Addiction Severity Index

Gauging The Seriousness of Your Substance Problems

Not everyone with symptoms of drug or alcohol addiction is equally affected. Some people have relatively mild symptoms. Others have problems that fall into a moderate range. In addition, some people are affected by severe addiction. How do doctors and addiction specialists determine the extent of problems in any given person? Over the years, a number of assessment tools have been developed. One such tool is the Addiction Severity Index, or ASI.

What Is the Addiction Severity Index?

The Addiction Severity Index was first developed in the 1980s by addiction researchers. At first, the tool was only used for academic purposes. However, it is now also used for real-world assessments of people with substance problems.

The ASI is structured in the form of an interview. During this interview, the person administering the test asks questions that cover seven separate topics, including your:

• Past and current medical status
• Employment status and level of additional financial support
• Level of involvement in alcohol use
• Degree of participation in drug use
• Status in regard to the legal system
• Social and family status
• State of past and current psychiatric health

There are multiple sub-topics covered in each of these areas. In total, you must answer dozens of questions to complete the full ASI.

It takes roughly an hour to complete the entire process. You will then receive two different ASI scores. The first of these scores is your severity rating. This is a subjective measurement based on your interviewer’s interpretation of your answers to the various questions. Your severity rating provides a gauge of your current need for drug or alcohol treatment. The second ASI score is calculated by a software program designed for that purpose. It measures the seriousness of your substance problems over the past month.

How Is the Addiction Severity Index Used?

The ASI can be administered to a wide variety of people. Specific suitable groups include:

• People with alcohol-related problems
• Those with opioid- or cocaine-related problems
• Men
• Women
• Pregnant women who drink or use drugs
• People affected by other mental health issues
• Homeless people

It can also be administered to people with gambling-related problems.

What Are Examples of ASI Screening Questions?

What kinds of questions will you encounter during an ASI substance screening? Questions drawn directly from the ASI itself provide the best possible examples. For example, the first question in the Medical Status subsection is:

• How many times in your life have you been hospitalized for medical problems?

Additional questions in this subsection include:

• Do you have any chronic medical problems which continue to interfere with your life?
• How troubled or bothered have you been by these medical problems in the past 30 days?

Questions in the Psychiatric Status subsection include:

• How many time have you been treated for any psychological or emotional problems?
• How many days in the past 30 have you experienced these psychological or emotional problems?

In the sections covering alcohol and drug use, you tell your interviewer whether you have used a given substance:

• In the past 30 days
• At any point in your lifetime

You also answer questions such as:

• How many times have you had alcohol DTs (delirium tremens)?
• How many times have you overdosed on drugs
• How many times in your life have you been treated for drug or alcohol abuse

Interpreting Addiction Severity Scoring

Your ASI score is broken down into what is known as a severity profile. This profile ranks you on a scale of 0 to 9 for each of the tool’s seven subsections. In each of these areas, your need for treatment is assessed.

A score of 0 or 1 means that no notable issue exists. A score of 2 or 3 indicates a slight problem that may require treatment. A score of 4 or 5 indicates moderate problems and a need to seriously consider treatment. A score of 6 or 7 indicates that treatment is clearly required. If you have an ASI score of 8 or 9, treatment is an absolute must.

Benefits of an Accurate Addiction Severity Index

An accurate ASI result provides you with some important benefits. First, it gives doctors and addiction specialists a reference point for creating an appropriate treatment plan. This is crucial, since you must have a plan that meets your specific recovery needs.

In addition, an accurate result indicates specific areas of your life where addiction has most affected you. This information can then be used to create a more holistic overall approach to your care. Instead of just getting help for the direct effects of addiction, you can get help for other issues impacting your well-being.

Limitations of the Addiction Severity Index

Despite its potential benefits, the Addiction Severity Index has some notable limitations. Most importantly, research shows that not all areas of the screening provide information of equal accuracy. Specifically, the computer-generated portion of the ASI provides consistent results in only three of seven subsections:

• Alcohol use
• Medical status
• Psychiatric status

There is too much variation in the other four subsections to ensure consistency.

