Residential High-Intensity Addictions Treatment (ASAM Level 3.5)

1116 E 20th Street LLC provides Residential High-Intensity Addictions Treatment (ASAM Level 3.5) for adults who require a highly structured, clinically managed residential environment with intensive therapeutic services to support recovery from moderate to severe substance use disorders.

This level of care is designed for individuals who are capable of self-care and clinically stable, yet not ready to return to independent or family living due to the severity of their substance use disorder, limited insight into relapse risk, or the need for continuous structure and monitoring. Residential Level 3.5 treatment provides 24-hour care, a strong therapeutic community, and a high level of clinical engagement to support stabilization, recovery skill development, and long-term community reintegration.

Entry Criteria (ASAM Level 3.5)

To be admitted, individuals must demonstrate motivation for treatment and meet ASAM Level 3.5 criteria, which may include:

• A diagnosis of moderate or severe substance use disorder
• No signs or symptoms of withdrawal, or withdrawal needs that can be safely managed in a Level 3.5 setting
• Biomedical conditions, if present, that are stable and do not require skilled nursing care
• Cognitive impairments related to the severity or duration of substance use
• Physical or mental disabilities resulting from prolonged substance-related disorders
• Limited recognition of relapse triggers or limited insight into the risks of continued substance use
• Continued substance use that poses imminent danger or harm to self or others without 24-hour monitoring
• A recovery environment, social network, or coping ability that places the individual at high risk of neglect, abuse, or continued substance use

24/7 Residential Care & Intake

This program operates as a true residential treatment program, meaning participants live on-site and receive 24-hour care, supervision, and monitoring.

• Intake and admissions are available 24/7
• Residential support and monitoring are provided at all times to ensure:
  • Safety and structure
  • Continuous engagement in the therapeutic environment
  • Crisis response and risk reduction
  • Support with daily living needs

Therapeutic Intensity & Frequency of Services

Residential High-Intensity (ASAM Level 3.5) treatment provides the highest level of therapeutic engagement within residential care.

Participants receive:

• A minimum of 36 hours of therapeutic activities per week
• Moderate- to high-intensity treatment and ancillary services
• Services that rely on the treatment community as a primary therapeutic agent
• Interventions focused on:
  • Relapse prevention
  • Recovery skill application
  • Behavioral change
  • Emotional regulation
  • Preparation for community reintegration

A minimum of five (5) hours per week is directed specifically toward preventing relapse, applying recovery skills, and reintegrating into the community.

Length & Frequency of Stay

Residential High-Intensity services are authorized based on medical necessity and individual treatment needs.

• Up to two non-consecutive residential stays per rolling calendar year
• Up to 30 days per stay
• Continued stay is subject to authorization and ASAM criteria

Exceptions may apply for court-ordered specialty populations, including:

• Health-General §8-507
• Title 3 commitments

Transition & Discharge Planning

Discharge and transition planning begins at admission and continues throughout all phases of treatment.

A participant is ready for discharge or transition when:

• Individual treatment goals are achieved
• Recovery supports are established
• Referrals to ongoing services are completed, when appropriate

Transition planning emphasizes continuity of care and long-term recovery stability.

Program Goals

The overall goal of Residential High-Intensity treatment is to increase quality of life through specialized addiction treatment services, while reducing the need for higher levels of care.

Areas of focus may include:

• Recovery and relapse prevention
• Education and vocational development
• Parenting and family relationships
• Emotional regulation and coping skills
• Anger management
• Grief and loss
• Spirituality, when desired

Specific objectives include:

• Improving mood and affect in daily living
• Improving social, family, and community integration
• Reducing the likelihood of hospitalization or higher levels of care