ASSIST screening tool guide

ALDWIN DEXTER A.
RUBIA, RN, MD
HEALTH HUMAN RESOURCE DEVELOPMENT BUREAU
Department of Health Central Office
+63 933 489 4535 | dex7reme@live.com.ph
The DRUG ABUSE SCREENING TEST (DAST) was
designed to be used in a variety of settings to
provide a quick index of drug-related problems.
The DAST yields a QUANTITATIVE INDEX of the

degree of consequences related to drug abuse.
The instrument takes approximately five minutes

to administer. The DAST has been evaluated and
demonstrated excellent reliability and diagnostic
validity in a variety of populations and settings.
THINK QUALITY!
DO IT RIGHT
THE FIRST TIME!
ALCOHOL, SMOKING AND
SUBSTANCE INVOLVEMENT
SCREENING TEST
The Alcohol, Smoking and Substance Involvement Screening Test
(ASSIST) was developed under the auspices of the World Health
Organization (WHO) by an international group of addiction researchers
and clinicians in response to the overwhelming public health burden
associated with psychoactive substance use worldwide.
Purpose
The ASSIST is designed to be used by PRIMARY HEALTH CARE WORKERS, but
has been found to be useful for any human services worker who may come
into contact with people who use substances in a harmful or hazardous way
in their line of work, or who work with people whose substance use may
place them at increased risk of harms compared with the rest of the
community.
THESE INCLUDE: Community health workers, mental health workers, nurses,

social workers, physicians, general practitioners, psychologists, youth
workers, indigenous workers, psychiatrists, obstetricians, midwives,
counsellors, correctional service officers and drug and alcohol workers.
The SCREENING PROVIDES AN OPPORTUNITY TO EDUCATE CLIENTS
ABOUT THE RISKS OF HAZARDOUS ALCOHOL OR OTHER SUBSTANCE
USE.
There is evidence that if primary health care workers inquire about

substance use risk factors then clients are more willing to talk about
substance use problems and to consider the possibility of changing
their substance use behaviours.
The ASSIST is the first screening test which covers all psychoactive
substances including alcohol, tobacco and illicit drugs, and can
help health care workers identify the level of associated risk for each
substance used by a client.
While substance use is associated with physical and mental health

problems, it is also worth noting that harmful or hazardous use
patterns of alcohol and drugs can also cause significant social
problems for the user, such as problems with family, friends, the law,
work or study and finances.
The ASSIST (version 3.1) is an 8 ITEM QUESTIONNAIRE designed to be
administered by a health worker to a client using paper and pencil, and
takes about 5-10 minutes to administer.
The ASSIST was designed to be culturally neutral and useable across a

variety of cultures to screen for use of the following substances:
TOBACCO PRODUCTS SEDATIVES AND SLEEPING PILLS
ALCOHOL (BENZODIAZEPINES)
CANNABIS HALLUCINOGENS
COCAINE INHALANTS
AMPHETAMINE-TYPE STIMULANTS OPIOIDS
(ATS) OTHER DRUGS
In brief the ASSIST comprises the following questions:
Question 1 (Q1) asks about WHICH Question 5 (Q5) asks about the frequency
SUBSTANCES have ever been used in the with which use of each substance has
clients lifetime. INTERFERED WITH ROLE RESPONSIBILITIES IN
THE PAST THREE MONTHS.
Question 2 (Q2) asks about the FREQUENCY
OF SUBSTANCE USE in the past three months, Question 6 (Q6) asks if ANYONE ELSE HAS
which gives an indication of the substances EVER EXPRESSED CONCERN about the clients
which are most relevant to current health use of each substance and how recently that
status. occurred.
Question 3 (Q3) asks about the FREQUENCY Question 7 (Q7) asks whether the CLIENT HAS
OF EXPERIENCING A STRONG DESIRE or urge EVER TRIED TO CUT DOWN OR STOP USE of a
to use each substance in the last three substance, and failed in that attempt, and how
months. recently that occurred

Question 8 (Q8) asks whether the CLIENT HAS
OF HEALTH, SOCIAL, LEGAL OR FINANCIAL
EVER INJECTED ANY SUBSTANCE and how
PROBLEMS related to substance use in the last
recently that occurred.
three months.
The ASSIST obtains information from clients about lifetime use of
substances, and use of substances and associated problems over the LAST
3 MONTHS.
It can identify a range of problems associated with substance use

including acute intoxication, regular use, dependent or high risk use and
injecting behavior.
If a client has been frequently injecting in the last 3 months then they may
require referral to specialist assessment and treatment.
Question 1 (Q1) asks about WHICH
SUBSTANCES have ever been used in the
clients lifetime.
OF SUBSTANCE USE in the past three months,
which gives an indication of the substances
which are most relevant to current health
status.
OF EXPERIENCING A STRONG DESIRE or urge
to use each substance in the last three
months.
OF HEALTH, SOCIAL, LEGAL OR FINANCIAL
PROBLEMS related to substance use in the last
three months.
Question 5 (Q5) asks about the frequency
with which use of each substance has
INTERFERED WITH ROLE RESPONSIBILITIES IN
THE PAST THREE MONTHS.
Question 6 (Q6) asks if ANYONE ELSE HAS
EVER EXPRESSED CONCERN about the clients
use of each substance and how recently that
occurred.
EVER TRIED TO CUT DOWN OR STOP USE of a
substance, and failed in that attempt, and how
recently that occurred
EVER INJECTED ANY SUBSTANCE and how
recently that occurred.
ASSIST SCORING:
Responses to Q8 are not included in calculating specific substance involvement

