Addiction Severity Index

When it comes to addiction treatment, many people assume that simply addressing the symptoms will be enough to enable lifelong sobriety. However, it is essential to address the root cause of any addiction. This helps ensure long term recovery and lessens the chance of relapse. Tools such as the addiction severity index can help diagnose the true causes behind an addiction and determine how far the disease has progressed.

What is the addiction severity index?

The addiction severity index (ASI) provides background information to professionals who can then use that information to treat the addiction more effectively. According to the Journal of Nervous & Mental Diseases, an experienced interviewer can use it to analyze information from recent experiences as well as life-long problems. The ASI accomplishes this by asking a series of questions which cover 7 different topic areas: 

  1. Medical status
  2. Employment and support
  3. Drug use
  4. Alcohol use
  5. Legal status
  6. Family/social status
  7. Psychiatric status

The primary purpose of using the ASI system is to ensure a more holistic treatment for the patient. Drug addiction can run deep into the lives of those affected and its implications usually go far beyond physical health. Many people with substance use disorders develop problems in their relationships, lose or jeopardize their jobs, and may even find themselves homeless. The ASI allows rehab centers to develop individualized treatment plans. Addressing and treating unique factors increases the chances of long-term sobriety.

ASI Scoring

The ASI is scored mostly with a 0-1 scale. If the patient answers yes, they get a 1 and if they answer no, they get a 0. At the end, the therapist or medical professional will tally up the total score. The higher the score, the greater the need for treatment. 

Other sections typically involve open-ended short answer questions or other types of scale ratings. The most important aspect of administering the ASI that the patient needs to understand is that the ASI is not a test. There is always the risk of patient misrepresentation when taking it. It is possible for someone to feel defensive or as if they are in trouble. Instead, it is helpful to think of it as more akin to an interview. The end goal is to understand the most accurate, comprehensive view of someone’s addiction so they can get the treatment they need. 

What kind of questions are on the ASI?

The ASI asks a variety of questions which all fall under one or more of the seven topics listed above. Most of the questions focus on the past 30 days of the patient’s life. However, that is just to understand the severity of the addiction in its current state. The interviewer also gathers information on the individual’s life and family history, since addiction can be genetic or be influenced by family patterns.

Typical ASI questions may include:

  • How many days were you paid for working the past 30 days?
  • In the past 30 days, how many days have you experienced employment problems?
  • How much money would you say you spent during the past 30 days on alcohol? Drugs?

Some versions of the ASI also have evaluator confidence ratings which allow the proctor to note how confident the patient seems. This helps identify and account for any potential dishonesty or misrepresentations. 

ASI can help identify the severity of addiction

When should the ASI be taken?

It is typical to administer the ASI at the beginning of a patient’s rehabilitation journey. Most of the time, it is a standard part of in-processing. This helps therapists understand the severity of the addiction. For example, an individual with a family history of addiction and drug abuse may require more specialized treatment since they may be genetically disposed to addiction. 

It is also common to administer the ASI at regular intervals – around every 30 days that a patient spends in treatment. This is one of the best ways to monitor for progress and treatment responsiveness before out-processing begins. 

Taking the ASI and more information

Addiction to drugs or alcohol is a difficult illness to treat and it is a chronic long-term illness. It even shares similar relapse rates to other chronic illnesses such as diabetes and heart disease. Addiction is complex and has potential for long term implications. Subsequently, it is important to treat addiction in a careful and comprehensive way. If you or a loved one is suffering from addiction, please contact us today so that our compassionate staff can help you start down the road to recovery.

Kayla E
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