Summary: Screening

A number of substance use screening instruments have been developed, and the use of instruments may vary based on state or local regulations, reimbursement policies, or personal preference.

Screening often is a 2-step process:

  1. ask a couple short questions to determine whether a patient is potentially using various substances
  2. use more targeted and longer screening tools to better explore the identified substance use areas

A screen should be simple enough that it can be administered quickly and to patients with a range of literacy levels. It should focus on the substance use severity (primarily consumption patterns) and a core group of associated factors such as legal problems, mental health status, educational functioning, and living situation.

The patient’s awareness of the problem, feelings about his or her substance use, and motivation for changing behavior may also be solicited.

The Bottom Line

In the end, is a patient using a substance? If so, how much and how often? Beyond these basic screening questions, we turn to examining the impact of use. What, how often, to what effect? That’s the bottom line when screening for substance use.