Addiction Severity Index

Since every individual suffering from substance abuse is different, shouldn’t their treatment plans be tailored to their individual needs? One way to understand each addict’s unique situation is through the Addiction Severity Index (ASI), which according to The National Institute on Alcohol Abuse and Alcoholism (NIAAA), is an assessment that looks at “the big picture” of the lives of those suffering from addiction in order to effectively plan their treatment process. Due to its simplicity and cost-effectiveness, the ASI is the most frequently used addiction assessment tool used by treatment providers and stage agencies today.

The History of Addiction Severity Index

“The Addiction Severity Index is a semi-structured interview designed to address seven potential problem areas in substance-abusing patients: medical status, employment and support, drug use, alcohol use, legal status, family/social status, and psychiatric status. In 1 hour, a skilled interviewer can gather information on recent (past 30 days) and lifetime problems in all of the problem areas. The ASI provides an overview of problems related to substance, rather than focusing on any single area” (NIAAA).

The ASI was developed in 1980 by A. Thomas McLellan and other contributors from the University of Pennsylvania’s Center for the Studies of Addiction. Along with being an advisor to an abundance of nonprofit and government scientific organizations, McLellan also served as the Deputy Director of the Office of National Drug Control Policy under the Obama administration. The ASI was the first assessment of its kind to weigh all of the potential substance abuse factors when determining a treatment plan.

The ASI’s one-hour interview format creates a personal experience between the researcher, clinician, or technician and the addict. The Teen-Addiction Severity Index (T-ADI) and the Addiction Severity North Dakota State (ASI-ND/NAV) for Native Americans are modified versions of the Addiction Severity Index used in different circumstances regarding age and cultural sensitivities. The ASI has been translated into 18 languages, including Japanese and Spanish, so that its benefits can be seen throughout the world.

A. Thomas McLellan understood the importance of taking all aspects of the addict’s life into account when trying to determine the most beneficial form of treatment for them. It is vital to fully understand the overview of the individual’s life to become aware of the events that may be contributing to their addiction. By exploring the following seven areas of the addict’s life, which could also be the factors that influence drug use, the more knowledge will be gained that can help to transition the addict into recovery.

Medical status — Discovering the addict’s current and previous medical conditions may give insight to their battle with addiction.

Employment and support — The individual’s work life may be contributing to their addiction in many ways, and becoming aware of them may give insight to its relation to addiction.

Drug use — Understanding the addict’s patterns of using drugs may help to further understand a way to intervene into the addiction battle.

Alcohol use — Becoming aware of the individual’s alcohol consumption can increase more knowledge regarding their substance abuse patterns.

Legal status — Knowing the legal status of the individual, or their status defined by law, can help to classify where the individual stands within society.

Family/social status — Exploring the addict’s family relationships as well as their social status can give insight to possible social triggers for their addiction.

Psychiatric status — Assessing the individual’s psychiatric status is important to understanding their potential biological reasons for forming an addiction.

Once the interview has been conducted, the interviewer collects the data into “lifetime severity ratings” and “30 day composite scores.”

Lifetime Severity Ratings: This rating system helps the interviewer to determine the severity of the addict’s problem. The greater the individual’s score is, the need for treatment is higher. The data is measured on the following ten-point scale:

0-1: Treatment not indicated, no real problem
2-3: Treatment probably not necessary, slight problem
4-5: Some treatment indicated, moderate problem
6-7: Treatment necessary, considerable problem
8-9: Treatment absolutely necessary, extreme problem

Composite Scores: These scores utilize the data that was only specific to the last 30 days of being interviewed. Composite scores are used to measure the outcomes of the treatments, and they are reliable for their ability to track how much progress is taking place.

The ASI is considered to be a reliable and trustworthy assessment to help those suffering from addiction to develop the most effective treatment plan for their specific needs. By taking in the seven factors; medical status, employment and support, drug use, alcohol use, legal status, family/social status, and psychiatric status, the interviewer will have a more comprehensive understanding of the individual’s biological, social, and environmental history. Every addict is differenteasons behind their addiction so that they can move forward with a comprehensive treatment program best suited for their needs.

If you or a loved one is suffering from addiction, get help as soon as possible. Call Stop Your Addiction to learn more about how to achieve long-term sobriety from addiction. With information on treatment, detoxification, intervention, and more, Stop Your Addiction will provide you with the resources you need to solve your unique situation. Call Stop Your Addiction today to get started on your journey. and has a unique story to tell, so their treatment should mirror the addiction factors they are trying to overcome in their battle with substance abuse.

According to the National Institute on Drug Abuse (NIDA), many people think the reason why people become addicted to substances are because they lack moral principles, have no willpower, or are a bad person. In reality, there are are many different factors that go into addiction formation within individuals all over the world, which is why the ASI is beneficial; it takes all of these factors into consideration.

“Addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences. The initial decision to take drugs is voluntary for most people, but repeated drug use can lead to brain changes that challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs. These brain changes can be persistent, which is why drug addiction is considered a “relapsing” disease—people in recovery from drug use disorders are at increased risk for returning to drug use even after years of not taking the drug” (NIDA).

According to an article from the New York Times, A. Thomas McLellan’s youngest son started struggling with addiction in the eighth grade, and later passed away. The article explains McLellan’s quest to figure out how to better assess and treat addiction:

“In recent years, Dr. McLellan has focused on the lack of addiction screening in primary health care settings like doctors’ offices and emergency rooms. For example, he said, just as with hypertension or diabetes, there is a concrete way to measure whether someone has an alcohol problem. The measuring stick is known as “3-14” — so if someone is having 3 or more drinks a day, or 14 per week, that should raise a red flag, and physicians should be much better equipped to intervene and offer treatment options if there is a problem. Ideally, Dr. McLellan said, that treatment would be available in the medical system itself, not segregated in rehabilitation and detox programs, with their high failure rates” (The New York Times).

Since addiction is such a complex issue, it is necessary to identify all possible factors for addiction before undergoing the treatment process. The Addiction Severity Index can help individuals determine which treatment program is right for you or your loved one.

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