Substance Use Disorders: Screening And Assessments

According to the Diagnostic Statistic Manual 5 (DSM-5) substance use disorder is when the individual has a dependency on alcohol or drug, followed by penetrating craving and antisocial behavior to acquire the substance. The terms substance abuse and substance dependence refer to substance use disorder, which has been separated into three classifications as follows

There is no doubt that there is a prevalence of substance abuse throughout several age groups. To a certain extent, a society is faced with the reality of controlling substance abuse. Or allow it run rampant throughout the community. Often times, we hear and read about the level of substance abuse among teen, young adults and mid-aged

Practice models used in treatment of substance abuse have up until recently only been recommended for the intervention of younger addicts. As a result, treatment approaches for older adults are lacking in evidence. However, screening for substance abuse is the first step towards determining if a more thorough assessment is needed. Cook et al. (1998) reported that it is necessary to take a holistic approach to treatment, and take a broader focus than just the chemical abuse because as people age their psychological and health problems become more complex (p. 146). Older adults face life changes and lack of poor support networks are more deeply felt. Bogunovic (2012) answered that, “A comprehensive evaluation should include a thorough physical examination and laboratory analysis and psychiatric, neurological, and social evaluation.” Such measures are effective when paired with screening

According to the SAMHSA (2010) report on the national survey on drug use and health almost 22.5 million people are reported to be associated with substance abuse disorder (SAMHSA, 2010). This illness was found to be very common in all age groups, both sex, and seniors. There are several effects on these individuals and their families. Many people who suffer from substance abuse disorders fail to acknowledge these serious consequences. First of all, no response of pain relief can be seen with smaller doses of pain medications, as their bodies are used to high levels of various substances at the same time. Nurses become frustrated when they try to treat and help these patients with pain. Sometimes it is difficult to think about ethical principles when nurses have to deal with such patients with pain and suffering.

This paper highlights 3 substance use screening and assessment measures that are commonly utilized in diagnostic assessment. The T-ACE, DALI and SBIRT tools are used across several domains, and in multiple healthcare settings. The purpose of this paper is to describe these assessment tools, and how they impact human services providers working in addictions treatment.

Alcohol abuse is growing rapidly throughout U.S. society. One in every twelve adults is being diagnosed with alcohol abuse (Barlow and Durand, 2006). All that are diagnosed with alcohol abuse must meet one or more of the following criteria within a twelve month period: he/ she must fail to accomplish major work, school or home

According to Feldstein and Miller (2007), explain that the SASSI was publish is 1985 and select by counselors to use with other screening instruments. Wormer and Davis (2013) describe the SASSI form with true/false question not pertaining to substance or alcohol. This SASSI assessment is the most used tool that has different versions (Miller, Woodson, Howell, & Shields, 2009). For instance, the SASSI 3 has 10 scales with 93 items to identify if a client has a substance disorders. In addition, the scales include the Face Valid Alcohol, Face Valid Other Drug, Symptoms, Obvious Attributes, Subtle Attributes, Defensiveness, Supplemental Addiction Measure, Family History, and Tendency to Involvement

Abuse and SUD can be separated by categories. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), define substance use disorders that are mild, moderate, or severe. It is within these levels that certain criteria’s are meet Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home (“Substance use disorder”, 2015). Other determining factors that define substance use disorder in the DSM-5 manual is the impaired control, social impairment,

Although there are several different assessments one could use, the Substance Abuse Subtle Screening Inventory, (SASSI-3) would be the first choice. It is a “brief self-report, easily administered psychological screening measure that is available in separate versions for adults and adolescents. The Adult SASSI-3 helps recognize individuals who have a high probability of having a substance dependence disorder with an overall empirically tested accuracy of 93%.” Dr. Glenn A. Miller developed the SASSI-3 and is comprised of 67 true-false items with additional 26 item self-report section on substance use for identifying people with a high probability of having a substance dependence disorder. The subtle items of the SASSI-3 appear to have no correlation with the rest of the test. The subtle items may identify some clients who have alcohol or other drug issues the client may not admit to. A counselor having an awareness of their client’s history of alcohol use aids the counselor in identifying clients who are at risk and what treatment strategies may be most effective. The SASSI-3 is quick and easy for the counselor to score; only taking 15 minutes to administer and score. This assessment is helpful in both inpatient and outpatient sites. Although some studies have shown that alcoholism is hereditary, the genes have yet to be identified. Alcoholism is not only complex but involves different pathways that may lead to the development of alcohol dependence. Some factors may

