The Addiction Severity Index (ASI)

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What Is The Addiction Severity Index?

Treatment for drug and alcohol abuse should always be personalized to the individual to be effective as possible. Addiction affects many people, so there is never a one-size-fits-all method to healing from this disease.

The ASI gives clinical staff a bigger picture of an addict’s issues outside of abusing drugs or alcohol. The individuals overall status is documented using this scale before treatment begins.

Often substance abuse is simply a symptom of a larger, more complex problem. Understanding a person on a larger scale allows clinicians to craft a highly individualized treatment plan that aims for complete recovery.

The Addiction Severity Index (ASI) can be utilized for diagnostic purposes by psychiatrists, psychologists, and therapists. It was first developed in 1980 and has remained one of the top assessment tools for professionals treating individuals with substance use disorders. At Ambrosia Treatment Center, our team of trained mental health professionals are cleared to utilize the ASI during the diagnostic part of a client’s care. We value the benefits of the ASI, as they allow us to gain a full understanding of the client’s environment and relationship to mind-altering substances so that we can craft a customized treatment plan for them.

Categories Evaluated on a 1-10 Scale

1

Medical Status

Drug addiction and medical problems go hand in hand. In many cases, physical pain can lead to prescription pill addiction. Also, drug use in its many forms has side effects that cause more ailments, resulting in a vicious cycle of pain and addiction.

How many times in your life have you been hospitalized for medical problems?
How long ago was your last hospitalization for a physical problem?
Do you have any chronic medical problems that continue to interfere with your life?
Are you taking any prescribed medication on a regular basis for a physical problem?
Do you receive a pension for a physical disability?
How many days have you experienced medical problems in the past 30 days?

2

Employment & Support

Maintaining a job is difficult during active addiction. Financial instability and lack of job security is a good indication that an individual’s disease is controlling their life.

How long was your longest full-time job?
Usual (or last) occupation?
Does someone contribute to your support in any way?
Does this constitute the majority of your support?
Usual employment pattern for the past three years?
How many days were you paid for working in the past 30 days?
How much money did you receive from:
- Employment
- Unemployment compensation
- Welfare
- Pensions, benefits, or Social Security
- Mate, family, or friends
- Illegal
How many people depend on you for the majority of their shelter, food, etc?
How many days have you experienced employment problems in the last 30 days?

3

Drug Use

While it may seem obvious, the severity of one’s addiction can be measured by how often, how many, and what kind of drugs are being abused. The Addiction Severity Index details patterns of substance abuse and how it affects everyday life.

Route of administration?
What drugs have you used in the past 30 days?
How long was your last period of voluntary abstinence from this major substance?
How many times have you been treated for drug abuse?
What amount were detox only?
How much money have you spent on drugs in the past 30 days?

4

Alcohol Use

Although alcohol is a legal drug, therefore it is one of the most commonly abused intoxicants. Whether or not the primary substance of choice for an individual, patterns in alcoholic behavior reveal deeper issues that need to be addressed.

How much alcohol have you used in the past 30 days?
How long was your last period of voluntary abstinence from alcohol?
How many times have you been treated for alcohol abuse?
What amount were detox only?
How much money have you spent on alcohol in the past 30 days?

5

Legal Status

Legal issues are one of the best indicators of a drug or alcohol problem. Having a history of law-breaking behavior is a telltale sign of substance issues.

Are you on parole or probation?
How many times have you been charged with:
- Shoplifting/vandalism
- Parole/probation violations
- Drug charges
- Forgery
- Weapons offense
- Burglary/larceny/breaking and entering
- Robbery
How many times in your life have you been charged with:
- Disorderly conduct, vagrancy, public intoxication
- Driving while intoxicated
- Major driving violations
How many months have you been incarcerated in your life?
How serious do you feel your present legal problems are?

6

Family/Social Status

Addiction is a family disease. Not only does it affect the user’s whole family, but studies have shown that there may be a genetic component that is passed down from family members. The ASI aims to discover where interpersonal relationships are strained, and why.

Have any of your family members had what you would call a significant drinking, drug use, or psychiatric problem?
What are your usual living arrangements?
Do you live with anyone who has a current alcohol/drug problem?
With whom do you spend your most free time?
How many close friends do you have?
Have you had significant periods in which you have experienced serious problems getting along with any family members, friends, neighbors, co-workers, etc.?
Has anyone ever abused you?

