ASSIST

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is a screening tool developed by the World Health Organization (WHO) to detect and provide early intervention for substance use disorders. The ASSIST is designed to identify individuals who are using substances in a harmful or risky manner, prompting further evaluation and appropriate intervention.

Key Features of ASSIST:

1. Broad Substance Coverage: The ASSIST assesses use of various substances, including tobacco, alcohol, cannabis, cocaine, amphetamine-type stimulants, sedatives, hallucinogens, inhalants, opioids, and other drugs.
2. Questionnaire Structure: The ASSIST consists of several questions that inquire about the following:
   1. Lifetime use of specific substances.
   2. Frequency of use in the past three months.
   3. Cravings or strong desire to use the substance.
   4. Problems related to substance use (health, social, legal, or financial).
   5. Failure to fulfill major obligations due to use.
   6. Concern expressed by others about the individual’s use.
   7. Attempts to cut down on use.
3. Scoring: Each substance is scored separately based on the responses. The scores fall into risk categories:
   1. Low-risk: Indicates that a person’s substance use is currently not putting them at risk for health or other problems.
   2. Moderate-risk: Suggests a need for brief intervention.
   3. High-risk: Indicates a need for more intensive intervention, possibly including referral for specialized assessment and treatment.
4. Versatility: The ASSIST can be used in various settings, including primary care, emergency departments, and other community health settings. It is suitable for adults and adolescents.
5. Guidance for Intervention: The ASSIST not only screens for substance use but also provides guidance on the level of intervention required based on the risk category.

Implementation:

1. Administration: The ASSIST can be self-administered or administered by a trained health worker.
2. Time Efficient: It takes about 5-10 minutes to complete, making it feasible for use in busy clinical settings.
3. Cultural Sensitivity: The ASSIST has been validated in multiple countries and is designed to be culturally neutral.

The ASSIST is valuable in identifying not just severe substance use disorders but also more moderate levels of risky use that might not be detected by other means. Early identification allows for timely intervention, which can prevent the progression of substance use disorders and reduce related health and social consequences.