Substance Abuse Evaluations

The substance abuse evaluation is then used as a tool to determine:

• The extent of the substance use disorder
• The presence of any co-occurring disorders
• How substance use has impacted the patient’s life
• A guideline for developing a recovery treatment plan that is carefully crafted to suit the patient’s specific needs

Addiction professionals rely heavily on substance abuse evaluations in directing their efforts to make an effective recovery plan for each individual patient.

What to Expect During a Substance Abuse Evaluation

Hearing terms like “drug evaluation” or “alcohol evaluation” can be intimidating for a patient. However, it is important to keep in mind that the main purpose of the substance abuse evaluation is to develop a tailored plan. This means that every step of the recovery journey from there on out will take into account the patient’s specific history, needs, and general well-being.

In most cases, the substance abuse evaluation is broken up into two parts: an initial screening and a comprehensive assessment:

• Screening: the initial screening aims to determine if a substance abuse problem is present, the results are typically either yes or no.
• Assessment: this part of the evaluation serves to determine the type of problem, establishing a diagnosis, and then creating a specific recovery treatment plan based upon the problem and diagnosis.

A number of different addiction treatment professionals may administer a substance abuse evaluation. In fact, the person administering the evaluation can range from an entry-level professional to a highly-trained professional. The most common people responsible for this assignment include:

• Doctor
• Nurse
• Psychiatrist
• Psychologist
• Therapist
• Counselor
• Social Worker

With a combination of written assessments and interviews, the addiction professionals will gather information about the patient’s health, drug and/or alcohol usage history, history of recovery treatment, and the behaviors that have impacted their life.

Substance Abuse Screening

As the preliminary portion of the substance abuse evaluation, the initial screening lays the groundwork for the next steps for both the staff and patient. Since so much of the treatment plan is based upon the screening, it is a highly important part of the process. There are a variety of screening tools available and they can be administered either in-person or online.

Some of the most common substance abuse screening tools include:

• Alcohol Use Inventory (AUI): this screening tool is self-administered who patients who believe that they are suffering from an alcohol abuse issue.
• CAGE Questionnaire: this is the most commonly used screening tool and is based on four questions, harnessed by the acronym CAGE. It asks if the patient feels they should cut down on drinking, if people have annoyed the patient by criticizing their drinking, if the patient feels guilty about drinking, and if ever engaged in an eye-opener drink (an alcoholic beverage first thing in the morning to alleviate a hangover).
• State Specific Inventories: in addition to or in place of the other screening tools, the patient’s state may have a screening tool that they utilize.
• Substance Abuse Subtle Screening Inventory (SASSI): this screening tool serves to determine the likelihood of a substance use disorder. It is known for being easy to administer and quite helpful in determining the scope and breadth of the substance abuse disorder.

While it is possible to do screenings at home with a loved one, the best results are achieved when the screening is conducted and reviewed by an addiction professional.

Substance Abuse Assessment

The second part of the substance abuse evaluation is known as a substance abuse assessment. This form of assessment is more thorough and accurate than that of a screening tool. In administering a substance abuse assessment, the addiction professional will aim to ascertain direct evidence to uphold the existence or nonexistence of a drug addiction or alcohol addiction.

After reviewing the initial screening, a diagnostic interview takes place in order to gain a better understanding of the patient’s substance use. There are two approaches to conducting the diagnostic interview:

• Structured Interview: using a set of specific questions, the interviewer sticks to the script and is thus less equipped to gather appropriate details about the substance abuse disorder.
• Semi–Structured Interview: an addiction professional with experience and skill is able to ask the interview questions while supplementing with additional questions that paint a clear picture of the substance abuse disorder. This is the most effective way to develop an individualized treatment plan.

While there are a variety of substance abuse assessments available, the two most common include:

• Addiction Severity Index (ASI): this assessment is a semi-structured interview that aims to evaluate alcohol use, drug use, medical condition, employment and support, psychiatric condition, family and social situation, and legal status. The ASI looks at the patient’s lifetime of substance use, not just the past 30 days.
• Diagnostic Interview Schedule–IV (DIS-IV): this is a structured interview that seeks to diagnose in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

Court-Ordered Drug Evaluations and Alcohol Evaluations

A legal case may cause for a judge to order a substance abuse evaluation through a state-certified agency. In some states, drug evaluations or alcohol evaluations are a mandatory part of the sentencing procedures.

The following charges often require a substance abuse evaluation:

• Disorderly conduct
• Driving under the influence (DUI)
• Driving while intoxicated (DWI)
• Minor in possession (MIP)
• Possession of false identification
• Public intoxication

In addition, you may be required to bring documentation to your court-ordered evaluation. These documents may be provided by you or your lawyer. The documents required may include:

• A copy of the arrest report
• A copy of your past arrests or criminal history
• A report from the Department of Motor Vehicles that outlines your driving history
• A copy of the NEEDS Assessment results, if you were enrolled in a DUI Alcohol or Drug Use Risk Reduction Program (RRP)

The Importance of a Substance Abuse Evaluation

While it may feel intimidating or even embarrassing to undergo a substance abuse evaluation, it is important to remember that doing so is best for you and your addiction recovery journey. In order to establish a path to sobriety, an addiction professional must create a tailored recovery treatment plan for you and this beings with a proper substance abuse evaluation.