Addiction Severity Index - 5th Edition Overview

INTRODUCING THE ASI

• Explanation of the Addiction Severity Index (ASI): a standardized interview to evaluate various aspects of an individual's life related to addiction.

  • Seven potential problem areas:

  • Medical

  • Employment/Support Status

  • Alcohol

  • Drug

  • Legal

  • Family/Social

  • Psychiatric

• All clients undergo the same ASI, with confidentiality assured regarding shared information.

• Timing of questions:

  • Two periods of focus: Past 30 days and Lifetime.

PATIENT RATING SCALE

• Scale for patients to express their level of distress concerning problems in the discussed areas:

  • 0: Not at all

  • 1: Slightly

  • 2: Moderately

  • 3: Considerably

  • 4: Extremely

• The importance of treatment for each area will also be ranked using this scale.

• Rights of the client: They have the option to refuse to answer questions.

INTERVIEWER INSTRUCTIONS

• Guidelines to facilitate an effective interview:

  1. No blanks in responses.

  2. Take comprehensive notes (indicate question numbers).

  3. Special codes for unanswered (-9) or not applicable (-8) questions.

  4. Terminate the interview in cases of misrepresentation across two or more sections.

  5. Use half-time rounding for questions regarding duration (e.g., 14 days up to 1 month).

CONFIDENCE RATINGS

• Assess whether the provided information is skewed by:

  • Patient misrepresentation

  • Patient misunderstanding

HOLLINGSHEAD CATEGORIES

• Classification of clients’ occupational and educational backgrounds:

  1. Higher executives, major professionals.

  2. Managers, lesser professions.

  3. Administrative personnel, minor professionals.

  4. Clerical and sales roles.

  5. Skilled manual workers.

  6. Semi-skilled roles.

  7. Unskilled labor.

ALCOHOL/DRUG USE INSTRUCTIONS

• Queries are grouped into two periods for assessment:

  • Past 30 days (require number of usage days).

  • Lifetime (focus on extended use periods).

• Identification of usage patterns (e.g., regular use is defined as 3+ times/week).

COMMONLY USED DRUGS

• Detailed classifications of drugs:

  • Alcohol: beer, wine, liquor.

  • Opiates: painkillers, codeine, etc.

  • Barbiturates and sedatives.

  • Cocaine: forms including crack.

  • Cannabis.

  • Hallucinogens: LSD, mushrooms.

  • Inhalants: various household or legal substances.

MEDICAL STATUS

• Assess history of hospitalization for medical issues, excluding addiction-related treatments.

• Questions include:

  • Frequency of medical hospitalizations

  • Time since last hospitalization

  • Chronic health issues affecting daily activities.

EMPLOYMENT/SUPPORT STATUS

• Questions covering:

  • Educational background and completion.

  • Employment status and patterns over the past three years.

  • Support from family or friends.

  • Financial specifics regarding income sources.

LEGAL STATUS

• Overview of legal history:

  • Arrests, convictions, and legal issues.

  • History of incarceration and its duration.

FAMILY/SOCIAL HISTORY

• Inquire about family background in relation to addiction and psychiatric issues.

• Evaluate current family and social relationships and their impact on the client.

PSYCHIATRIC STATUS

• Questions related to mental health treatment:

  • Frequency of inpatient and outpatient treatment for psychological issues.

  • Current mental health challenges and their impact on functioning.

SEVERITY PROFILE

• Profile summary of distress levels across all categories ranging from Medical, Employment, Alcohol, Drug, Legal, Family/Social to Psychiatric.