Alcohol use has spanned history. In fact, there is speculation that alcohol use actually preceded the formation of societies (Doweiko, 2015, p. 30). Thus, alcohol has long been a part of mankind’s life. The function of alcohol has unarguably changed throughout the course of history, as it was first used for nutritional purposes and then later on for religious purposes (Doweiko, 2015, p. 32). Today, alcohol serves a social purpose. In the United States, the prevalence of use is quite high, with just over 50% of the population partaking monthly (Doweiko, 2015, p. 34). This statistic is somewhat alarming considering alcohol use comes with a number of potential adverse consequences. Case in point, even

The standardized Screening, Brief Intervention & Referral to Treatment (SBIRT) instrument form is a comprehensive, integrated tool that can enable health professionals in any setting to quickly assess persons with substance use disorders (SUDs) or at risk of developing these disorders, to deliver early intervention to at-risk substance users, and assist those in need of a brief intervention or more intensive treatment receive appropriate treatment services (SAMHSA, 2015). The SBIRT form consists of few sections. It incorporates a 10-item Alcohol Use Disorders Identification Test (AUDIT) questionnaire made of two sections: the alcohol pre-screen which is the first level screen that assesses patients or clients for alcohol use and consists of questions one to three, and the full screen which consists of questions four to 10 and identifies signs of dependence with questions four to six and related problems with questions seven to 10.

The National Council on Alcoholism and Drug Dependence cites fourteen primary indicators of alcohol or

The client, Maria received a score of nineteen on her Alcohol Screening Questionnaire (AUDIT). Maria’s score can be interpreted as being in zone three which is considered harmful. The appropriate action for the aforementioned zone is a brief intervention or referral to specialized treatment. The intervention process is a procedure that is used to highlight how problematic alcohol use can be in one’s life. After the client and social worker’s realization of the frequency and seriousness of the patient’s alcohol use, it is advantageous to formulate a plan to lessen alcohol usage. Motivational Interviewing is a method that can be used in counseling sessions which encourages the client to become a motivated participator of change by identifying, exploring, and resolving he or she’s ambivalence towards their damaging behavior [PowerPoint Slides]. MI is collaborative and client-centered thus the patient can contribute to their planned change process. The process of MI involves appealing to, concentrating on, evoking, and lastly, planning with the patient. Subsequent steps of MI are reflection, summarization, and exploring inconsistencies [PowerPoint Slides]. Shifting gears,

In this study Hagsand et al screen 178 participants over the phone collecting information on age, gender, BM, education level, use of medicine, mood status, amount and frequency of alcohol consumption, smoking, and use of drugs. Any Participants who had poor physical or mental health were excluded, and the remaining were examined by a physician also completing a psychiatric symptom checklist. Participants were excluded if they had any current medical condition that required medication, psychiatric disorders or any history of psychosis, history of drug or alcohol abuse or dependence, night-shift work, reported any currently harmful alcohol drinking habits. After the intense screening, there were 117 participants who qualified take part in the experiment. Participants in the control group consumed only orange juice, while participants in the alcohol group consumed alcohol (vodka,

Johnny Obrien aged 79 years, presented to the Emergency Department after a fall at the RSL, resulting in a laceration on his left elbow which required 3 stitches. He lives by himself with no family close by, and has a history of hypertension and alcohol addiction. Clinical reasoning is a cyclic process, where cues are collected and their data processed to come to a conclusion of the patient situation so that appropriate interventions can be implemented and evaluated through reflective practices which allows for further learning (Levett-Jones 2013). Applying these clinical reasoning skills in practice is important as it has a positive impact on patient outcomes, resulting in less adverse effects due to the detection of patient deterioration throughout this process to ensure safe and effective care (Levett-Jones 2010).Subjective data is information from the patient’s point of view, including their feelings, perceptions and concerns, whereas objective data is information that is observable or measurable (Delmar Cengage Learning 2015).