Detailed Assessment of Substance Use Disorders (Alcohol and Drugs Use )

Substance use disorders are diseases that affect a person’s brain and behavior. Prolonged substance use can lead to dependence and cravings, meaning that the body becomes dependent on a specific substance to function. The way that addiction occurs is that substances activate the brain’s reward systems, which produce feelings of pleasure, relaxation, and euphoria. The rewards felt from taking abusing substances are so great that people will continue to use despite negative consequences.

While some people are more susceptible to substance use disorders than others, almost everyone is at risk of developing a substance use disorder if they abuse substances.

Dependence / Addiction Criteria -

The DSM-5 outlines 11 different criteria that are used to determine the presence of a substance use disorder.​​​ The presences of at least two criteria out of 11 to diagnose dependence. Depending upon the number of criteria are fulfilled that apply to a patient will determine the severity of their disorder.

ICD-10 requires three criteria out of six in the past one year to diagnose dependence.

Tips for assessments

Depending upon the nature of assessment, patients ability to be cooperative and professional's years of experience plays crucial in the assessment.

Good assessment of a substance or drug misuser requires training and competency in the clinician.

An empathetic, non-judgemental approach should be used.

The full assessment process may take several consultations. A drug-misusing patient may present at a time of crisis. An exhaustive initial interview may reduce the chance of them engaging in a treatment programme. However, enough information needs to be obtained in the initial consultation to assess the presenting problems safely.

Relatives or carers should be involved where appropriate.

A multidisciplinary approach to assessment may be needed, as the drug misuser may have associated physical and psychological health problems, social functioning problems and/or be involved with the criminal justice system.

There may be a locally agreed shared assessment process/care pathway already in place.

Once a full assessment has been carried out, a care or treatment plan can be established.