Overview
Welcome to the Screening Tools interaction, where you will learn more about some of the tools that are commonly used in screening for addiction, including:
- ASSIST: The Alcohol, Smoking and Substance Involvement Screening Test
- AUDIT: The Alcohol Use Disorders Identification Test
- CAGE: Cutdown, Annoyed, Guilty, Eye-Opener
- Fagerstrom (FTND): The Fagerstrom Test for Nicotine Dependence
- PAT: Paddington Alcohol Test
- TWEAK: Tolerance, Worried, Eye-Opener, Amnesia, Cut Down
Click each tab above to learn more about each tool.
Description
The ASSIST was developed under the auspices of the World Health Organization. It is a questionnaire with 8 items, and takes about 10 minutes to administer.
The ASSIST screens for risky use of all main substance types and determines a risk score for each substance.
Meaning
The scores are reported back to the person via a brief intervention. The focus of the brief intervention is determined by the client’s risk category.
Clients whose scores are all in the low risk range should receive positive feedback and encouragement not to increase their use.
Clients whose scores are in the moderate risk range are using substances in a risky, hazardous or harmful way that has the potential to cause problems. This is the principal target group for a brief intervention to help them understand the potential risks and help motivate them to reduce or cease their substance use.
For clients whose scores are in the high risk range, the focus of the brief intervention should be on encouraging them to explore options for further assessment and treatment. Clients in the high risk category are likely to meet the criteria for dependence.
Scores
The score falls into a ‘low’, ‘moderate’ or ‘high’ risk category which determines the most appropriate intervention for that pattern of use. For adults, scores of 11 or more for alcohol, or 4 or more for other substances indicate moderate risk, and scores of 27 or more indicate high risk. Any injecting use in the last 3 months indicates moderate to high risk.
Description
The AUDIT was developed under the auspices of the World Health Organization. It is a questionnaire with 10 items that assess alcohol misuse over a 12 month period. It is designed to screen for a range of alcohol-related problems and in particular for hazardous and harmful consumption.
Scores
A score of 8 is associated with harmful or hazardous drinking, and a score of 13 or more is likely to indicate alcohol dependence.
Description
Designed to identify potential alcohol abuse and dependence, the CAGE can be administered in less than a minute and hence is readily incorporated into routine primary health care assessments. The CAGE consists of 4 questions requiring only yes/no answers:
- Have you ever felt you ought to cut down on your drinking?
- Have people annoyed you by criticising your drinking?
- Have you ever felt bad or guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?
Scores
The CAGE is scored by adding the number of “yes” answers. A score of 2 or more indicates that the client may be drinking at harmful or hazardous levels and further assessment of potential alcohol abuse is warranted.
Description
The Fagerstrom Test assesses the intensity of physical addiction to nicotine. The full version contains 6 items, although abbreviated versions are also in use. The six items are:
- How soon after you wake up do you smoke your first cigarette? (5, 5-30, 31-60, after 60 minutes)
- Do you find it difficult not to smoke in places where you shouldn’t? (Yes/no)
- Which cigarette would you most hate to give up; which cigarette do you treasure the most? (First in morning or any other one)
- How many cigarettes do you smoke each day? (0-10, 11-20, 21-30, 31 or more)
- Do you smoke more during the first few hours after waking up than during the rest of the day? (Yes/no)
- Do you still smoke if you are so sick that you are in bed most of the day, or if you have a cold or the flu and have trouble breathing? (Yes/no)
Scores
Yes/no items are scored 0 or 1, and multiple choice items are scored from 0 to 3 giving a maximum possible score of 10. Scores of 7 to 10 points indicate a high level of dependence, 4 to 6 points indicates moderate dependence, and less than 4 points indicates minimal dependence.
Description
The PAT was developed in the UK specifically for use in hospital emergency departments to detect high risk alcohol use. It is short and very quick to administer.
- What is the most alcohol you will drink in any one day? If 5 or more for women, 7 or more for men, “Is that at least once a week”?
- Do you feel your current attendance at the ED is related to alcohol?
Scores
A “yes” response to either question indicates likely high risk alcohol use.
Description
Derived from the CAGE and another longer assessment tool, the MAST, the TWEAK comprises 5 questions. It has been shown to detect alcohol problems in both men and women in the general population and can be administered, or self-completed, in less than 2 minutes.
The 5 questions are:
- How many drinks can you hold? (Tolerance)
- Have close friends or relatives worried or complained about your drinking in the last year? (Worried)
- Do you sometimes take a drink in the morning when you first get up? (Eye-opener)
- Has a friend or family member ever told you about things you said or did while you were drinking that you could not remember? (Amnesia)
- Do you sometimes feel the need to cut down on your drinking? (Cut down)
Scores
The Tweak has 5 questions. The first two questions attract two points each. Each following question attracts 1 point if the answer is yes. The maximum possible score is 7. A total score of 3 or more for men, or 2 or more for women is indicative of alcohol problems.