The Assessment and Diagnosis of Substance Abuse

Screening and assessment for substance abuse involve the evaluation to determine whether there are signs of substance abuse and establish whether there is a diagnosable level of drug abuse. After the screening process shows that the client has potentially abused a substance, the assessment is conducted in order to determine whether it calls for the treatment of the problem. Professionals involved in the screening and assessment can use various methods. Hence, there is a need to consider the best method to apply by looking at the various factors. The methods available for the process and the factors to consider when selecting the method are discussed (Segal & Hersen, 2010). In addition, the differences in techniques applied in related disorders from those in the process of addictions are also discussed.

There are five key methods: the Adult substance use survey, the Alcohol use disorders identification test, CRAFFT, and the Michigan alcohol screening test. The adult substance use survey is a 64-item survey applied to assessing individuals perceived to have abused alcohol and other drug use. The method is also applied in the identification problem in emotional or mode adjustment by asking a client questions biased to mental health screening. The WHO developed the alcohol use disorders identification test to assist professionals in the identification of whether an individual’s alcohol consumption has turned harmful to his/her health. The method involved written and oral administration but may not effectively determine whether the client has reached the diagnostic criteria. CRAFFT is a six-item based screening where screening on alcohol and drug use among adolescents is conducted and is biased toward risky drinking than diagnostic issues. Michigan alcohol screening test is a 25 item and is used in diagnosable abuse or dependence (Segal & Hersen, 2010). The method is based on alcohol and, therefore, should be paired with other methods in case there are issues with drug abuse.

The selection of the screening and assessment tool should consider three key factors. Each of the tools would require different expertise and time for the administration. It is important for the professionals involved to ensure that the method adopted can be supported by the personnel available and that it is adequate for the administration. The other factor to put into consideration is the credibility of the test, where approval from academic and treatment professionals. The third element to consider is the client’s motivation and verbal and reading skills to be assessed and screened.  A client who cannot read or write should be assessed using methods in which oral questioning and interaction occur (Abueg & Fairbank, 1992). Lastly, the method selected should be valid to ensure that it measures the intended elements and is reliable in proving results upon which the right decision can be made.

The screening and assessment techniques applied in substance-related disorders differ from those used in measuring addictions. The techniques applied to substance-related disorders assessment and screening are considered to be simply less costly and less time-consuming. The professional involved in the screening and assessment can be used simple oral interaction. After a few questions, it would be easy to determine whether an individual suffers from a substance-related disorder. On the other hand, assessment and screening used in measuring addition are intensive, time-consuming, and costly. Experts involved should have the knowledge and experience on the type of addiction the client suffers from, the process is intense as it aims at determining the noxious level at which the client is at the given time (Ball & Young, 2000). The overall objective of testing the addiction level is to pave the way for the diagnosis and treatment of the client. 



Abueg, F., R., &  Fairbank, J., A. (1992). Behavioral treatment of posttraumatic stress disorder and co-occurring substance abuse. In: Saigh, P.A., ed. Posttraumatic Stress Disorder: A Behavioral Approach to Assessment and Treatment. Boston: Allyn and Bacon, 1992. pp. 111–144.

Ball, S., A, & Young, J., E. (2000).  Dual focus schema therapy for personality disorders and substance dependence: Case study results. Cognitive and Behavioral Practice. 7(3):270–281.

Segal, D. L., & Hersen, M. (2010). Diagnostic interviewing. New York: Springer.

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