Learn more about substance use assessment and screening in a mental health facility.
In this section we will learn about accessing the needs of your patients, referred throughout the article as clients, and how to screen a client for potential substance use or mental health problems. We will also learn how to perform a brief intervention if a client is identified as a person at risk following assessment and screening.
Assessing Substance Use
Assessing the needs of your clients is always the first step before recommending any intervention or treatment. An assessment can simply mean engaging a person in a meaningful conversation about what’s going on in their lives. People in addiction treatment with the comorbidity of mental health and substance use problems, known as dual diagnosis, may have challenges around legal issues, homelessness, housing, family, and medical and mental health challenges (13).
The process of assessment should be conducted within an atmosphere where practitioners and individuals share the power to plan and deliver care and support together. Therefore, an assessment will not be exactly the same for everyone and should be -specific to the individual’s circ*mstances. The focus of assessment should involve providing information, advice and assistance which guides the person to engage with services that provide support so the client can achieve their desired outcome (14).
Want to keep learning?This content is taken from Trinity College Dublin online course, Identifying and Responding to Drug and Alcohol Addiction in Nursing, Midwifery and Allied Healthcare PracticeView Course
For people with anxiety problems resulting from a pending legal case or the threat of homelessness, for example, it may mean listening to the cause of anxiety and providing the information they need to access legal or homeless services.
However, if the client has experienced a significant life event such as the death of a close family member and has begun to self-medicate, an assessment may lead to the need for a mental health or substance misuse screening assessment.
A number of screening tools are used for detecting mental health issues or harmful substance use. For example, the CORE 10 is a mental health screening tool for detecting possible psychological issues. The Alcohol Use Disorder Identification Test (AUDIT C) and the Fast Alcohol Screening Test (FAST) are commonly used assessment tools for alcohol use. The Drug Use Disorders Identification Test (DUDIT) and Drug Abuse Screening Test (DAST) are used to assess drug use. The Screening, Brief Intervention, and Referral to Treatment (SBIRT), widely used in the US also incorporates a referral to treatment path for clients identified with problematic substance use (15).
Although the assessment tools can be different for alcohol or drugs, the assessment process is very similar. The AUDIT C is a gender-specific tool and scored by asking a person three questions based on how much and how often they consume alcohol. When the individuals’ score suggests risky or a harmful range of alcohol use (4 to 5 for males; 3 to 5 for females), the health practitioner would usually conduct a more in-depth assessment for alcohol use using the AUDIT assessment tool followed by a brief intervention. We will discuss brief interventions in more detail in the next activity of the course.
Evidence suggests that people are not offended by health professionals asking about their substance use habits, with commentators also showing that patients find it appropriate when GPs take a non-judgmental interest in the wider aspects of their health. These assessments and screening tools can therefore provide vital information in creating the best plan for your client’s treatment (16).
References
13. O’Shea J, Goff P, Armstrong R. SAOR Screening and Brief Intervention for Problem Alcohol and Substance Use. In: Executive HS, editor. 2 ed. Dublin: Health Service Executive; 2017.
14. Organization WH. Motivational Interviewing for Substance Use: A Manual for Use in Primary Care. Geneva: WHO; 2003.
15. Babor TF, McRee BG, Kassebaum PA, Grimaldi PL, Ahmed K, Bray J. Screening, Brief Intervention, and Referral to Treatment (SBIRT) toward a public health approach to the management of substance abuse. Substance abuse. 2007;28(3):7-30.
16. EMCDDA. The role of psychosocial interventions in drug treatment (Perspectives on drugs). Lisbon: European Monitoring for Drugs and Drug Addiction; 2016 8 April 2021.
Want to keep learning?This content is taken from Trinity College Dublin online courseIdentifying and Responding to Drug and Alcohol Addiction in Nursing, Midwifery and Allied Healthcare PracticeView Course
FAQs
Scoring and interpretation: A score of “1” is given for each YES response, except for items 4,5, and 7, for which a NO response is given a score of “1.” Based on data from a heterogeneous psychiatric patient population, cutoff scores of 6 through 11 are considered to be optimal for screening for substance use disorders ...
What is the difference between screening and assessment for substance abuse? ›
Screening is a process for evaluating the possible presence of a particular problem. The outcome is normally a simple yes or no. Assessment is a process for defining the nature of that problem, determining a diagnosis, and developing specific treatment recommendations for addressing the problem or diagnosis.
