What To Expect At A Substance Abuse Assessment And Evaluation

What Is A Substance Use Disorder Assessment Or Evaluation?

Treatment is available for anyone who is struggling with substance use disorder or addiction. Many of these services are designed to be tailored to individual needs. Providers need to have an evaluative process that can be used to create individualized, evidence-based treatment, and that process includes a substance use disorder assessment.

There are many feelings a person experiences when standing face to face with their own substance misuse, use disorder, or addiction. All too often, shame and embarrassment keep a person from reaching out for treatment. Sometimes, nervousness and fear over not knowing what to expect can make reaching out for treatment seem even more impossible. Knowing how the process starts and what to expect early on can help a person finally accept the help they need.

When exploring treatment options for substance use disorder and addiction, obtaining a substance use disorder evaluation is typically how that journey begins. Assessments and evaluations are used to explore addiction, the degree of addiction, and additional potential diagnoses (co-occurring disorders or conditions). Using the results of the assessment can help form the foundation for an individual’s substance abuse treatment.

The Motivation Behind A Substance Use Disorder Evaluation

The purpose of a substance use disorder evaluation is to explore the following:

• establish if the person meets criteria for a substance misuse disorder (drug or alcohol use disorder or addiction)
• find out the degree or severity of the substance misuse disorder
• explore the possibility of a co-occurring disorder or poly-drug use
• discover how much substance use is affecting the life of the individual

All of the information obtained during the substance use disorder evaluation is used to gain understanding and insight into the individual being assessed. Being able to see the circumstances connecting substance use disorder and the person can help providers develop individualized treatment plan options with a solid baseline and focus on recovery.

Substance Abuse Evaluation Expectations

Substance abuse evaluations are divided into two separate sections. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the sections of a substance abuse evaluation are screening and assessment.

Substance Abuse Screening

Substance abuse screening evaluates if a person’s substance use may need further exploration for the potential of an abuse disorder. There are different types of screening, and the result of a screening is usually yes (positive) or no (negative).

If the answer is yes (positive), it is used to indicate that a closer look is needed to determine if the substance use may warrant treatment.

Different types of screenings for substance abuse include:

• Substance Abuse Subtle Screening Inventory (SASSI) – a self-report that is easy to take, administer, and score. This screening tool has scientific evidence supporting 93 percent accuracy when identifying substance use disorders
• CAGE questionnaire – This screening tool’s acronym stands for Cut down, Annoyed, Guilty, and Eye-opener, which are the four areas the questions address. It assesses alcohol misuse in four simple questions. Because it is brief and non-invasive, it’s important that the person answering the questions is honest and doesn’t try to cover their use.
• BSTAD (Brief Screener for Alcohol, Tobacco, and other Drugs) – For use in teens and adolescents, this self-assessment can be taken online with or without a clinician present. Results should only be interpreted by a professional.
• TAPS (Tobacco, Alcohol, and other Drugs – a versatile screening tool that offers a more in-depth screen, online or face-to-face administration, and explores recent and past substance use habits. Results still need to be reviewed with a professional.

Screenings are also available for specific substance use, including alcohol and opioids, as well as specific demographics, such as teens, adults, and pain management patients. Some states have specific screenings that they prefer to be used when conducting a screening for substance abuse and addiction.

It is important to understand that a screening tool is not an assessment. A screening for substance use is one of many tools used to determine if further assessment is needed. The results of all screenings and assessments should always be analyzed by a qualified individual.

Substance Abuse Assessment

The assessment process is more in-depth. This is a way to further define and explore the results of the screening. These results can be used to diagnose and create recommendations for treatment services.

Assessments involve obtaining a thorough history of the patient. They explore previous substance use, mental health, physical health, medical history, family history, and personal history. The interview process is conducted either by a structured interview or a semi-structured interview, and most professionals in the field use the following resources when conducting an assessment

Structured Clinical Interview for DSM-5 (SCID-5) uses structured questions to explore the potential diagnoses within the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 was published in 2013 and updated in 2022 as the DSM-5-TR, and it contains all mental health diagnoses, including substance use disorders.

This manual also provides questions to provide a range (mild, moderate, severe) of substance misuse. The diagnostic criteria from this manual are accepted by medical and substance abuse facilities. This method is very structured, and it is not recommended that the person interviewing deviate very far from the questions as written.

The Addiction Severity Index (ASI) uses a semi-structured interview process. Because the person being assessed is asked questions about both recent and past substance use, a pattern of abuse can be documented. This index also provides a thorough assessment of seven areas that tend to be affected by substance abuse and addiction. Individuals using this index tend to use their expertise in the field to further understand the depth of the client’s addiction. The results of this assessment can be used to focus treatment goals and build a plan or service for the patient.

It is common for more than one person to assess a person during this assessment process. This is to make sure that the facility gathers as much information as possible. Additionally, a provider may ask to speak with friends or family members to better understand how substance abuse is affecting the life of the person being assessed.

Many substance use assessments can also now be completed via telehealth, making it easier for individuals to begin the evaluation process from home.

Co-Occurring Diagnoses And Evaluation Results

It is not uncommon for a person who is struggling with substance abuse to also be struggling with a mental health issue as well. Depression, anxiety, and even mood disorders can sometimes happen at the same time as a substance abuse disorder, called co-occurring disorders. While it isn’t always clear if the mental health issue is a result of the substance abuse or if the substance abuse is an attempt to self-medicate the mental health issue, it is important to treat both conditions at the same time to help increase the likelihood of long-term sobriety.

Co-Occurring diagnoses are not limited to mental health issues. There are physical conditions that can occur alongside substance use disorders. Liver disease, infections, STDs, and diseases associated with intravenous drug use are among the few co-occurring physical issues associated with substance abuse

Who Conducts A Substance Abuse Evaluation

The people conducting these evaluations are professionals who have been educated in the substance abuse or mental health fields and are trained to administer these assessments. Substance abuse counselors, mental health counselors, therapists, psychologists, psychiatrists, medical professionals, and psychometrists are just a few of the professionals who are qualified to give these types of assessments.

The results of a substance abuse evaluation and assessment are confidential. The results should only be used to help evaluate addiction and explore treatment options that meet the needs of the person being assessed. There are some circumstances when results may be requested by the court or legal system, but only the relevant documentation is provided. If there is any question about information that may be disclosed, the person giving the assessment should be able to answer those questions or find the answers.

How A Substance Abuse Evaluation Helps In Substance Abuse Treatment

Substance abuse evaluations determine how substance abuse is affecting the life of the person struggling with substance abuse. The assessment will gather enough information to provide a thorough history, which shows patterns of abuse, triggers, substances that are being abused, substances that have been used previously, and problems that have occurred as a result of substance abuse.

These evaluations also allow the treatment facility to explore what is important to the person seeking treatment and discover what the person wants to see as a result of treatment. In this way, the rehab center determines if they can meet the needs of the patient and, if so, then develops a treatment program that is uniquely designed with the patient in mind.

To begin the journey to sobriety, browse our website to find a treatment center to contact today.

Written by the Addiction Resource Editorial Staff