Addiction Severity Index (ASI): Using the ASI Assessment
The Addiction Severity Index (ASI) is an assessment tool used to assess an adult’s condition in 7 key problem areas that are typically affected by substance abuse, including medical status, employment, and more.1 A testing administrator can perform the test in approximately 1 hour in a structured interview format.1
The ASI screening tool is helpful for practitioners in assessing clients so that they can determine the types of addiction treatments the client may need and make a plan for moving forward.2 This article will outline the details of the ASI assessment so that you can have a better understanding of its use.
What Is the Addiction Severity Index (ASI)?
The ASI is an assessment tool used by psychologists, psychiatrists, and therapists to gauge the severity of a person’s substance abuse and provides a comprehensive overview of a person’s addiction-related issues.1 Established in 1980 in the United States, ASI screening can be used in a variety of settings, such as clinics, mental health facilities, prisons, psychiatric wards, and rehab centers.3 It was developed at the Philadelphia Veterans Affairs Medical Center to be used as a tool to assess and treat people with drug or alcohol addiction issues.4
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The ASI addresses 7 main aspects of a person’s behavior and environment.1 The areas assessed include:1
- Medical status.
- Employment and support.
- Drug use.
- Alcohol use.
- Legal status.
- Family/social status.
- Psychiatric status.
ASI Screening Questions
The ASI is a questionnaire that the clinician administers and then scores. Some of the ASI screening questions are as follows:5
- How many days have you experienced medical problems in the past 30 days?
- Are you taking any prescribed medication on a regular basis for a physical problem?
- Level of education completed?
- How long was your longest full-time job?
- How many people depend on you for the majority of their food, shelter, etc.?
- How many times in your life have you been treated for alcohol abuse?
- How much money would you say you spent during the past 30 days on drugs?
- How many days have you been treated in an outpatient setting for alcohol or drugs in the past 30 days?
- How many times in your life have you been arrested and charged with shoplifting or vandalism?
- How many times in your life have you been charged with driving while intoxicated?
- Are you presently awaiting charges, trial, or sentencing?
- Do you live with anyone who uses non-prescribed drugs?
- How many close friends do you have?
- Has anyone ever abused you?
- How many times have you been treated for any psychological or emotional problems?
- Have you had a significant period of time (that was not a direct result of drug/alcohol use) in which you have experienced serious anxiety or tension?
How Should the ASI be Used?
The ASI assessment tool must be administered by a trained professional. It is an important tool in providing a comprehensive picture of clients struggling with addiction. Not only will it aid in planning a substance abuse treatment plan, it may also help to reveal the most appropriate mental health treatment for those in need.
How Is the ASI Scored?
Each questions typically has a score attached to it of 1 or 0.5 For example, if the patient answers yes, they may score 1; if they answer no, they may score 0.5 For some items, the scoring may be reversed. At the end of the test, the trained clinician tallies the scores and places them in the chart under the appropriate categories.5 The higher the score, the higher the need for treatment.
ASI Severity Ratings
The ASI substance abuse assessment uses the composite score to assign a severity rating. The ratings are based on a scale of 0 to 9 as follows:5
- 0–1: No imminent problem, treatment not indicated.
- 2–3: Slight problem; treatment may not be necessary.
- 4–5: Moderate problem, a treatment plan should be considered.
- 6–7: Considerable difficulty, begin a treatment plan.
- 8–9: Extreme problem, treatment is vital.
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- McLellan, A.T., Luborsky, L., O’Brien, C.P. & Woody, G.E. (1980). An improved diagnostic instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous & Mental Diseases, 168, 26-33.
- NCBI. (n.d.). Appendix G: Screening and assessment instruments.
- NCBI. (2013). Addiction Severity Index (ASI) summary scores: comparison of the recent status scores of the ASI-6 and the composite scores of the ASI-5.
- Science Direct. (2021). Addiction Severity Index.
- Adai. Washington.Edu. (n.d.). Module Addiction Severity Index – fifth edition.