GraceRoot Relationship Healing Institute
Substance Use Screening
2 validated screeners • ~5 minutes • Completely private โ results stay in your browser
This screening includes:
Please answer all three questions before continuing.
Please answer all questions before viewing your results.
Completed on • For educational purposes only โ not a clinical diagnosis
These results are educational only and do not constitute a medical diagnosis. A licensed clinician can provide a thorough assessment and personalized treatment recommendations.
Substance use disorders are medical conditions โ not moral failures. The brain is changed by repeated substance use. This is biology, and biology can be treated. Recovery is not about willpower alone; it's about getting the right support.
Screening is the beginning, not the end. A positive screen means further evaluation is warranted โ not that you have a disorder. A licensed professional can assess severity, identify root causes, and build a plan tailored to you.
Untreated substance use escalates over time. Early intervention consistently produces better outcomes and shorter treatment time. The sooner you reach out, the more options are available.
Effective treatments exist. Medication-Assisted Treatment (MAT), Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), 12-step programs, and faith-integrated recovery programs all have strong evidence bases.
You are not your use. Seeking help is a sign of strength and wisdom โ it reflects clarity about what matters to you and who you want to be.
Clinical scoring guide for AUDIT-C and DAST-10 • For licensed or training clinicians
AUDIT-C (Bush et al., 1998) โ First 3 items of the 10-item full AUDIT. Sensitivity 86% / Specificity 72% for hazardous drinking in primary care settings. Range: 0โ12. Free to use (WHO). Gender-based cutoffs apply: โฅ3 women, โฅ4 men for a positive screen; this tool uses a single cutoff of โฅ3 for general screening.
| Score | Severity Level | Clinical Action |
|---|---|---|
| 0โ2 | Low risk / Abstinence | Reinforce healthy patterns; brief psychoeducation if clinically indicated |
| 3โ4 | Hazardous use | Brief Intervention (BI); Motivational Interviewing; monitor; full AUDIT if indicated |
| 5โ7 | Harmful use | Full AUDIT; evaluate for AUD; consider referral to SUD specialist; psychoeducation |
| 8โ12 | Likely Alcohol Use Disorder | Immediate referral to SUD evaluation; assess for physical dependence; withdrawal risk assessment; MAT evaluation |
Clinical Notes
Withdrawal risk: Abrupt cessation in dependent drinkers carries seizure and delirium tremens risk. Always screen for physical dependence (CIWA-Ar) before recommending abstinence without medical supervision.
Gender: Women develop alcohol-related organ damage at lower consumption levels. Use โฅ3 as positive cutoff for women.
Full AUDIT: When AUDIT-C is positive, administer the full 10-item AUDIT for comprehensive hazardous drinking and AUD evaluation.
Bush K, Kivlahan DR, McDonell MB et al. Arch Intern Med. 1998;158(16):1789โ1795. The AUDIT: WHO collaborative project (Babor et al., 2001).
DAST-10 (Skinner, 1982; Gavin et al., 1989) โ 10-item abbreviated version of the 20-item DAST. Yes/No format; most items YES = 1 point; the "always able to stop" item is reverse-scored (NO = 1 point). Score range 0โ10. Internal consistency ฮฑ = 0.86. Sensitivity 80% / Specificity 66% for drug use disorder at cutoff โฅ3. Free to use for clinical and research purposes.
| Score | Severity Level | Clinical Action |
|---|---|---|
| 0 | No problems reported | Reinforce healthy behavior; revisit if clinical picture changes |
| 1โ2 | Low โ some use present | Psychoeducation; brief advice; monitor at next visit |
| 3โ5 | Moderate โ drug abuse likely | Comprehensive SUD evaluation; Motivational Interviewing; treatment referral if indicated |
| 6โ8 | Substantial | Immediate comprehensive evaluation; intensive outpatient or residential referral; co-occurring disorder assessment |
| 9โ10 | Severe | Urgent referral; consider medical detox; level-of-care determination (ASAM criteria); crisis planning |
Item Scoring Key
Most items: YES = 1 point
Item 3, "always able to stop" (reverse scored): NO = 1 point (inability to abstain or control use)
Item 1 gateway: If the client answers NO to item 1 (have you used non-prescribed drugs?), a score of 0 is standard โ however, clinicians should use judgment if other items suggest use.
Clinical Notes
Drug type matters: DAST does not identify which substance is used. Follow a positive screen with a detailed substance history (type, route, frequency, last use, withdrawal symptoms).
Opioid overdose risk: For clients scoring โฅ3 with suspected opioid use, assess overdose history, current tolerance, and naloxone access.
Limitations: DAST relies on self-report and underestimates in populations with stigma concerns. Clinician observation and collateral information strengthen validity.
Skinner HA. Addict Behav. 1982;7(4):363โ371. Gavin DR et al. Addiction. 1989;84(3):301โ307. Yudko E et al. J Subst Abuse Treat. 2007;32(2):189โ198.
