According to the American Society of Addiction Medicine (ASAM)’s criteria levels of care, there are five types of detoxification strategy that may be administered to patients with alcohol or substance abuse disorders. Two of these strategies involve medically monitored detoxification for the more intense cases of withdrawal: Level III.7-D and Level IV-D.
Level III.7-D is medically monitored inpatient detoxification and is used to treat severe cases of withdrawal. Patients assigned to this level of treatment require 24-hour nursing care and physician supervision, evaluation, withdrawal management and visitation when necessary. It usually takes place within a licensed health care facility, rehabilitation facility or a freestanding detoxification center. If the patient experiences no complications after two to three days at Level III.7-D, then staff may place the patient in a lower level of detoxification, such as Level III.5-D, which involves a therapeutic community, providing continued support during withdrawal, structural support during risk of relapse and reinforcing commitment to the program.
Level IV-D is medically managed intensive inpatient detoxification and is used to treat severe and unstable cases of withdrawal. These patients require 24-hour nursing care and daily physician visitation. This level of care is similar to the medical setting provided in Level III.7-D, but patients at Level IV-D require primary medical and nursing care services. Treatment may take place in a psychiatric hospital, general care hospital or a chemical dependency specialty care facility with life-support equipment available.