Other Forms of Diagnosing a Substance Use Disorder

The Addiction Severity Index is not the benchmark for diagnosing substance problems in the U.S. Instead, the standard is set by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Illness, or DSM. Substance use disorder, or SUD, is the general name given to all serious drug or alcohol problems. Under this heading are a broad range of conditions, including:

• Alcohol use disorder
• Stimulant use disorder
• Opioid use disorder
• Sedative, hypnotic or anxiolytic use disorder
• Cannabis use disorder

Doctors and addiction specialists use a total of 11 possible symptoms to diagnose each of these conditions. Those symptoms are:

• Repeatedly taking drugs or drinking in dangerous situations
• Spending much of your day using a substance and/or recovering from its effects
• Using a substance more often or in larger amounts than you intend to
• Not being able to quit or cut back after trying multiple times
• Going into withdrawal when you try to quit or cut back
• Not modifying your substance use when you know that it harms you
• Keeping up a pattern of use that leads to damage in your key relationships
• Turning to drug or alcohol use as a preferred recreational activity
• Having substance-related problems fulfilling important responsibilities
• Developing a rising tolerance to the effects of drugs or alcohol
• Experiencing strong cravings between periods of drinking or taking drugs

Most of these symptoms are indicators of drug or alcohol addiction. Others are indicators of non-addicted abuse that disrupts your ability to function.

Assessing Addiction Severity

You only need to have two of the 11 possible symptoms within a year’s time to receive an SUD diagnosis. The effects of your condition are considered mild if you have two or three total symptoms. The effects are moderate if you have four or five symptoms. If you have six symptoms or more, you have a severe substance use disorder.

Dual Diagnosis and the Severity of Addiction

Some people are not only affected by a substance use disorder. In addition, they have diagnosable symptoms of another mental illness. Dual diagnosis is the accepted term for this combination of problems.

The presence of dual diagnosis can lead to the onset of more severe addiction symptoms. Why? An untreated mental illness can reinforce the impact of addiction. At the same time, untreated addiction can reinforce the impact of a separate mental illness. These facts help explain why effective dual diagnosis treatment focuses on your SUD and your additional illness.

How Do I Find the Right Treatment for Addiction?

The addiction treatment you receive must match the severity of your problems. If you are mildly affected, you may be able to enroll in a standard outpatient program. For more serious problems, you may need any of the following:

• Intensive outpatient treatment
• Partial hospitalization
• Residential or inpatient treatment

How can you find the treatment that will work best for you? Start by talking to your doctor or an addiction specialist. Both types of professionals can help determine the level of care you need. They can also recommend appropriate program options for your situation.

Effective Aftercare Depends on Addiction Severity

Addiction severity also matters when your time in treatment ends. At this stage, you are ready for a follow-up aftercare program. This kind of program, also known as continuing care, provides ongoing support for your sobriety.

How does addiction severity impact your aftercare needs? Say, for example, you went through drug or alcohol treatment in an inpatient program. In these circumstances, you might enroll in an outpatient program for your continuing care. If you participated in an outpatient program, you might only need periodic check-ins with your treatment team during aftercare.

Get More Information on Addiction Severity at The Discovery House

Symptom severity has a major impact on both addiction and your successful recovery. The Addiction Severity Index is a screening tool used to gather information on how much your substance problems affect you. When used properly, it can help you and your doctor determine appropriate treatment options.

However, the ASI is not the only diagnostic tool available. The most widely used criteria are the 11 potential symptoms defined by the American Psychiatric Association’s DSM. Under these criteria, the more symptoms you have, the greater the effects of addiction and/or non-addicted abuse. The DSM is the standard reference tool for diagnosing substance problems in the U.S.

Reach out Now for a Consultation at No Cost

Need help determining the severity of the substance problems affecting you or your loved one? Talk to the specialists at The Discovery House. We have the expertise needed to ensure that you receive a proper diagnosis. The Discovery House is also a premier provider of luxury substance treatment. No matter the severity of your addiction, our holistic, customized recovery plans will support your needs. For more information on how we can help, just call us today.