What assessments are used for substance use? ›
The most commonly used drug abuse screening tests are:
- Drug Abuse Screen Test (DAST, also known as DAST-10). ...
- NIDA Drug Use Screening Tool, also known as the NIDA Quick Screen. ...
- NIDA Modified Alcohol, Smoking, and Substance Involvement Screening (NM ASSIST). ...
- Cut-down Annoyed, Guilty, Eye-opener (CAGE).
Screening, Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based approach to identify individuals who use alcohol and other drugs (substances) at risky levels. SBIRT has been shown to be valid and reliable in identifying and improving outcomes for people who use substances.
What happens if you fail drug screening? ›
Common potential consequences of failing a drug test at work are termination, suspension, recommended substance use disorder treatment, or other disciplinary actions. Although positive test results often accurately indicate a history of drug use, a false positive may also occur.
What is a 5 point drug test? ›
What does a 5-panel drug test screen for? A 5-panel drug test screens for commonly abused prescription medications and drugs, including amphetamines, phencyclidine, cocaine, opiates, and marijuana.
What comes first, screening or assessment? ›
The answer to this question is simple. Typically, a screening is done to determine if a particular issue exists that warrants a full assessment.
What is an example of a screening assessment? ›
When multiple measures are used to screen students, the accuracy of identifying those at risk improves significantly. Some examples of screening assessment tools include (but are not limited to) DIBELS Next, Aimsweb, Predictive Assessment of Reading (PAR), and the Texas Primary Reading Inventory (TPRI).
What is appropriate assessment screening? ›
An Appropriate Assessment (AA) is an assessment of the potential adverse effects of a plan or project (in combination with other plans or projects) on Special Areas of Conservation and Special Protection Areas. These sites are protected by National and European Law.
What do they test for in a substance abuse test? ›
Urine tests are painless and only requires a urine sample of the person getting tested. The urine drug test usually screens for alcohol, amphetamines, benzodiazepines, marijuana, cocaine, PCP, and opioids (narcotics).
The DSM-5-TR allows clinicians to specify how severe or how much of a problem the substance use disorder is, depending on how many symptoms are identified. Moderate: Four or five symptoms indicate a moderate substance use disorder. Severe: Six or more symptoms indicate a severe substance use disorder.
What is the addiction assessment? ›
Definition. Addiction Screening. determines whether or not there is a possibility of a substance abuse. Addiction Assessment. determines and defines the type of problem while also helping to determine any possible diagnosis and provides recommendations for a customized treatment plan.
What is the 5 P's screening tool? ›
The 5Ps* is an effective tool of engagement for use with pregnant women who may use alcohol or drugs. This screening tool poses questions related to substance use by women's parents, peers, partner, during her pregnancy and in her past.
What is screening in substance abuse? ›
The goal of substance abuse screening is to identify individuals who have or are at risk for developing alcohol- or drug-related problems, and within that group, identify patients who need further assessment to diagnose their substance use disorders and develop plans to treat them (see Chapter 4).
What is the Core 5 screening tool? ›
The Social Needs Screening tool screens for five core health-related social needs, which include housing, food, transportation, utilities, and personal safety, using validated screening questions, as well as the additional needs of employment, education, child care, and financial strain.
How do you score the Dast-10 scale? ›
When each item has been scored in this fashion, the DAST-10 total score is simply the sum of the 10 item scores. This total score can range from 0 to 10. In brief: score 1 point for each item answered “Yes” except for item #3 where a “No” receives 1 point. Then add up the points for the total DAST -10 score.
How to score the mast? ›
The MAST can either be scored using a weighted scoring system or by assigning one point per item. Raw unweighted scores are calculated by summing the points assigned to each question (yes = 1, no = 0). Questions 1, 4, 6 and 7 are reverse scored (yes = 0, no = 1).
How do you interpret the DAST-10 test for drug abuse? ›
Interpreting the DAST-10
The DAST-10 yields a total score out of 10, calculated by assigning one point to each response that indicates problematic drug use. Higher scores indicate a greater degree of problems or consequences related to drug abuse.
How do you get the results of a drug test? ›
Urine drug screen results usually come back within a few days or on the same day. If a result is positive, a person may need to take a second test for confirmation. This may be a GC-MS test, which gives more accurate results. The person who carried out the test or a medical review officer will explain the results.
