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Diagnosis of Addictions

Substance use disorders are diagnosed based on a clinical interview with the individual in question and, at times, with their family members or close friends.  The goal of this assessment is to determine whether the individual meets the clinical criteria for Substance Abuse or Dependence based on the reports that they or their family members and friends provide. 

There are a few simple screening tools that can help clinicians identify individuals with substance use disorders:

The CAGE screen [ref] for alcohol abuse is a set of four questions. If an individual answers 'yes' to two or more of these questions, this suggests that they suffer from alcohol abuse or dependence. These questions are: 1) Have you ever felt the need to Cut down on drinking; 2) been Annoyed by others' criticism of your drinking; 3) felt Guilty about drinking; 4) needed an Eye-opener drink first thing in the morning?

The Alcohol Use Disorders Identification Test (AUDIT) is a 10-question self-report questionnaire that can also be used to identify individuals with alcohol abuse or dependence and also rate the severity of their condition.

The Drug Abuse Screening Test (DAST) [ref] is a 28-item self-report questionnaire that helps to identify individuals who misuse substances usually other than alcohol. A score above 6 (item 4 is reverse-scored) indicates strong chances the the individual has a substance use disorder.

The Fagerstrom Test for Nicotine Dependence (FTND) [ref] is a self-report questionnaire that helps to identify people with nicotine dependence. A score of less than 3 on this scale indicates that an individual has very low or no nicotine dependence, whereas a score of 6 or above suggests that an individual is highly dependent on nicotine.

There are no laboratory tests or imaging tests (such as CT scans or MRI scans) that can help make a diagnosis of Substance Abuse or Dependence. However, blood and urine tests are often used in order to determine whether an individual has recently consumed a substance and also to assess the level of medical complications that have resulted from the substance use. (Please see the sections on the individual substances for further information on these tests.)


Substance Dependence