What Are Substance Abuse Evaluations?

Substance abuse evaluations are interviews conducted by mental health workers or substance abuse therapists. Generally, the interviewer is looking for the patterns of substance use in a person's life, as well as destructive behaviors around or caused by substances. This information helps the interviewer to determine if the individual's substance use is interfering with her life and if she is in need of treatment.

Substance Abuse History

• Substance abuse evaluations commonly include a thorough history of many aspects of the individual's life. The interviewer asks about substance abuse history, including when the individual first started using, what the trajectory of use, abuse and addiction has been; patterns and history of use in his family; how the substance has impacted his life in the past and past treatment history. These questions give the clinician a good idea of the role that substances have played in the person's life and the impact they have had.

Social and Mental Health History

• Clinicians also gather data about the individual's social history, such as family relationships. This includes patterns of physical or sexual abuse, significant relationships and losses the person has experienced. This history is important in helping the clinician understand how the individual's life experiences have impacted her substance use. For instance, if she started using drugs to cope with her divorce, the clinician will want to make sure that this issue is a focus in her future therapy or treatment. The clinician also asks about whether the individual has ever been given a mental health diagnosis or been treated for a mental disorder, such as depression. Mental health problems are a key reason why some people are addicted to substances.

Current Use

• The interviewer assesses the current substance use of the individual. The most common way to do this is the use of the CAGE questionnaire. This is a brief questionnaire that simply asks if the individual has ever tried to cut back, been annoyed when others talked about her use, felt guilty about using or had an "eye opener." And eye opener, for people with alcohol dependence, involves having a drink in the morning to avoid symptoms of withdrawal. The clinician also asks about withdrawal systems. Other questions concerning current use include the type of drug or drugs used, how often, when, and in what combination.

Current Functioning

• When a person is having a major problem with alcohol or other drugs, this usually has an impact on her current life. Therefore, substance abuse evaluations also look at current life areas that are being affected. The clinician asks about physical symptoms, such as unexplained illnesses, weight loss or gain, hangovers, signs of withdrawal and other physical problems. He also asks about social issues, such as domestic problems, isolation and strained relationships. People with major substance abuse problems frequently have problems with finances, work and school, including problems paying bills, and frequent absences. The interview asks about legal issues, since problems such as DWIs and drug related arrests are also common for people with addictions.