Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)

Dr. Rachel Humeniuk

A download of Rachel’s session can be accessed here.

Pre session summary

The WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and linked Brief Intervention: The first step in stepped-care drug and alcohol treatment.

The ASSIST and linked Brief Intervention was developed by the World Health Organisation in response to the overwhelming public health burden associated with psychoactive substance use worldwide. The ASSIST covers all substance groups (alcohol and drugs) as well as IV use, and generates a risk score for each of the substances (‘low’, ‘moderate’ or ‘high’) which can be used to determine the most appropriate level of care for clients. ASSIST scores are used to start a conversation with ‘moderate risk’ clients about their substance use (a brief intervention) while ‘high risk’ clients can be referred onto higher intensity treatment. Some options for higher intensity treatment will be covered in the session, as well as how to administer the electronic version of the ASSIST (eASSIST) and an ASSIST-linked Brief Intervention.

Post session facilitator summary notes

  • Simple client & practitioner interactions, such as ASSIST administration, can significantly benefit people’s outcomes
  • Screening tools should be used primarily to start a conversation with the client
  • Some evidence that undertaking ASSIST itself may contribute to behaviour change (pre contemplation to contemplation)
  • If you cannot undertake full ASSIST, ask about Q2 – frequency of use in the last 3 months (look for monthly or more), Q4 – health social, legal problems and Q6 – concern by others
  • Pro-inflammatory hypothesis of addiction
    • Combined drug and talk based therapy
    • Immune targeted therapy
    • Physical exercise
  • Immune genetics can predict what dependency you have