Treating co-occurring substance use and mental health conditions simultaneously produces significantly better outcomes than sequential treatment (SAMHSA TIP 42). Positive screens on both AUDIT-C and DAST-10 ("polysubstance use") require additional assessment and specialized treatment planning.
| Combination | Prevalence / Risk | Clinical Significance |
|---|---|---|
| Alcohol + Drug Use (Polysubstance) | ~30โ40% of SUD presentations | Dramatically increases overdose, withdrawal, and organ damage risk. CNS depressants (alcohol + opioids/benzodiazepines) cause respiratory depression โ high overdose lethality. Requires comprehensive dual-substance treatment planning. |
| SUD + Depression | ~30โ40% | Bidirectional: substance use causes depressive episodes; depression drives self-medication. Abstinence alone often improves mood. Treat both; antidepressants may be appropriate after 2โ4 weeks of sobriety. |
| SUD + Anxiety | ~20โ30% | Alcohol and benzodiazepines provide short-term relief but cause rebound anxiety and dependency. Non-addictive anxiety treatment (CBT, SSRIs) essential alongside SUD treatment. |
| SUD + PTSD | ~30โ50% of PTSD | Among the highest-risk dual diagnoses. Substances used to cope with intrusive symptoms. Integrated trauma + SUD treatment (e.g., Seeking Safety, COPE) is the gold standard. |
| SUD + Bipolar Disorder | ~60% lifetime | Mood instability drives substance use; substances destabilize mood cycles. Mood stabilization must precede addiction treatment. Psychiatric evaluation essential. |
| SUD + ADHD | ~25โ50% of ADHD adults | ADHD impulsivity and self-medication are common. Stimulant medications require careful monitoring in SUD populations. Non-stimulant ADHD medications (atomoxetine, bupropion) preferred initially. |
| SUD + Eating Disorders | ~25โ35% | Especially alcohol + bulimia (shared impulse dysregulation pathway). Integrated treatment required; each condition destabilizes recovery from the other. |
Sources: SAMHSA TIP 42 (2005); Kessler RC et al. (2003); National Comorbidity Survey Replication; Brady KT et al.
Evidence-based treatment options organized by level of care and modality. Use ASAM Patient Placement Criteria for level-of-care determination.
| Modality | Substance | Evidence Base & Notes |
|---|---|---|
| Motivational Interviewing (MI) | All substances | First-line brief intervention. Effective at all severity levels. Builds intrinsic motivation for change. FRAMES framework. |
| Cognitive Behavioral Therapy (CBT) | All substances | Addresses triggers, coping skills, and relapse prevention. Strong evidence for alcohol, cannabis, cocaine, opioids. Can be delivered individually or in groups. |
| Naltrexone (oral or injectable) | Alcohol, Opioids | FDA-approved. Reduces cravings and blocks opioid euphoria. Vivitrol (monthly injectable) improves adherence. No abuse potential. |
| Buprenorphine / Suboxone | Opioids | Gold-standard MAT for opioid use disorder. Reduces mortality ~50%. Schedule III. Can be prescribed in office-based settings. |
| Methadone | Opioids | Highly effective for severe OUD; dispensed at licensed OTPs only. Best for clients with multiple treatment failures or high overdose risk. |
| Acamprosate | Alcohol | FDA-approved for alcohol abstinence maintenance. Reduces protracted withdrawal discomfort. Best for clients who have achieved initial abstinence. |
| Disulfiram (Antabuse) | Alcohol | Creates aversive reaction to alcohol. Requires high motivation and supervised administration. Not first-line; most effective with strong social support. |
| 12-Step Facilitation | All substances | AA/NA/CA peer support with strong long-term outcomes. Complements clinical treatment; does not replace it. Faith-integrated versions available (Celebrate Recovery). |
| Contingency Management (CM) | All substances | Strongest evidence for stimulant (cocaine, meth) use disorder where no FDA-approved MAT exists. Reinforces abstinence with tangible rewards. |
| Dialectical Behavior Therapy (DBT) | All substances | Most effective when SUD co-occurs with BPD, trauma, or emotional dysregulation. Skills: distress tolerance, emotion regulation, mindfulness. |
| Residential / Inpatient Treatment | All substances | For severe presentations, high relapse history, unsafe environments, or co-occurring conditions requiring intensive stabilization. |
Faith-Integrated Resources
Celebrate Recovery (CR) โ Christ-centered 12-step program with strong community outcomes.
Many clients with faith backgrounds respond better to spiritually integrated treatment alongside clinical care. Collaboration with pastoral counselors can enhance engagement and long-term recovery maintenance.
Sources: SAMHSA TIPs; NIDA Principles of Drug Addiction Treatment (3rd ed.); ASAM Patient Placement Criteria; Carroll KM & Onken LS (2005).