Substance Abuse Assessment for Drug & Alcohol Addiction

A substance abuse assessment can help a treatment provider diagnose your substance addiction and determine the nature of it, such as its severity. They can then use this information to refer you to the appropriate level of care, such as inpatient rehab or outpatient addiction treatment. Conversely, if you choose to enter a rehab program first, then the first thing the treatment team will do is conduct a substance abuse assessment to guide your treatment planning.

In this article:

What Is a Substance Abuse Assessment?

A substance abuse assessment is an evaluation conducted by a treatment professional, such as a doctor, substance abuse counselor, or psychologist. The purpose and goals of a substance abuse assessment include:

  • Determining if you have a substance use disorder, the clinical term for an addiction
  • Evaluating the extent and nature of the substance use disorder
  • Determining the presence of co-occurring medical or mental health disorders, as well as polysubstance use
  • Evaluating how your drug and alcohol misuse impacts various aspects of your life
  • Building a treatment plan for addiction treatment

What Is the Difference Between a Screening and Assessment?

Although substance abuse screening and assessment may be used interchangeably, they actually have different meanings and functions. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), a screening assesses the presence of a condition, such as a drug or alcohol addiction. The outcome of a screening is typically a yes or no answer as to whether the disorder is present.1

A substance abuse assessment is more comprehensive and dynamic—it not only establishes the presence of a substance use disorder but it also defines the nature of the condition, such as longevity and severity of the addiction, as well as other factors that may have contributed to it. An assessment also includes treatment recommendations, such as inpatient rehab.1

Who Can Conduct a Substance Abuse Assessment?

Many different treatment providers and professionals can conduct a substance abuse assessment, including:

  • Doctor
  • Nurse
  • Psychiatrist
  • Psychologist
  • Therapist
  • Substance abuse counselor
  • Social worker

Ultimately, the person who conducts your addiction evaluation will depend on your needs and preferences. If you feel very comfortable with your therapist, you may want to ask them to conduct it, especially if you’ve already opened up about substance use challenges. Conversely, if you don’t have a psychologist or therapist and you have a good relationship with your primary care doctor, then you may ask them to conduct one.

Where Can I Get an Assessment?

You can receive a substance abuse assessment in a variety of settings, including:

  • Doctor’s office
  • Hospital-based setting
  • State-certified agency for court-ordered substance abuse assessments
  • Outpatient rehab program
  • Inpatient rehab program
  • Detox facility

What Types of Substance Abuse Assessment and Screening Tools Are Used?

A variety of screening and assessment tools may be used to diagnose your substance use disorder as well as any other related problems. The tools used may depend upon the substance you use as well as the provider, cost, and administration time.

Screening Tools

Screening involves determining the presence of a substance use disorder, typically by a short interview or written questionnaire. Think of it as a preliminary tool to determine if the treatment professional should then conduct an assessment. Substance abuse screening is also helpful because it can determine problematic substance misuse before to progresses to an addiction, allowing providers to recommend preventative services, such as counseling.

These substance abuse screening tools are commonly used to determine the presence of an addiction:1,2

  • The Alcohol Use Disorder Identification Test (AUDIT): A tool, which can be self-administered and read by a provider, consisting of 10 questions related to harmful and problematic alcohol misuse.
  • The Texas Christian University Drug Screen II (TCUDS II): A self-administered screening tool consisting of 15 questions, some of which are based on diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM).
  • CAGE Questionnaire: A tool comprised of four questions measuring lifetime drug and alcohol misuse, with the normal cutoff for substance use disorder being two “yes” answers; however, one positive answer could indicate an addiction or problematic substance use.
  • Screening to Brief Intervention (S2BI): This screening tool is designed to measure substance misuse in adolescents by categorizing their drug and alcohol use into various risk categories.
  • Opioid Risk Tool (ORT): This self-report screening tool measures the risk of opioid misuse in adults who are prescribed painkillers for chronic pain management.

