What Is a Substance Abuse Evaluation?

A substance abuse evaluation is a screening to determine if a patient takes drugs excessively or dangerously. This can be part of a patient intake at an emergency room or when a patient enters a new medical practice. It may also be performed by police officers and court representatives in legal settings, like arrests or meetings with a probation officer. If the testing reveals that a patient may have a substance abuse problem, recommendations to pursue treatment may be made.

Patients who are abusing substances like illegal or prescription drugs may be secretive about it because of fears about being caught or shamed. Blunt questions about substance use sometimes alienate a patient, who may not respond honestly. An important part of the evaluation involves making the patient comfortable and framing questions neutrally to get honest replies. An emergency room doctor, for example, might stress that medical information is confidential, but could be important for patient care.

During a substance abuse evaluation, a care provider can ask a series of questions about drugs the patient may take, and at what frequency. Generic tests are available and doctors may customize them for specific patients to get accurate answers. Care providers may pay attention to signs that the patient may be lying, such as hesitance when asked about the frequency of drug use. Body language can also be important.

This may provide an opportunity for an intervention. Patients could be asked about their emotional state with questions like “do you worry about how much you use a particular drug?” If patients indicate that they do have concerns or want treatment, this could be noted to ensure that a referral is provided.

In a medical setting, a substance abuse evaluation may provide important information about risks. Patients with opiate tolerance, for example, need to be handled carefully and may require more aggressive analgesia. Substance abuse can also be a cause for concern because of long term health effects. Doctors who note that a patient is at risk and might be interested in help can provide information about community resources.

Legal contexts, like booking of prisoners and reviewing prisoners on probation, may involve different uses of the substance abuse evaluation. Prison officials may want to know about substance abuse because inmates might require counseling or medical care if they experience withdrawal. Probationers might be ordered not to abuse drugs as a term of their probation, in which case the substance abuse evaluation may reveal a violation and the need for counseling or re-imprisonment.