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Substance Use

ASI-Lite (Addiction Severity Index- Lite)

Type of Tool: Diagnostic
Repeatability:
Repeatable by Clinician’s Judgment
Description: The Addiction Severity Index - Lite version is a shortened version of the Addiction Severity Index (ASI). The ASI is a semi-structured instrument used in face-to-face interviews conducted by clinicians, researchers or trained technicians. The ASI covers the following areas: medical, employment/support, drug and alcohol use, legal, family/social, and psychiatric. The ASI obtains lifetime information about problem behaviors, as well as problems within the previous 30 days. The ASI-Lite can be administered in approximately 30 minutes.

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*McLellan, A. T., Luborsky, L., Woody, G. E., & O’Brien C. P. (1980). An improved diagnostic evaluation instrument for substance abuse patients. The Addiction Severity Index. Journal of Nervous and Mental Disorders, 168(1):26-33. 
 

ASSIST (The Alcohol, Smoking & Substance Involvement Screening Test)

Type of Tool: Screening
Repeatability: Repeatable by Clinician’s Judgment
Description: The ASSIST is an 8-item questionnaire developed by an international group of substance abuse researchers for the World Health Organization. Its purpose is to detect psychoactive substance use and related problems among primary care patients. The ASSIST provides information about: the substances people have ever used in their lifetime; the substances they have used in the past three months; problems related to substance use; risk of current or future harm; level of dependence; and injecting drug use. Substances addressed include: tobacco, alcohol, cannabis, cocaine, amphetamine type stimulants, sedatives, hallucinogens, inhalants, opioids, and other drugs. 
        The ASSIST provides information about: the substances people have ever used in their lifetime; the substances they have used in the past three months; problems related to substance use; risk of current or future harm; dependence; and injecting drug use.

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*WHO ASSIST Working Group (2002). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addiction, 97 (9): 1183-1194.


AUDIT-C (Alcohol Use Disorders Identification Test – Consumption Items)

Type of Tool: Screening
Repeatability: Repeatable by Clinician’s Judgment
Description: The AUDIT-C is an alcohol screening instrument consisting of the first three questions of the Alcohol Use Disorders Identification Test -- those that focus on alcohol consumption. The items ask about frequency of drinking, quantity consumed at a typical occasion, and frequency of heavy episodic drinking (six standard drinks or more on a single occasion). By using both the AUDIT-C score, and the patient’s history of alcohol treatment, it is possible to identify those most likely to be alcohol dependent.

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*Allen, J. P., Litten, R. Z., Fertig, J. B., & Babor, T. (1997). A review of research on the Alcohol Use Disorders Identification Test (AUDIT). Alcoholism: Clinical and Experimental Research, 21(4): 613-619. 

*Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R. & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption. II.
Addiction, 88:791-804. 

*Conigrave, K. M., Hall, W. D. & Saunders, J. B. (1995). The AUDIT questionnaire: Choosing a cut-off score.
Addiction, 90:1349-1356.


DAST-10 (Drug Use Questionnaire)

Type of Tool: Screening
Repeatability: Repeatable by Clinician’s Judgment
Description: The Drug Abuse Screening Test (DAST) was designed as a brief instrument for clinical and non-clinical screening to detect drug abuse or dependence disorders. It is most useful in settings in which seeking treatment for drug use problems is not the patient's stated goal. The DAST-10 is a shorter adaptation with 10 self-report items covering a variety of consequences related to drug abuse without being specific about the drug. The DAST-10 can be used to guide further inquiry into drug-related problems and to help determine treatment intensity. It takes about 3 minutes to administer, and 1 minute to score the DAST-10.

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*Cocco, K. M., & Carey, K. B. (1998). Psychometric properties of the Drug Abuse Screening Test in psychiatric outpatients. Psychological Assessment, 10, 408–414.

*French, M. T., Roebuck, M. C., McGeary, K. A., Chitwood, D. D., & McCoy, C. B. (2001). Using the Drug Abuse Screening Test (DAST-10) to analyze health services utilization and cost for substance users in a community-based setting. Substance Use & Misuse. 36, 927-946.

*Maisto, S. A., Carey, M. P., Carey, K. B., Gordon, C. M., & Gleason, J. R. (2000). Use of the AUDIT and the DAST-10 to identify alcohol and drug use disorders among adults with a severe and persistent mental illness. Psychological Assessment. 12, 186-192.


TSR (Treatment Services Review)

Type of Tool: Health Services Assessment
Repeatability: Repeatable by Clinician’s Judgment
Description: The TSR is an interview used to gather information about specific services provided to patients attending substance abuse and other types of treatment programs. The TSR focuses on services for seven potential problem areas-medical status, employment and support, drug use, alcohol use, legal status, family/social status, and psychiatric status-that correspond to the seven patient functioning areas assessed by the Addiction Severity Index. Patients are asked about the services that they received in the past week either in a program or outside of a program through referral. The TSR consists of 56 items. It takes approximately 10 minutes to administer and 1 minute to score.

   In clinical settings, the TSR can be used to describe the types of services patients receive in a treatment program. In this way, it is possible to differentiate types of programs and to determine whether the patient problems presented at admission have been addressed during treatment.

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*Cacciola, J. S., Alterman, A. I., Lynch, K. G., Martin, J. M., Beauchamp, M. L. & McLellan, A. T. (2008). Initial reliability and validity studies of the revised Treatment Services Review (TSR-6). Drug and Alcohol Dependence, 92(1-3): 37-47.
  
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