Assessment Tools

After a brief screening, your treatment provider will conduct a substance abuse assessment. There are many different tools, including:1,2

  • Addiction Severity Index (ASI): ASI is a commonly used substance abuse assessment tool that is administered as an interview, evaluating many areas of a person’s life, including substance misuse, mental health, physical health, employment, finances, legal situation, and relationships.
  • The Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) Tool: TAPS combines screening and assessment into one tool, broken up into two stages, which can be self-administered or conducted as an interview by a treatment provider.
  • CRAFFT: This tool, designed to assess substance abuse in teenagers and young adults between the ages of 12 and 21, conducted as an interview or a self-assessment.
  • The Structured Clinical Interview for DSM-5 (SCID-5): SCID-5 is a structured interview intended to diagnose alcohol use disorder and other substance use disorders, based on the criteria from the DSM-5.

Self-Assessment for Addiction

Only a treatment professional can diagnose you with a drug or alcohol addiction; however, taking a self-assessment for addiction can help you to determine if your substance misuse is problematic.

The following self-assessment is based on the criteria for substance use disorder in the DSM-5:3

1. Do you often use substances in larger amounts or for longer than intended?
2. Have you found that you are unable to cut down or control substance use?
3. Do you spend a significant amount of time obtaining and using substances, as well as recovering from the effects?
4. Do you experience strong cravings to use drugs or alcohol?
5. Does your substance use affect your ability to meet responsibilities at home, school, or work?
6. Do you continue to use drugs or alcohol despite relationship problems caused by use?
7. Have you found that you neglect previously enjoyed hobbies or important activities due to substance use?
8. Do you repeatedly use substances in dangerous situations, such as while driving?
9. Do you continue to use alcohol or drugs despite psychological or physical issues caused or worsened by use?
10. Do you find that you need higher amounts to obtain the same desired effects?
11. Do you experience withdrawal symptoms when you reduce or stop use?

If you answered “yes” to two or more questions, you may have a substance use disorder and could benefit from a professional evaluation and addiction treatment.

Does Insurance Cover a Substance Abuse Assessment?

Most insurance plans and providers cover a substance abuse assessment as well as various types of addiction treatment, such as detox, inpatient treatment, and outpatient rehab. This includes private insurance providers as well as Medicare and Medicaid.

However, every insurance plan has different coverage details, so you’ll want to check with your provider to verify your coverage.

Court-Ordered Drug and Alcohol Assessments

If you are charged with an offense related to drugs or alcohol, a judge may order a drug or alcohol assessment, administered by a state-certified agency. Every state operates differently, but some may require a court-ordered substance abuse assessment as part of the sentencing procedure.

A judge could require a court-ordered alcohol and drug assessment if you’ve been charged with:

  • Public intoxication
  • Disorderly conduct
  • Underage alcohol possession
  • Drug possession
  • Using a fake ID
  • Driving under the influence (DUI)
  • Driving under the influence of drugs (DUID)

Much like standard substance abuse assessments, a court-ordered evaluation can determine if you have a drug or alcohol addiction or are at risk of developing one.

If the test administrator diagnoses you with a substance use disorder, you may be required to attend:

  • Narcotics Anonymous (NA) or Alcoholics Anonymous (AA) meetings
  • Random alcohol/drug urine tests
  • Substance abuse counseling
  • Substance abuse education classes
  • Drug Use Risk Reduction Program (RRP)
  • Inpatient or outpatient rehab

What Happens After a Substance Abuse Assessment?

After administering the substance abuse assessment, the treatment professional will determine if you meet the criteria for a drug or alcohol addiction. They will then recommend treatment options, such as:

  • Standard outpatient care
  • Intensive outpatient programs (IOPs)
  • Partial hospitalization programs (PHPs)
  • Inpatient alcohol and drug rehab

If you receive your assessment at a rehab facility, your treatment team will use this information to create an individualized treatment plan that takes your unique needs into consideration. A sample addiction treatment plan may include:

  • Individual therapy, such as cognitive behavioral therapy (CBT)
  • Group counseling
  • Family therapy
  • Peer support meetings
  • Drug education and relapse prevention
  • Addiction treatment medications or medication-assisted treatment
  • Aftercare planning

If you have been diagnosed with a substance use disorder or suspect that you have an addiction, call our helpline at 800-662-4357 to find the right rehab program for you. One of our treatment support specialists is available 24/7 to assist you.

Resources

1. Substance Abuse and Mental Health Services Administration. (2009). 4 Screening and Assessment. In Treatment Improvement Protocol (TIP) Series, No. 51. Substance Abuse Treatment: Addressing the Specific Needs of Women [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US).
2. National Institute on Drug Abuse. (2022). Screening and Assessment Tools Chart.
3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

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