7

Psychiatric Status

Almost all of those struggling with addiction and alcoholism have some other mental illness. Many of them are unaware upon entering treatment. Similar to medical issues, psychiatric issues need to be brought to the attention of staff so that a proper course of action can take place.

How many times have you been treated for any psychological or emotional problems?
Have you ever had a significant period of time where you experienced:
- Serious depression
- Serious anxiety
- Hallucinations
- Trouble understanding, concentrating, or remembering
- Trouble controlling violent behavior
- Thoughts of suicide
- Attempted suicie
- Being prescribed medication for any psychological or emotional problems
How many days in the past 30 days have you experienced these psychological or emotional problems?

These are just some of the questions that clients are asked when a mental health professional at Ambrosia is conducting an ASI. There are several additional questions to help further understand the severity of one’s substance use disorder. In general, it takes approximately one hour for the ASI to be conducted.

The Process

The Addiction Severity Index is calculated through a one-on-one interview with a trained staff member upon intake at the treatment facility. The questions are predetermined, but the interview process is informal and conversational. The laid-back approach allows the addict to open up and speak naturally about their addiction history and other issues they might be facing. One of the main advantages of the Addiction Severity Index is the fact that it creates a more comprehensive report than other data collecting methods.

The responses are recorded using a 10-point scale, with zero being the least severe and nine being the most severe. The information collected is then utilized by the treatment center to:

Understand the status of an individual upon intake
Create a treatment plan customized to the needs of the individual
Get a general idea of recovery progress

Once this information is reported, clinicians have a much better idea of the individual’s needs and strengths upon entering treatment. People come to treatment at all stages of addiction, so it is important they are treated on a one-by-one basis.

The ASI is used as a primary reference for creating a treatment plan to suit these attributes on a personal basis. Core issues surrounding addiction that are not dealt with can keep an addict or alcoholic from achieving sobriety. For example, psychiatric issues, legal trouble and family problems can distract an individual when working through the recovery process. A customized treatment plan effectively attacks addiction on all fronts and significantly improves the chances of a full, happy and sober life after treatment.

Beyond the Initial Assessment

Composite Scores are another great feature of the Addiction Severity Index. These can be used to track progress throughout rehabilitation and during other phases of recovery. Modified versions of questions are revisited after treatment is complete to reveal improvements in that individual. From here, the treatment plan can be adjusted accordingly. Composite questions are phrased for a 30-day period. For Example, “How many days in the past 30 have you had serious conflicts with your family?” The updated scores are weighted and calculated so that they can be compared with the intake scores.

Everything Else You Want to Know

What if my score is “severe”?
You can absolutely recover from a “severe” rating. Just because an individual’s ASI score is high in a certain category, does not mean they cannot recover. Most addicts and alcoholics score high in at least one section of the index.
Can my score change?
Yes! The Addiction Severity Index includes questions with responses that potentially change over time. Scores will increase or decrease and can be used to track improvements during treatment.
Is it accurate?
Studies show results from The Addiction Severity Index are highly consistent and highly reliable. While no assessment is perfect, the ASI is considered the industry standard for evaluating substance abuse patients.
Does it matter what my score is?
Yes and No. The Severity Index give counselor’s, therapists and staff a better idea of the needs of the individual. Some people have more trouble in certain areas than others. Regardless of the actual score, your treatment will be tailored to your needs.

Our Addiction Severity Index (ASI) for West Palm Beach Treatment

The Addiction Severity Index is done in a one-on-one setting with a mental health professional at our South Florida treatment facility. While the questions are predetermined, the interview is informal and conversational. This approach allows all involved to feel comfortable.

The responses provided by the clients are recorded using a 10-point scale, with zero being the least severe and 9 being the most severe. The information collected is then utilized by Ambrosia to:

Understand the status of an individual upon intake
Create a treatment plan customized to the needs of the individual
Get a general idea of the recovery progress

Once this information is collected, clinicians have a much better idea of the individual’s needs and strengths upon entering treatment.

If you or your loved one are ready to start your road to recovery in West Palm Beach, visit our admissions page to get started today.

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