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Who Are Chemical Dependency Assessments For?

Comprehensive Substance Abuse Assessments play a crucial role in evaluating individuals who exhibit signs of substance abuse or are suspected to have a substance abuse problem. These assessments provide a holistic understanding of an individual’s substance abuse patterns, addiction severity, and the impact on various aspects of their life.

Let’s explore the significance of these assessments in different contexts and why they are essential for effective treatment planning.

Seeking Treatment and Personalized Care:
When individuals voluntarily seek treatment for substance abuse, a comprehensive assessment becomes the foundation of their recovery journey. These assessments are conducted to evaluate the severity of addiction, identify any co-occurring disorders, and develop personalized treatment plans tailored to their unique needs. By understanding the individual’s substance abuse history and its impact on their life, healthcare professionals can recommend the most appropriate treatment approach. LifeStance mental health care providers can provide chemical dependency assessments. Find your nearest provider using our Provider Directory.

Legal Requirements and Court-Mandated Evaluations:
In legal settings, comprehensive substance abuse assessments are often mandated for individuals involved in cases related to substance abuse, such as DUI/DWI offenses or probation requirements. These evaluations help determine the extent of the substance abuse problem, provide insights into any underlying issues, and guide the court in deciding appropriate interventions or treatment referrals. By integrating these assessments into the legal process, it becomes possible to address the root causes of the behavior and promote long-term recovery.

Workplace Interventions and Employee Assistance Programs:
Employers and employee assistance programs recognize the impact of substance abuse in the workplace and overall productivity. In some instances, comprehensive assessments are utilized to identify employees struggling with substance abuse or those involved in workplace incidents related to substance use. The assessments assist in understanding the severity of the problem, implementing appropriate interventions, and facilitating referrals to treatment programs. By addressing substance abuse issues in the workplace, employers can support employees on their path to recovery and create a healthier work environment.

Academic Settings and Student Support:
Educational institutions play a critical role in identifying and addressing substance abuse issues among students. Comprehensive assessments are valuable tools for evaluating students who display problematic substance use behaviors or experience consequences related to substance abuse. These evaluations help assess the severity of the issue, design suitable interventions, and connect students with appropriate support services. By implementing comprehensive assessments, academic institutions can promote the well-being and academic success of their students.

Medical Referrals and Holistic Care:
Healthcare professionals may refer patients for comprehensive substance abuse assessments if substance abuse is suspected as a contributing factor to their health issues. These assessments provide insights into the individual’s substance abuse history, its impact on their overall health, and any co-occurring disorders that require attention. By understanding the complex relationship between substance abuse and physical health, healthcare providers can develop integrated treatment plans that address both aspects and enhance the patient’s overall well-being.

Family Interventions and Support:
Families deeply affected by a loved one’s substance abuse often seek ways to support their recovery. Comprehensive assessments can provide a comprehensive understanding of the individual’s substance abuse patterns, addiction severity, and the associated challenges. Armed with this knowledge, families can better navigate the treatment process, access appropriate interventions, and provide the necessary support to their loved ones.

Commonly Abused Substances

Chemical dependency evaluations or assessments are for people who abuse substances or experience drug or alcohol addiction. People with a chemical dependency may not realize it for some time, as taking certain drugs is sometimes normalized in society. Substance abuse becomes an issue when people feel the compulsion to take that substance in increasing quantities and frequencies.

Physical resistance to a substance, causing people to take larger doses, suggests chemical dependency. Similarly, when someone cannot stop taking the substance even after serious issues including interpersonal, legal, or financial problems, a chemical dependency evaluation is required.

Commonly abused substances include:

  • Alcohol
  • Marijuana (While it is increasingly legalized for medicinal and recreational purposes in some regions, heavy and persistent cannabis use can lead to dependence, impaired cognitive function, and other negative consequences.)
  • Tobacco
  • Benzodiazepines (including drugs like Xanax®, Valium®, and Ativan®, are prescribed to treat anxiety, insomnia, and other conditions. However, they carry a risk of misuse and addiction. Benzodiazepine abuse can cause sedation, relaxation, and a sense of well-being, but it can also lead to dependence, overdose, and withdrawal symptoms.
  • Stimulants (Drugs such as cocaine and amphetamines (e.g., methamphetamine), are frequently abused for their energizing and euphoric effects. Prolonged use can result in addiction, cardiovascular complications, psychological disturbances, and other serious health problems.
  • Opiates (Opioids, including prescription painkillers like oxycodone and hydrocodone, as well as illicit drugs like heroin, are highly addictive substances. Opioid abuse can lead to euphoria, pain relief, and sedation, but it also carries significant risks, including overdose and respiratory depression)
  • Hallucinogens (Hallucinogenic substances, such as LSD (acid), psilocybin mushrooms, and MDMA (Ecstasy), alter perception, mood, and cognitive processes. While not as physically addictive as some other substances, they can still be abused and may have long-lasting psychological effects.)
  • Inhalants (Inhalants refer to a broad range of substances that produce mind-altering effects when inhaled. They include volatile solvents, aerosols, and gases found in common household products like glue, paint thinner, and gasoline. Inhalant abuse can cause serious health consequences, including damage to the brain, liver, kidneys, and other organs)

LifeStance Health is a national leader in mental, behavioral, and emotional wellness with multiple locations in 33 states. Services vary by location.

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What to Expect in a Chemical Dependency Assessment

The evaluation is typically conducted by a licensed addiction counselor or a multidisciplinary team consisting of social workers, medical doctors, psychologists, psychiatrists, and therapists. The evaluation can take place in an addiction treatment center, a mental health care clinic like LifeStance, at a private clinician practice, or a hospital.

