Substance Abuse Evaluations

Medically reviewed by

Jennifer Cousineau MSCP, LPCI, NCC

April 21, 2020

Once you start an addiction treatment program, you may receive a substance abuse evaluation. This evaluation is a tool used to determine the extent of your substance use and how treatment professionals can create an individualized care plan well-suited to your needs and situation.

The Purpose Of A Substance Abuse Evaluation

A comprehensive substance abuse evaluation:

• determines if you have a drug or alcohol addiction
• assesses the extent or level of addiction
• determines if there are any co-occurring conditions, including any physical or mental health concerns, as well as polydrug use
• assesses how substance use affects your life
• allows the treatment team to establish a baseline and build a treatment plan for your needs and recovery

What To Expect At A Substance Abuse Evaluation

An evaluation is broken down into two steps: screening and assessment. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines these steps as:

• Screening: a process for evaluating the possible presence of a particular problem, in which the outcome is normally a simple yes or no.
• Assessment: a process for defining the nature of that problem, determining a diagnosis, and developing specific treatment recommendations for the problem or diagnosis.

These components may be administered by a wide range of professionals trained to assess addiction. The professional responsible for this task could be a:

• social worker
• counselor
• therapist
• psychologist
• psychiatrist
• doctor
• nurse

Through written assessments and interviews, staff will inquire about your health history, past and present drug and/or alcohol use, the manner and behaviors by which it affected your life, and history of treatment. If the evaluation is administered by a physician, a physical may also occur.

Substance Abuse Screening

The screening is a preliminary evaluation that helps staff determine if there is a situation that warrants a more in-depth look.

It’s an important element of the process because it allows for preemptive care and support if it highlights a risk factor, helping you before your substance use progresses even further. This is the first step in helping you see if drug or alcohol abuse may be present.

These commonly used screening tools can be administered both online or in-person:

• CAGE Questionnaire: This is a widely used method that asks four questions in a brief, yet sensitive manner. One criticism of CAGE is its measure of usefulness in circumstances where you may try to shield the extent of your substance abuse.
• Alcohol Use Inventory (AUI): This is a self-administered screening tool for when you believe you have an issue with alcohol abuse. AUI is useful because it recognizes that each person has a set of unique perspectives associated with the risks, results, and lifestyle choices associated with drinking.
• Substance Abuse Subtle Screening Inventory (SASSI): SASSI is easy to both administer and score. It helps the assessor determine if your use extends past social drinking or recreational drug use, what level of seriousness your use implies, and how willing you are to identify problems and change.
• State Specific Inventories: Your state may have a screening tool that it uses in place or in addition to any of the tools on this list.

Though some screening methods can be done on your own or by family or friends, screening is most effective when it’s administered and reviewed by a professional who can assess the results and provide you with support and direction.

Substance Abuse Assessment

A substance abuse assessment is more thorough than screening tools. The purpose of an assessment is to find direct evidence that supports either the presence or absence of a condition that can be diagnosable, such as drug or alcohol addiction.

A diagnostic interview is performed when an interviewer goes over the results of the screening and asks more questions to get a better picture of your substance use. This could be a structured interview or a semi-structured interview.

A structured interview is a set of structured questions that make it easier for someone without an intense background in the field to administer. This interview may not result in the most detail, and information to use in an individualized treatment plan may be limited.

A semi-structured interview allows a more skilled professional to supplement the structured questions with ones derived from their specific expertise within the field. This allows them to better cross-examine your substance abuse.

Two widely used tools within the assessment process include:

• Diagnostic Interview Schedule-IV (DIS-IV): This is a fully structured questionnaire that determines the presence of a diagnosis as listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
• Addiction Severity Index (ASI): This is a semi-structured interview that assesses employment and support, drug use, alcohol use, medical status, psychiatric status, legal status, and family/social status. ASI addresses not only your use over the past thirty days but also the implications of use over the course of your lifetime.

Involvement Of Family Or Friends

You may be asked to sign a release that allows people with first-hand knowledge of your substance use to report their observations to the professionals assessing you. This information would only be collected from those closest to you and can help round-out the evaluation to better meet your treatment needs.

Evaluations For Entering A Treatment Facility

The first step of alcohol or drug rehabilitation—before treatment can even begin—is to have your substance use evaluated by the facility’s team. This evaluation gives staff a comprehensive perspective into your individual situation and reveals any special concerns that must be addressed.

For example, co-occurring mental health conditions must be addressed in addiction treatment. Mental health problems like depression or anxiety can worsen addiction if left untreated. During a substance use evaluation, you’ll also be screened for mental health concerns.

It’s important to remember that any information obtained during these procedures is confidential. The information is used for the sole purpose of creating and following through with the best method of care for your situation.

Court-Ordered Evaluations

If a charge involves drugs or alcohol, then a judge may order a substance abuse evaluation. This evaluation is administered from an agency that is certified through the state. Some states may require evaluation as part of the mandatory sentencing procedures.

A judge might require a substance abuse evaluation when you’re charged with:

• driving under the influence (DUI) or driving under the influence of drugs (DUID)
• minor in possession (MIP)
• drug or alcohol possession
• disorderly conduct
• public intoxication
• using a false ID

There are certain documents that you’ll need to bring to the evaluation, which may be furnished by yourself or your attorney should you have one. These may include:

• a copy of the results of your NEEDS Assessment if you went to a DUI Alcohol or Drug Use Risk Reduction Program (RRP)
• a report from the Department of Driver Services or Department of Motor Vehicles detailing your driving history (generally going back 7 years)
• a copy of any criminal history or arrests
• a copy of the arrest report

During the course of the evaluation, which typically takes between 60-90 minutes, you’ll have an interview with a person who is trained in substance abuse treatment. They will do an in-depth review of your substance abuse history and look over the documents you provide.

What’s The Point Of A Court-Ordered Evaluation?

A court-ordered evaluation determines if an ongoing condition like substance use disorder (SUD) is present, or if there is not enough evidence to support a diagnosis. Even if there isn’t enough evidence, many states will still require you to undergo various programs or treatment obligations as deemed acceptable by the court.

Depending on the state, the incident/sentencing, and the recommendations of the agency that evaluated you, you may be required to attend one or more of the following:

• DUI Alcohol or Drug Use Risk Reduction Program (RRP)
• random drug and/or alcohol urinalysis
• AA or NA meetings
• substance abuse education classes
• substance abuse counseling sessions
• an inpatient or outpatient treatment program

Even though you did not choose these circumstances, it’s advantageous for you to begin this process immediately. Not only does this exhibit to the judge and prosecution that you take your responsibilities seriously, but it also helps coordinate the care and support you may need.

A Substance Abuse Evaluation Is A Tool To Help You Succeed

Though you might feel embarrassed, ashamed, or inclined to not be forthcoming about your substance use, an evaluation is ultimately for your own benefit. Treatment professionals cannot fully develop a plan without knowing your history of substance abuse or addiction.

This is also a time for you to be honest about any other factors that may influence your recovery options. The more honest you are, the greater the benefits. If you hide any habits or information, you’re only hurting yourself and hindering your chances for a healthier life.

If your substance abuse is having a negative impact on your life, or if you see this behavior in someone you love, don’t hesitate any longer—contact us today.