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Addiction Severity Index (ASI)

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What is the Addiction Severity Index (ASI) Assessment?

The Addiction Severity Index (ASI) - Fifth Edition is an assessment tool. It’s used by medical professionals to assess someone with substance use problems. 

The assessment looks at seven key areas that are affected by substance use. The assessment takes approximately an hour to complete. It is conducted using an interview format.

What Does the Addiction Severity Index (ASI) Measure? 

The Addiction Severity Index looks at the ‘big picture’ of the issues people with substance use problems are facing. 

The ASI takes into account a person’s: 

  • Lifestyle
  • Previous and current life events
  • Psychiatric status
  • Medical status
  • Legal status
  • Employment status

The ASI also measures seven factors of addiction and asks questions related to each factor, including:

1. Alcohol Use

ASI questions:

  • How many times have you received treatment for alcohol abuse in your life?
  • How much have you spent on alcohol in the last 30 days?

2. Drug Use

ASI questions:

  • How much have you spent on drugs in the last 30 days?
  • Do you live with anyone using drugs not prescribed to them by a doctor?

3. Legal Problems

ASI questions:

  • How many times have you been arrested and/or charged with DUI/DWI, vandalism, or shoplifting?

4. Family History of Addiction

ASI questions:

  • Do any close relatives have a substance use issue or did they in the past?
  • Have you ever experienced abuse?
  • How many close friends do you have?

5. Psychiatric Illness

ASI questions:

  • Have you ever been treated for emotional or psychological issues?
  • Do you experience severe anxiety or tension?

6. Employment/School Problems

ASI questions:

  • What’s your highest level of education completed?
  • What’s the longest you’ve worked in a full-time job?
  • Does anyone depend on you for shelter, food, or other survival needs?

7. Health Problems

ASI questions:

  • Have you experienced any medical problems within the last 30 days?
  • Are you using any prescribed medications to treat physical ailments?
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Types of ASI Screening Questions

ASI screening questions fall into one of seven categories, including:

  • Medical
  • Employment
  • Drug and alcohol use
  • Legal issues related to drug and alcohol use
  • Family history of alcohol and drugs
  • Relationships with friends and family
  • Co-occurring mental or physical health conditions

People undergoing the screening have the right to refuse to answer any question. This is important for people if they consider the topic too personal, uncomfortable, painful, or traumatic. 

However, it’s important to remember that you’ll benefit from answering as many questions as possible and doing so honestly. 

The information compiled from the assessment is used to design a comprehensive treatment plan that is appropriate for your individual needs.

ASI Severity Ratings 

The ASI uses a scale ranging from 0 to 9 to rate the severity of each factor. Overall, this helps to assess the seriousness of the patient’s problem. 

The higher the overall score in each category, the greater the need for intervention or treatment. 

The score is also used to help with planning a treatment program.

Severity ratings are as follows:

  • 0 to 1: No problem, treatment not needed
  • 2 to 3: Slight problem, treatment probably not needed
  • 4 to 5: Moderate problem, some treatment probably needed
  • 6 to 7: Considerable problem, treatment needed
  • 8 to 9: Extreme problem, treatment definitely needed
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How Reliable is an ASI Assessment?

The Addiction Severity Index is an accurate and consistent tool for assessing substance use issues. 

It helps medical professionals identify problem areas related to substance use. Once these issues are identified, ASI results make designing a course of treatment easier.

There is also evidence that ASI is effective for:

  • Comparing various forms of treatment
  • Predicting treatment outcome
  • Matching a client to the appropriate type of treatment

The ASI is an evolving tool. 

Someone struggling with substance use can utilize the assessment to self-report via telephone or the internet. 

This allows the assessment to be anonymous and it costs less to administer the assessment. 

The tool might one day be used to create a national database for tracking substance use treatment.

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Treatment Planning Using ASI

The ASI is important because of the complexities of substance abuse. SUD is affected by a variety of factors that impact many areas of someone’s life. 

The more information healthcare providers have about your situation, the better able they are to create an effective treatment plan.

The questions are used by medical professionals when dealing one-on-one with a patient. It helps them devise treatment plans that address every aspect of the addiction.

For example, if you struggle with maintaining employment or you’re dealing with legal issues the recovery plan can focus on these issues, as well as the medical aspects of addiction.

Additionally, addiction often damages personal relationships, self-esteem, and other factors. The ASI allows you to identify and address these things in your treatment plan. 

The ASI makes it easier for the person designing your treatment to include these issues, many of which are directly linked to substance use. The ASI provides a complete picture of what your life is like and how substance abuse plays a role.

Finally, it’s an essential tool for addressing co-occurring disorders, including anxiety and depression. 

Successful treatment is only possible when you address these conditions simultaneously with substance abuse. Left untreated, the risk of relapse is far greater.

Updated on March 29, 2022
7 sources cited
  1. Adult ASI Questionnaire.” Great Plains Tribal Chairmen’s Health Board, Accurate Assessments.
  2. Addiction Severity Index (ASI).” National Institute on Alcohol Abuse and Alcoholism.
  3. Addiction Severity Index - 5th Edition,” University of Washington.
  4. Center for Substance Abuse Treatment. “Chapter 4: Screening and Assessment.” Nih.gov, Substance Abuse and Mental Health Services Administration (US), 2009.
  5. National Institute on Drug Abuse. “Screening and Assessment Tools Chart.” Drugabuse.gov, 22 June 2018.
  6. National Institute on Drug Abuse. “Understanding Drug Use and Addiction.” Drugabuse.gov, June 2018.
  7. National Institute on Drug Abuse. “Treatment Approaches for Drug Addiction.” Drugabuse.gov, Jan. 2019.

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