Drug Assessment: What to Expect
A drug assessment is usually one of the first steps in treatment when entering a drug or alcohol rehab. These evaluations help clinicians develop an appropriate detox and treatment plan based on the types of substances abused and severity of addiction. Specific drug assessment tools vary by treatment program and provider. According to substance abuse and co-occurring disorders assessment guidelines created by the Substance Abuse and Mental Health Services Administration (SAMHSA), some of the main components of a mental health and drug assessment might include the following:
Substance Abuse Subtle Screening Inventory (SASSI) — The SASSI helps clinicians assess clients who have a high probability of having a substance use disorder. It also helps them evaluate the patient’s beliefs around their substance use — for instance, whether they consider it a problem and their readiness to change their behaviors and get help.
The Alcohol Use Disorders Identification Test (AUDIT) — This self-report survey assesses attitudes, behaviors and use of alcohol, helping to determine problematic drinking patterns. Questions include inquiries into how often and how much the individual drinks as well as whether alcohol use has interfered with their family, work and social obligations.
CAGE Questionnaire — The CAGE assessment is a four-question survey used to assess alcohol abuse. Questions center around areas like the ability to cut back on drinking, feeling guilty about drinking and needing alcohol to feel “normal.”
Laboratory tests — A drug assessment usually includes a urine test and sometimes a blood test. These drug screens determine the types of substances a client has been using.
Background/history — Treatment providers gather details about a client’s behavioral health history and substance use patterns and those of their family members. They also obtain information about physical and mental illnesses experienced by the client and immediate and extended family.
Mental health assessment — A mental health professional gathers information about co-occurring mental health symptoms and confirms or revises existing mental health disorder diagnoses. Examples of mental health assessment tools that might be used include:
- University of Rhode Island Change Assessment Scale (URICA)
- Mental Health Screening Form-III
- Symptom Distress Scale (SDS)
- Minnesota Multiphasic Personality Inventory – II (MMPI-II)
- Millon Clinical Multiaxial Personality Inventory – III (MCMI-III)
- Mini-Mental State Examination (MMSE)
Clients might also undergo trauma assessments, as this can be an underlying issue for substance use disorders that should be addressed in treatment.
Safety screening — Patients may also be assessed for their risk of self-harm. Some of these screening tools include:
- ASAM PPC-2R — Identifies considerations for immediate risk of self-harm.
- Components of the ASI and Global Appraisal of Individual Needs (GAIN) LOCUS — Determines the severity of risk of harm and appropriate level of care.
Physical assessment — Patients may undergo a physical exam to determine the impact substance use has had on their bodies. Physical exams may include blood tests, urinalysis, and blood pressure and weight checks.
The end goals of drug assessments are to determine the types of substances used, the severity of drug abuse and identify any co-occurring conditions — and then figure out the best way to help the patient. It’s an important step in the recovery process, providing information that will help clinicians create treatment approaches that begin repairing clients’ physical and mental health.