Substance Abuse Evaluation: A Caregiver Guide
Substance use disorder is a behavioral health condition that can have serious consequences if not treated. If you care for a loved one who misuses drugs or alcohol, they could benefit from a substance abuse screening or a more thorough substance use evaluation.
Addiction can be a touchy subject, but it’s important to speak up so your loved one can benefit from a treatment plan. Here, we explain:
- What substance use evaluations are
- What to expect from them
- When someone may need one
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What Is A Substance Use Disorder?
What used to be called alcohol or drug addiction is now more often called substance use disorder. A person might have an alcohol use disorder or a specific drug use disorder. All types are characterized by the misuse of intoxicating substances.
Someone with a substance use disorder continues to drink or use drugs even when they cause harmful consequences. For example, substance use can lead to accidents, legal problems, health problems, or strained or broken personal relationships.
Addiction has physical components, such as changes to the brain that make it more difficult to stop using. It can also be categorized with mental disorders because it’s a psychological and behavioral health condition.
Many people with an addiction can benefit from substance abuse treatment. Medical care, counseling and therapy, group support, and lifestyle changes can help individuals manage their substance use issues. Without treatment, substance abuse can lead to significant complications, such as serious health problems or even death.
What Is A Substance Use Evaluation?
Substance use or substance abuse evaluations are professional assessments used to determine if a person’s drug or alcohol abuse is problematic. The assessments are done by mental health, behavioral health, or addiction specialists. These may include psychiatrists, psychologists, social workers, or licensed addiction counselors.
A substance abuse evaluation is typically more comprehensive than a screening. A screening is a shorter assessment that can lead to an alcohol or drug evaluation. For example, your loved one’s primary doctor might screen them with a few questions during a checkup and recommend a more complete evaluation that can better determine if they have a substance use disorder.
An alcohol or drug abuse screening test is helpful, but full drug assessments give a better picture of your loved one’s behaviors. Getting an alcohol or drug evaluation is important for early interventions. The sooner you can help a loved one identify and start treating a substance abuse problem, the better the outcome will be.
Who Needs A Substance Abuse Assessment?
Substance abuse assessments can benefit anyone with problematic drug use or alcohol consumption. Sometimes a person needs an assessment for legal reasons. Courts can require individuals to undergo an evaluation after a DUI (driving under the influence), public intoxication, or other charges that might be related to alcohol or drug use.
Substance abuse evaluations are not restricted to people legally compelled to undergo them. Anyone can request or pay for a comprehensive drug or alcohol assessment. Family members may suggest that a loved one undergo an assessment when they observe concerning behaviors.
Healthcare professionals can also recommend or require a drug or alcohol evaluation. Your loved one’s primary care doctor might suggest a more thorough evaluation, for example. Patients entering a treatment program for substance use issues may be required to go through a complete assessment.
How To Know If Your Loved One Should Have An Evaluation
Suggesting a substance abuse evaluation can be difficult. It’s often very difficult for a person to recognize or admit to having an issue with drug or alcohol use. However, it’s important for loved ones to speak up when they have concerns.
For the caregiver and other family members, the first challenge is deciding if their loved one actually has an issue that needs to be addressed. There are characteristic signs, but it’s also important to remember that you’re looking for a pattern of behaviors. A single worrying incident doesn’t mean someone has a substance use disorder. You might be concerned, though, if they repeat these behaviors again and again.
The American Psychiatric Association recognizes several signs of substance use disorder. Having one or two of these or experiencing them once or twice is not necessarily cause for concern. If your loved one shows several of these signs and they interfere with their normal functioning, they could be a good candidate for a professional evaluation:
- Using more of a substance or for longer than they intended to, or more than directed, if the substance is a prescription
- Experiencing strong urges or cravings for the substance
- Trying but failing to cut back on drug or alcohol use
- Spending a considerable amount of time or energy getting, using, or recovering from substances
- Being unable to fulfill ordinary responsibilities because of substance use
- Continuing to use a substance even when it causes problems in personal relationships
- Limiting social activities or responsibilities in favor of substance use
- Continuing substance use even when it is dangerous, for instance, when driving
- Continuing substance use even when it causes physical or mental health problems
- Becoming increasingly tolerant of the substance and needing to use more and more to get the same effects
- Experiencing withdrawal when not using the substance
The experience of withdrawal is particularly worrying. Withdrawal from drugs or alcohol usually means an individual has developed a significant addiction that requires treatment.
