Drug and alcohol evaluations are used to demonstrate responsible efforts to assess and control problems with substance abuse, and to help determine whether substance abuse treatment is necessary. This is often done to show cooperation with licensing boards, bar associations, or court systems, and to demonstrate that any past problems are being addressed appropriately.
I have an extensive background in the evaluation and treatment of addictions, in both public and private hospital settings as well as private practice. When I conduct a substance use assessment, I generally include some or all of the following elements:
- A thorough clinical interview – I begin the interview by getting to know a little about my clients and their reasons for seeking an assessment, and helping them to begin to feel comfortable with the evaluation process. I then administer some brief screeners for symptoms of mental health or addictive disorders (described below), and discuss the results in the broader context of the individual’s life — stressors, family history, substance use history, medical history, living situation, relationships, plans for the future, etc.
- Montreal Cognitive Assessment (MoCA) – This brief cognitive screening tool provides an overview of current cognitive functioning across various dimensions such as memory, attention, concentration, motor coordination, spatial reasoning, and verbal fluidity. Depending on the results of this test, additional cognitive testing may be indicated.
- Drug Abuse Screening Test (DAST-20) – This 20-question inventory assesses the basic patterns of drug and alcohol use over the past year.
- Drinker Inventory of Consequences (DrInC) – This questionnaire helps determine what types of consequences a person has experienced as a result of drinking (or drug use) in the recent past, and over the course of their life.
- Brief Addiction Monitor (BAM) – If a history of addiction is present, I’ll use this questionnaire to obtain a detailed, self-reported account of past and current alcohol and drug use. If addiction counseling or psychotherapy are indicated by the results of the initial substance abuse evaluation, then I will also use the BAM to document progress during the course of treatment.
- Minnesota Multiphasic Personality Inventory II (MMPI-2) – If the results of the interview and self-report inventories are unclear, I may include a personality test in the assessment. The MMPI-2 is the most commonly used and widely accepted personality test. It produces a fairly detailed picture of many different aspects of personality functioning — such as current mental health symptoms, social functioning, and self-image. One of the reasons for this test’s popularity are its strong validity scales. The test has a number of different ways to determine whether someone is over-reporting their problems, under-reporting their problems, responding randomly or inconsistently, etc. For this reason, I always advise my clients that the best approach to taking this test is to simply answer as honestly as possible.
This straightforward evaluation process usually takes about 2 hours (3 if a personality test is used), and allows me to reasonably ascertain the likelihood of current or future problems with drugs and alcohol that might adversely affect my client’s ability to reach their goals.
I am generally able to produce a letter explaining my findings and recommendations within one week after the evaluation. The appropriate course of action following the evaluation depends on the results; I will generally provide the letter along with a brief discussion of the findings and their meaning over the phone. If treatment is recommended, I may schedule a follow up session to help my client plan and strategize the most efficient and effective course of action.
A final note: These evaluations are strictly confidential. I am not an employee of any governmental agency or regulatory body. When I conduct a substance abuse evaluation, I do so only for my client, and my client is the only one with access to the results of the assessment and any related records. The only time I will ever release any information about a client’s evaluation is if they have given me explicit written permission to do so, or if I am legally compelled to do so.