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SUBSTANCE ABUSE ASSESSMENT FORM Please make copies as needed and please type or print legibly. Instructions for use: Complete this form and use these questions to guide the EAP client interview when.

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How to fill out the Substance Abuse Assessment.doc online

Completing the Substance Abuse Assessment online can properly guide the evaluation of a client's treatment needs. This guide provides clear instructions to help users successfully navigate each section of the assessment.

Follow the steps to complete the assessment form effectively.

  1. Press the ‘Get Form’ button to access the Substance Abuse Assessment.doc. This will open the document in your preferred editor for completion.
  2. Begin by filling in the client’s personal information at the top of the form, including their name, job title, employer, and any pertinent information regarding the referral made by an employer.
  3. In the 'Substances used and history' section, indicate the client's history with various substances by marking the appropriate response for each substance listed (never used, currently using, past use) and providing the age of first use.
  4. For each substance used or abused, describe the type, amount, and frequency. This helps clarify the extent of use and gives context to the assessment.
  5. Respond to the questions regarding dangerous use situations, attendance at obligations, loss of interests, and emotional reliance on substances. For each 'Yes' answer, provide a detailed description.
  6. Review the work problems section and check any applicable issues related to the client’s employment, including policy violations and performance concerns.
  7. Document any family problems exacerbated by substance use in the corresponding section, checking all relevant boxes.
  8. List any legal or financial problems the client may be facing, alongside descriptions as needed.
  9. Record any mental health disorders and physical or medical problems associated with substance use by checking applicable boxes and providing additional comments.
  10. Complete the section on the client's control over their substance use, noting any loss of control or history of attempts to reduce use.
  11. Fill in the multi-axial diagnostic impressions, outlining relevant diagnoses and prognosis.
  12. Check any recommended treatment options and provide details for the recommended program, facility, or counselor.
  13. Have the counselor sign and date the form before submission. Ensure all sections are complete to avoid delays.
  14. Save your changes, then download or print the completed assessment for sharing as needed.

Complete your Substance Abuse Assessment online today to ensure a thorough evaluation.

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In Fiscal Year 2012, Trilogy aligned its strategic plan for growth with the Substance Abuse and Mental Health Services Administration's (SAMHSA) definition of the four major dimensions that are essential to a life in recovery: health, home, purpose and community.

Basic demographic and historical information, and identification of established or probable diagnoses and associated impairments. General strengths and problem areas. Stage of change or stage of treatment for both substance abuse and mental health problems.

Substance use disorder occurs when a person's use of alcohol or another substance (drug) leads to health issues or problems at work, school, or home. This disorder is also called substance abuse.

A thorough substance use assessment includes a detailed inventory of the type, amount, frequency, and consequences of the patient's substance use, their perception of their use and readiness to change, an assessment of co-occurring psychiatric disorders, a medical history, physical examination and laboratory tests, the ...

Recent findings from the 2009 National Household Survey on Drug Use and Health (NSDUH) indicate that approximately 7% of adolescents in the US met DSM-IV criteria for an alcohol or illicit drug disorder in the past year (SAMHSA, 2010b), representing over 1.7 million youth age 12-17 (SAMHSA, 2010a).

Taking the substance in larger amounts or for longer than you're meant to. Wanting to cut down or stop using the substance but not managing to. Spending a lot of time getting, using, or recovering from use of the substance.

Mainly, it's to determine if an individual meets the criteria for a substance use disorder diagnosis and, if so, how severe the disorder is at that time. Other reasons include finding out if there's a comorbid disorder or other drugs being used and to learn how much substance use affects the person's daily life.

Criteria for Substance Use Disorder Withdrawal: When you stop using the substance, you experience withdrawal symptoms. Tolerance: You have built up a tolerance to the substance so that you have to use more to get the same effect.

Basic demographic and historical information, and identification of established or probable diagnoses and associated impairments. General strengths and problem areas. Stage of change or stage of treatment for both substance abuse and mental health problems.

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