Substance Abuse Questions 

Description

The Substance Abuse Questions Tab is the place to document the client’s answers to questions about substance use. When complete, the answers are used by the clinician to make a determination whether to recommend further substance abuse assessment for the client or not.

If the clinician screening for substance abuse services determines the need, the clinician may also ask and document answers to some or all of the questions in the Mental Health Questions Tab.

If the client being screened is a person less than 18 years of age, the Substance Abuse Youth Screening questions will also display.

 

Substance Abuse Questions

Begin documenting answers to the substance abuse screening questions.

QUESTION 1

Are you currently or recently have you been under the influence of alcohol or drugs?

• Required for substance abuse services. Optional for mental health services.

• This question does not include medications prescribed by a physician if the medications are being used by the client exactly as the physician prescribed.
• If the client is taking medications prescribed by a physician, document the medications under the Medical Tab of the assessment.

CLICK HERE for information on documenting prescribed medications.

• To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

QUESTION 2

If Yes, what are you using?

• Required for substance abuse services. Optional for mental health services.
• This question will only display if 'YES' was selected to QUESTION #1 above.
• The user may select by the category of the substance(s) being used by the client (i.e. stimulants) or may select by the specific drug(s) being used (i.e. crack).
• If the client is using more than one substance, you may select more than one substance.
• To select more than one substance:
  • Press and hold down the Ctrl (Control) key on your keyboard. While holding down the Ctrl key, move your mouse over each substance and CLICK ON each one used by the client.

The answer choices for this question are:

None

Alcohol

Hallucinogens

- DMT

- LSD

- Marijuana/Hashish

- Mescaline

- Peyote

- Psilocybin Mushrooms

- STP

Inhalants

- Aerosols

- Anesthetics (Nitrous Oxide, Either, Chloroform)

- Nitrites

- Solvents (Paint Thinner, Gasoline, Glue)

Opiates and Synthetics

- Codeine

- Darvocet/Darvon (D-Propxyphene)

- Demerol (Meperidine Hcl)

- Dilaudid (Hydromorphone)

- Heroin

- Methadone (Non-Prescription)

- Oxycodone

- Pentazocine

- Ultram (Tramadol)

- Vicodin (Hydrocodone)

Over-the-counter

- Asprin

- Benadryl (Diphenhydramine)

- Cough Syrup

- Ephedrine/Psuedoephedrine

- Sominex

Sedatives

- Benzodiazepines

-- Ativan (Lorazepam)

-- Dalmane (Flurazepam)

-- Halcion (Triazolam)

-- Klonopin (Clonazepam)

-- Librium (Chloridiazepoxide)

-- Restoril (Temazepam)

-- Rohypnol (Flunitrazepam)

-- Tranzene (Clorazepate)

-- Valium (Diazepam)

-- Xanax (Alprazolam)

- Barbiturate Sedatives

-- Luminal (Phenobarbital)

-- Nembutal (Pentobarbital)

-- Seconal (Secobarbital)

-- Tuinal (Secobarbital/Amobarbital)

- Other Sedatives

-- Doriden (Glutethimide)

-- Miltown (Meprobamate)

-- PCP (Phencyclidine)

-- Placidyl (Ethchlorvynol)

-- Quaalude (Methaqualone)

-- Sonata (Zaleplon)

Stimulants

- Amphetamine

- Benzedrine

- Cocaine

- Crack

- Dexedrine

- MDMA/Ecstasy

- Methamphetamine

- Preludin

- Ritalin (Methylphenidate)

Other Drugs

- Anabolic Steroids

- Dilantin (Diphenylhydantoin/Phenytoin)

- GHB/GBL (Gamma-Hydroxybutyrate, Gamma-Butyrolactone)

- Special K (Ketamine)

-Other Cannabinoids

QUESTION 3

Do you use a drug with a needle?

