can be managed equally for all young people.
Why Does SUD Require Urgent Intervention in Young People?
Substance use during the age of adolescence is not just a simple experiment; it is a high-risk process that ultimately forms chronic dependence. Numerous studies confirm that the early start of use directly determines the subsequent severity of the disease.
The high plasticity of the brain during the stage of development determines a dual effect: it increases sensitivity toward the harmful impact of substances, but, at the same time, provides the best opportunity for intervention. Accordingly, the new standards assign priority to working with those risk groups that do not yet satisfy the full criteria for SUD. To suppress the further development of the disease, the manual envisions specialized care at levels 1.5Y (early intervention stage) or 2.1Y (intensive outpatient treatment).
The new strategy is built on the principles of family systems. It envisions that the role of parents, sibling relationships, and the overall family environment determines the effectiveness of therapy. Due to the abundance of comorbid conditions, the full integration of mental health services represents an essential part of the process. Along with this, close cooperation with schools, social services, and other state agencies encompasses those complex factors that impact the formation or rehabilitation of SUD.
Joseph Lee, head of the “Hazelden Betty Ford Foundation,” emphasizes the advantages of the publication’s digital format. The platform was formed to facilitate the joint work of clinicians, families, and patients. The mentioned technological solution simplifies the integration of the new standards into daily practice.
Key Innovations
The ASAM criteria consider treatment as a dynamic process divided into four levels, which has now been supplemented with specific standards tailored to the needs of young people:
First of all, the chronic care model (Level 1.0Y) is important, which serves to maintain stable remission. It includes constant monitoring of the recovery process and medicinal control. A strategy of this kind is decisive for young people who are on pharmacotherapy, as it helps them in maintaining long-term sobriety.
Another important innovation is the management of concomitant diseases, which has been implemented at all levels of care. Every stage of service now requires integrated mental health support. This approach envisions a link with such SUD problems as depression, anxiety, or trauma. The mentioned step ensures close coordination between the addiction and mental health systems.
Against the background of the alarming increase in fentanyl use, special attention was devoted to integrated medical management. Withdrawal, or detox, services (x.7Y programs) now connect biomedical stabilization and psychosocial care to each other. The mentioned strategy successfully responds to the difficult medical challenges arising during the detoxification of young people.
The system was finally based on holistic and family-oriented principles. Treatment responds complexly to the biopsychosocial and cultural needs of the patient and the family. Family therapy and risk reduction are considered a mandatory part of the process. Interests of the patient themselves and their family determine the decisions, which determines the adequacy of medical services.
Organizational Support
Authoritative organizations stand behind these large-scale changes. ASAM, which was founded in 1954, today unites more than 8,000 professionals. The activity of the organization serves to improve treatment accessibility, quality, education, and research, as well as to strengthen the role of the doctor in addiction care.
As for the “Hazelden Betty Ford Foundation,” it represents the country’s leading non-profit organization. The foundation manages a wide network of addiction and mental health services, including specialized centers and telemedicine across the entire country. The organization’s many years of experience and the rich traditions of the “Betty Ford Center” create the foundation for those innovative approaches that are being implemented in youth programs, publishing, and preventive research.
Future Plans
Many practical auxiliary means were developed to master the new standards. The levels of treatment and corresponding criteria are presented in detail on the official ASAM platform. Along with this, a webinar organized by “Hazelden Betty Ford” on April 16, 2026, will help specialists in the correct management of treatment programs and in the use of new guidelines in practice.
It is noteworthy that this publication represents only the second part of a four-volume set. It prepares the foundation for those future standards that encompass patients who are in the justice system and such behavioral addictions as gaming and gambling. A gradual development of this kind forms the ASAM criteria as an evidence-based and constantly progressing mechanism.
Despite the fact that problems of funding and infrastructure remain relevant, the mentioned publication establishes a specific strategy of action for interested parties. For clinicians, decision-makers, and families, this is a message that the treatment of adolescents should be established as a systemic priority. Such a vision will protect the future of young people before real danger threatens their lives.
Source: ASAM
