Substance Abuse Evaluation Tools & Forms
When trying to determine if someone is likely to use substances, experts must craft a full picture of their lives. This includes everything from the history of use in their families, instances of neglect and abuse at a young age, as well as intrinsic factors like genetic predispositions. It takes a carefully devised evaluation that mixes the perspective of the person who uses and scientific research in equal measure.
Deciding to take an evaluation for symptoms of substance abuse is a valuable first step toward getting help. The decision can be made by the individual who is using, concerned family members or, in certain cases, by court order.
Evaluations take different forms, but all of which intend to uncover the same information. First and foremost being if someone has a substance use problem at all. From here, physicians can use assessments to determine the extent of the issue at hand, the effect it has on the person’s life, and begin the process of crafting a substance abuse treatment plan if necessary.
Each type of evaluation fits into two overreaching categories: screenings or assessments. The screening process is helpful for both identifying those who are abusing drugs and alcohol, as well as those who may potentially do so in the future. Screens are preliminary attempts at pinpointing whether a full assessment is vital for a given individual. They are an identification tool, not a decision-making tool.
This procedure is dependent on likelihoods of substance abuse, as such, the end result of these screenings is often a straightforward answer of yes or no.
Three such screening tools are put into practice: the CAGE questionnaire, Alcohol Use Inventory (AUI), and the Substance Abuse Subtle Screening Inventory (SASSI). A brief description of each can be found below.
CAGE:
Even though it is considered a questionnaire, at only four questions in length, it hardly qualifies. The answers are not required to be long either; yes-or-no responses will suffice. Though this method is concise, it only works if the person is willing to divulge their substance use behavior. This can be a serious hindrance if they are not seeking treatment voluntarily. If they are not upfront and honest, the CAGE questionnaire becomes virtually useless.
AUI:
This screening tool is intended for supposed alcohol abuse only. This approach is more in-depth than CAGE, in that the questions take feelings, attitudes, behaviors, and lifestyle into consideration. Despite the more robust line of questioning, AUI is also plagued by the same potentially fatal flaw: the need for transparency.
SASSI:
A SASSI screen delves deeper into the psychological side of substance use. It measures the responses as well as how the responses are given, i.e. openness, defensiveness, aggressiveness, and the like to determine if someone may be abusing substances.
Addiction Severity Index:
An ASI is a semi-structured interview which helps brings to light recent and lifetime use habits. This form is extensive and is thus used as a standardized measurement tool to assess those entering rehabilitation. Throughout the interview, the administrator will be able to touch upon considerations of medical history, substance use, time in custody if any, whether the person has a job, their relationship and familial statuses, and mental health.
Diagnostic Interview Schedule-IV:
If ASI is semi-structured, it should come as no surprise that the DIS-IV is the structured alternative. All questions administered from this interview are created by knowledge acquired from the Diagnostic and Statistical Manual of Mental Disorders. While thorough in its own right, it may lack the most recent research into substance abuse. The questions may suffer as a result.
In this way, personal evaluations may not be enough. Onsite substance abuse testing removes all subjectivity for an objective measurement. Urinalysis is a preferred method of determining whether someone has taken a substance with the last three days — or up to 30 days for cannabis. The time frame of such tests make them effective for identifying short-term use, but they lack the foresight of whether abuse is a longstanding issue or not. Put simply, there is no laboratory test for dependence or addiction.
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