• Answer if the client says that he/she has used a needle to inject drugs within the last 20 years, select yes.
• Additional information can be provided in the comment box.
• To document the client’s response to this question, CLICK ON the 'yes' or 'no' button matching the clients answer.

Are you Pregnant?

• Required for substance abuse services. Optional for mental health services.
• If the client answers No to this question, ask how she knows she is not pregnant.
• If there is any question regarding the reliability of the information, select Unknown and document the reason for your selection in the Comments box.
• To document the client’s response to this question, CLICK ON the Yes or No or Unknown button matching the client’s answer.

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DURING THE PAST 12 MONTHS

QUESTION 4

Have you gotten sick or had withdrawal if you quit drinking or missed taking a drug?

• Required for substance abuse services.Optional for mental health services.
• To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

QUESTION 5

Have you used larger amounts of alcohol or drugs or used them for a longer time than you had intended?

• Required for substance abuse services. Optional for Mental Health Services.
• To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

QUESTION 6

 Have you tried to cut down on alcohol or drugs and were unable to do it?

• Required for substance abuse services. Optional for mental health services.
• If the client says they tried to do more than cut down, they tried to quit and were unable to do it, this is considered a Yes answer.
• To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

 

QUESTION 7

 Have you spent a lot of time getting alcohol or drugs, using them, or recovering from their use?

• Required for substance abuse services. Optional for mental health services.
• To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

QUESTION 8

Have you gotten so high or sick from alcohol or drugs that it:

• Required for substance abuse services. Optional for Mental Health Services.

1. Kept you from doing work, going to school, or caring for children?
2. Caused an accident or became a danger to you or others?
3. Caused physical health or medical problems?

For this question, consider a yes answer if:

• The client describes tardiness to school or work or an inability to respond to the needs of children in a timely manner;
• Caused even one accident or one situation that presented as a danger;
• Even if the physical health/medical problems are not diagnosed by a doctor but are experienced by the client.
• To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

QUESTION 9

 Have you spent less time at work, school, or with friends so that you could drink or use drugs?

• Required for substance abuse services. Optional for mental health services.
• This includes tardiness and skipping work or school, and avoiding certain social situations so that you can get and use alcohol and/or other drugs.
• To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

QUESTION 10

• Required for substance abuse services. Optional for mental health services.

Has your use of alcohol or drugs caused:

1. Emotional or psychological problems?
   • Answer this question from the perspective of the client.
   • Consider symptoms they experience as emotionally or psychologically distressful even if they have not been diagnosed by a physician or other mental health professional.
   • To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.
2. Problems with family, friends, work, or police?
   • Include any conflicts or situations the client considers problematic.
   • To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

QUESTION 11

Have you increased the amount of alcohol or drugs you were taking so that you could get the same effect as before?

• To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

QUESTION 12

Have you continued drinking or taking a drug to avoid withdrawal or to keep from getting sick?

• To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

 

 

NOTE:

To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

Questions below are 'Required for substance abuse services and optional for mental health services'

RISK OF HARM

QUESTION 13

Do you often feel like “giving up” because you feel things are not going to get better?

To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

QUESTION 14

In the past month have you thought of harming yourself or killing yourself?

To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

QUESTION 15

Have you ever attempted to harm or kill yourself?

• If the client says he/she tried to harm or kill themselves with actions that were unlikely to result in serious harm or a fatality, answer yes anyway if the client says it was their intention.
• To document the client’s response to this question, CLICK ON the Yes or No button matching the client’s answer.

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Substance Abuse Youth Screening Questions

When screening a youth for Mental Health Services, ask these questions in addition to the questions required for Mental Health Screening for youth.

Note:

These questions will only display if the person being screened is less than 18 years of age.

 

CLICK HERE for information on Substance Abuse for Youth

What’s Next?

• If you are screening a client for mental health services, CLICK ON the Recommendations tab.
• If you are screening a client for substance abuse services, CLICK ON the Recommendations tab.

NEXT SCREENING, RECOMMENDATIONS TAB