What Is The Addiction Severity Index?
Medically reviewed byIsaac Alexis, M.D., AAMA, AMP-BC
January 17, 2019
Developed in the 1980s, the ASI is used internationally as a baseline measurement of the severity of issues relating to the medical conditions, employment status, alcohol and drug use frequency, legal issues, family or social struggles, and mental health associated with substance abuse. This “big picture” survey can be instrumental in the creation of a comprehensive treatment plan that addresses issues arising in the six primary categories addressed by the ASI.
The Addiction Severity Index (ASI) was developed by A. Thomas McLellan, a man known for his pioneering work in the field of addiction treatment and specifically the development of two interview-based modalities to measure addiction severity and treatment needs: the ASI and the Treatment Services Review (TSR). He also served as the Deputy Director of the Office of National Drug Control Policy under President Obama.
The Addiction Severity Index measures:
- Medical issues relating to drug use
- Employment/Support Status
- Levels of Alcohol and Drug Use
- Legal Issues Arising from Substance Abuse
- Family/Social Factors
- Psychiatric/Mental Health Status
Each of these categories is rated based on responses by patients to determine its significance relative to substance abuse. For instance, questions regarding medical issues examine significance of these issues, duration, medications used to control these issues, and whether continued care is needed during treatment. The ASI also measures current use of alcohol and/or prescription or illicit drugs.
During the course of the interview, a treatment patient is asked to evaluate his or her own perception of the severity of the issue described as well as his or her need for counseling or treatment relating to those issues. Someone who has struggled with maintaining employment for a long, for example, while might indicate a need for employment counseling or professional training.
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The typical ASI interview takes about an hour and examines everything from the person’s mental health status, to their socioeconomic background and religious beliefs. An ASI interview occurs at the time of admission to a treatment facility. These interviews have demonstrated that examination of the underlying issues relating to addictive behaviors, rather than the addiction specifically, help treatment professionals design more integrated and successful treatment plans. Instead of comparing drug types, professionals compare individuals with similar risk factors among certain demographics.
Follow up interviews often occur at one month intervals and can afford researchers some additional valuable data.
Addiction Severity Index As A Measure Of Treatment Outcomes
Data collected during the course of ASI interviews is often later reviewed and examined to determine whether certain treatment types prove more or less effective. Measuring treatment outcomes is one way to improve treatment options for those suffering with specific addiction types at varying levels of severity and from a wide range of socioeconomic backgrounds.
The ASI can also serve as a means to evaluate the success of pharmacotherapy and behavioral therapies often used as part of a comprehensive treatment strategy. These measurements can prove invaluable in improving patient care and successful treatment outcomes.
Similarly, individual treatment centers can compare data from the baseline interview to interviews conducted throughout the duration of stay to determine areas of strengths and weaknesses within their programs.
Addiction Severity Index And Individualized Treatment Plans
Addiction Severity Index data is one tool treatment providers have in assessing the individual needs of those seeking recovery. Today, more than ever, someone entering treatment is assessed not only for their addiction-related needs, but also for those underlying issues that can sometimes increase the chance of relapse. An individualized treatment plan means the recovering alcohol or drug-addicted person receives a full spectrum of care from what they need to get clean to the tools they need to find work, improve their overall mental and physical health, to addressing relationship issues with family and friends.
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