The process involves both screening and assessment components. The screening aims to determine the presence of drug or alcohol dependency and to determine if treatment would be beneficial for the individual. A comprehensive chemical dependency evaluation usually takes around one to two hours to complete. During this time, the patient will undergo an interview covering topics such as their substance use history, previous treatment experiences, medical background, as well as aspects related to their work, recreation, and family life. There are several different questionnaires used because each questionnaire has its own focus, purpose, and target population. These questionnaires are designed to gather specific information about an individual’s substance use, patterns, and associated consequences.

Here are some commonly used screening questionnaires:

  1. CAGE Questionnaire: The CAGE questionnaire is a brief self-report tool that assesses alcohol use disorders. It consists of four questions that inquire about feeling the need to cut down on drinking, being annoyed by criticism of drinking, feeling guilty about drinking, and using alcohol as an eye-opener in the morning.
  2. AUDIT (Alcohol Use Disorders Identification Test): AUDIT is a comprehensive screening tool that assesses alcohol consumption patterns, alcohol-related problems, and alcohol dependence. It consists of 10 questions covering various aspects of alcohol use and related consequences.
  3. DAST-10 (Drug Abuse Screening Test): The DAST-10 is a self-report questionnaire used to assess drug use and related problems. It consists of 10 questions that cover a range of substances and inquire about the frequency and consequences of drug use.
  4. ASI (Addiction Severity Index): The ASI is a comprehensive interview-based assessment tool that assesses the severity of substance use and related problems across various domains. It covers areas such as substance use, medical status, employment, family/social relationships, legal issues, and psychiatric status.
  5. DAST-20 (Drug Abuse Screening Test – 20): Similar to DAST-10, the DAST-20 is an extended version that provides a more comprehensive assessment of drug use and related problems. It includes 20 questions that cover a wider range of substances and associated consequences.
  6. SASSI (Substance Abuse Subtle Screening Inventory): The SASSI is a self-report tool designed to identify individuals at risk for substance abuse or dependence. It assesses various areas, including recent substance use, denial of substance-related problems, and the presence of defensive or distorted attitudes regarding substance use.
  7. MAST (Michigan Alcohol Screening Test): The MAST is a questionnaire that assesses alcohol use and related consequences. It consists of 22 questions that cover aspects such as alcohol-related problems, social consequences, and drinking behaviors.
  8. CRAFT (The Comprehensive Alcohol Screening Instrument for Adolescents): CRAFT is a screening tool specifically designed for assessing alcohol-related issues in adolescents. It includes questions that address alcohol use, consequences, and family dynamics related to adolescent drinking.

Below are examples of the common questions from the screening:

Medical History:

  1. Do you have any current medical concerns?
  2. Do you have a healthcare provider?
  3. When was your most recent appointment?
  4. What concerns were identified during your last appointment?
  5. What medications are you currently taking?

Substance Use History:

  1. How often do you use alcohol?
  2. Have you ever used marijuana or other non-prescribed drugs?
  3. If so, please describe the frequency and amount of use over the past year.
  4. Have you ever been to detox?
  5. Do you smoke tobacco products?

Mental Health:

  1. Did you experience abuse or neglect during your upbringing?
  2. Is there a family history of drug problems or alcoholism?
  3. When was the last time you experienced significant problems with depression, anxiety, attention, or sleep disruption?
  4. Do you have a history of head injuries?
  5. Have you ever served in the military?
  6. Have you ever been prescribed mental health medication?

Living Environment:

  1. Can you tell me who you live with?
  2. Is alcohol or drugs readily available in your home?
  3. Do you have roommates? If so, do they have a history of alcohol misuse or drug abuse?
  4. Do you have any plans to move in the foreseeable future?

Day-to-Day Life:

  1. What activities keep you busy on a daily basis?
  2. Are you currently employed or attending school?
  3. Do you have any hobbies?
  4. Are you involved in regular exercise?

Addiction Symptoms:

  1. Do you experience alcohol or drug cravings?
  2. Do you drink or use more than intended?
  3. Are you having a hard time controlling your substance use?
  4. Do you feel you need help in quitting or moderating your substance use?
  5. Do you find yourself drinking or using more than you had planned?

In addition to questionnaires, there are certain lab tests that can be used as part of the screening process for chemical dependency. These tests are not definitive diagnostic tools on their own but can provide valuable information to aid in the assessment.

  1. Urine Drug Screening (UDS): This is one of the most common lab tests used for screening substance abuse. It detects the presence of various drugs or their metabolites in the urine. UDS can identify substances such as opioids, cocaine, amphetamines, marijuana, benzodiazepines, and more.
  2. Blood Tests: Blood tests can be used to screen for the presence of drugs or alcohol in the system. Blood tests can detect recent substance use and provide information on the levels of drugs or alcohol in the bloodstream.
  3. Breathalyzer Test: Breathalyzer tests are commonly used to measure the blood alcohol concentration (BAC) in individuals suspected of alcohol intoxication or impairment. This test measures the amount of alcohol in a person’s breath to estimate the level of alcohol in their blood.
  4. Hair Follicle Testing: Hair follicle tests involve analyzing a hair sample for the presence of drugs over an extended period. This type of testing can detect drug use that occurred months prior to the test. It is particularly useful for detecting long-term substance abuse patterns.
  5. Saliva Tests: Saliva tests, also known as oral fluid tests, can detect the presence of drugs within a short timeframe. These tests are non-invasive and can identify recent drug use.
photo of LifeStance provider Jami Shanes, LPC, LICDC

Clinically Reviewed By:

Jami Shanes, LPC, LICDC
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Jami Shanes is a licensed professional counselor and licensed independent chemical dependency counselor. She has a specialized interest in working with dual diagnosis, panic disorder, life transitions, mood disorders and anxiety disorders.