score but injecting is an indicator of risk.
INJECTING BEHAVIOUR (Q8) is a particularly high risk activity associated with increased
likelihood of overdose, dependence, infection with bloodborne viruses such as HIV and
hepatitis C and with higher levels of other drug related problems.
If a client has been frequently injecting in the last 3 months then they may require referral to
specialist assessment and treatment.
ASSIST SCORING
Questions particularly associated with DEPENDENT OR HIGH RISK
use are:
Compulsion to use (Q3),
failed attempts to cut down (Q7) and
Injecting behaviour (Q8)
ASSIST SCORING:
The ASSIST determines a RISK SCORE for EACH SUBSTANCE which is used to start a
discussion (brief intervention) with clients about their substance use.
LOW RISK MODERATE RISK HIGH RISK

Comm. Surveillance CBTx DOH TRC
RECOMMENDATION
HEALTH EDUCATION
HEALTH EDUCATION
HEALTH EDUCATION
HEALTH EDUCATION
HEALTH EDUCATION
HEALTH EDUCATION
HEALTH EDUCATION
HEALTH EDUCATION
HEALTH EDUCATION
HEALTH EDUCATION
Instruction!
Palihog og tubag sa mga pangutana batay sa
kamatuoran og inyong konsensya.
Dayun markaha og [X] mark ang inyong tubag

dapit sa gihatag nga espacio.
QUESTION #1 Unsang mga klase nga substance o droga ang imong
nasulayan sa paggamit sukad sa tibuok nimong kinabuhi?
DILI OO
A SIGARILYO (Cigarettes, Cigars, Tobacco)
B ALKOHOL (Beer, Vino, Tuba, Lambanog)
C CANNABIS (Marijuana)
D COCAINE
E AMPHETAMINE (Shabu, Ecstacy)
F INHALANTS (Rugby, Paint Thinner, Gasolina, Petrolyo)
G SEDATIVES OR SLEEPING PILLS (Valium, Diazepam, Alprazolam)
H HALLUCINOGENS (LSD, PCP, acid, mushrooms)
I OPIODS (Heroin, Morphine, methadone, Codeine)
J Others, specify
Kadtong mga item nga nahisgot gikan letrang
[A] hangtod letrang [J] nga dili applicable nga
inyong tubagon palihog og markahi og [X]
gikan sa Question 2 to 7.
QUESTION #2 Sa niaging 3 ka-buwan, ikapila ka mugamit sa droga o
substance imong nahisgot nga nagamit?
WALA KAS-A O KADA KADA HALOS KA
DUHA KA BUWAN SEMANA ADLAW
BESES
D COCAINE
G SEDATIVES OR SLEEPING PILLS (Valium, Diazepam,
Alprazolam)
J Others, specify
QUESTION #3 Sukad sa niaging 3 ka-buwan, unsa ka kanunayon nga
nagpangita ka sa mga nahisgot nimong nga drogas o substance?
BESES
D COCAINE
Alprazolam)
J Others, specify
QUESTION #4 Sukad sa niaging 3 ka-buwan, ikapila nakahatag og
problema sa aspeto sa panglawas, katilingban, legal o sa kwarta/
financial sa imong paggamit sa nahisgot nga drogas o substance?
BESES
D COCAINE
Alprazolam)
J Others, specify
QUESTION #5 Sukad sa niaging 3 ka-buwan, ikapila ka
napakyas sa pagtuman sa imong mga trabaho sa panimalay o
opisina?
BESES
D COCAINE
Alprazolam)
J Others, specify
QUESTION #6 Naa ba kay kaila (higala o kapamilya) nga nagpakabana
sa imong paggamit sa mga nahisgot nga drogas o substance?
WALA OO, SA SULOD SA 3 OO, PERO DILI SA
NIAGING BUWAN SULOD SA 3
NIAGING BUWAN
D COCAINE
Alprazolam)
J Others, specify
QUESTION #7 Nisuway na ba ka pero napakyas og
hunong sa paggamit sa nahisgot nga drogas o
substance?
WALA OO, SA SULOD SA 3 OO, PERO DILI SA
NIAGING BUWAN SULOD SA 3
NIAGING BUWAN
D COCAINE
Alprazolam)
J Others, specify
QUESTION #8 Nakagamit ka og tambal pinaagi
sa injection (i.e. Nalbupine)
WALA OO, SA SULOD SA 3 NIADGING OO, PERO DILI SA SULOD SA

BUWAN 3 NIAGING BUWAN
Thank You!

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ALDWIN DEXTER A.

The DAST yields a QUANTITATIVE INDEX of the

The instrument takes approximately five minutes

THESE INCLUDE: Community health workers, mental health workers, nurses,

There is evidence that if primary health care workers inquire about

While substance use is associated with physical and mental health

The ASSIST was designed to be culturally neutral and useable across a

Question 4 (Q4) asks about the FREQUENCY

It can identify a range of problems associated with substance use

Responses to Q8 are not included in calculating specific substance involvement

LOW RISK MODERATE RISK HIGH RISK

Dayun markaha og [X] mark ang inyong tubag

WALA OO, SA SULOD SA 3 NIADGING OO, PERO DILI SA SULOD SA

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