What Happens During A Substance Use Assessment?
Your loved one might resist getting an evaluation. Knowing what the evaluation process is like can make it a little easier and reduce some of the stress associated with the situation.
- Duration: A comprehensive substance use assessment takes between 90 minutes and two hours.
- Format: The evaluation is an interview. Your loved one will answer questions posed by a professional specializing in addiction. There are standard questions, but the professional may change questions or ask more in-depth questions based on the answers and use their professional judgment.
Unless your loved one is legally ordered to undergo an assessment, they likely will not be drug tested. The interview is sufficient to determine what your loved one needs going forward. The interviewer will use the information to decide if they have a substance use disorder, the severity of the disorder, and what addiction treatments are needed.
What To Bring To The Assessment
The organization or professional providing the assessment should tell you what to bring. They may ask you to bring:
- Medical records relevant to substance abuse, such as any previous screenings or evaluations
- Results of drug tests, if taken
- A list of medications your loved one is currently taking
- Relevant legal documents if the evaluation is court-ordered
Common Assessment Tools
The mental health or healthcare professional might use one or more assessment tools. These are standard questionnaires that help them screen for substance abuse problems. Examples include the:
- Alcohol use inventory
- The Addiction Severity Index
- The Substance Abuse Subtle Screening Inventory
These tools are useful and serve as starting points for further exploration.
Talking To Your Loved One About Undergoing A Drug Evaluation
Convincing someone to undergo this type of assessment can be a challenging task. Many people resist admitting that they have an issue or need help. Involving a doctor your loved one trusts can make it easier to discuss and help them feel more comfortable about taking this step.
There are many reasons they might resist, including not wanting to change. They might also be worried about the assessment itself. Explain what will happen and ensure they understand that it will be done in private and that the information they share will be kept confidential. If they choose, they can have you present for the interview.
Assure your loved one that undergoing an evaluation does not mean they will be immediately sent to treatment. Once the assessment is complete, you can use the information to make decisions together about treatment.
What Happens After The Drug Or Alcohol Assessment?
The professional who provided the assessment will present their results. Their results might include a diagnosis of a substance use disorder as well as its severity. It may contain information about other mental health concerns. They’ll also include recommendations for treatment and guidance on what to do next.
Even after receiving this professional opinion, your loved one may still resist seeking treatment. Encourage your loved one to look at the options. Emphasize that they’re not being forced into treatment and that there is more than one way to get help.
If they’re resistant to treatment, consider taking small steps. Involve other family members to help talk about the issue and start removing the stigma. Encourage your loved one to join a support group, like Alcoholics Anonymous, so they can see that they’re not alone in having a problem with drug or alcohol misuse.
As a caregiver, you can’t force your loved one to take the next steps. You can encourage them and help keep them safe as they come to terms with the results of their evaluation.
How Caregivers Can Support Treatment & Recovery
When your loved one agrees to treatment, the journey toward recovery begins. As a caregiver, you play a significant role in supporting them.
Here are some things you can do to be part of a positive support network:
- Learn more about substance abuse disorders to better understand what your loved one is going through.
- Help your loved one navigate the treatment options and select one that best suits their needs and makes them most comfortable.
- Communicate regularly with their primary doctor or medical team to provide updates and receive guidance.
- Provide practical support that makes it easier for them to benefit from treatment. For example, you can make appointments for them and drive them to meetings or counseling sessions.
- Avoid enabling problematic behaviors. This might mean not lending money or not making excuses for them.
- Keep your loved one busy with activities they enjoy, which can help take their mind off substance use.
- Help your loved one develop healthy lifestyle habits, like eating well and exercising, which will support their recovery.
- With your loved one’s approval, involve other family members to expand their support network.
Substance use disorders can have very serious consequences, but they’re treatable. If you have concerns about your loved one’s substance use, consider an evaluation to help you both determine what next steps to take.
References
- American Psychiatric Association. (2024). What is a substance use disorder? Psychiatry.org.
- Center for Substance Abuse Treatment. (2010). Chapter 4—Assessment. Nih.gov; Substance Abuse and Mental Health Services Administration (US).
- Cleveland Clinic. (2024). Substance use disorder (SUD): Symptoms & treatment. Cleveland Clinic.
