Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)

Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is a screening tool designed to assess substance use and related problems. It was developed by the World Health Organization (WHO) in response to the need for a standardized tool that could be used globally to identify individuals who may have problems with alcohol or substance use. The ASSIST has been validated in numerous studies and is used in a variety of settings, including primary care, emergency departments, and drug treatment centers.

Background History and Description:

Drug abuse and its consequences pose a major threat to public health all over the globe. The World Health Organization (WHO) identified a need for a standardized screening instrument that could be used all across the world to detect signs of alcohol and drug abuse. Hence, the ASSIST was developed with input from scientists all across the globe using rigorous scientific methodology.
Smoking, drinking, cannabinoids, cocaine, amphetamine-type stimulants, sedatives, hallucinogens, and opiates are all covered in the ASSIST’s eight questions. The questions center on use patterns, potential drawbacks, and other relevant topics. The screening takes between five and ten minutes to complete and may be given by a nurse, doctor, or the patient themselves.

Psychometric Properties:

Several research have been conducted in order to validate the ASSIST, and the results have shown that it has strong psychometric qualities. Research have revealed that the ASSIST has a high degree of sensitivity as well as specificity when it comes to identifying persons who have issues related to drug use. The ASSIST also has excellent test-retest reliability, which means that it generates findings that are consistent over the span of time.

The reliability of a test is measured by how consistently it produces the same findings. Cronbach’s alpha values for the ASSIST range from.74 to.94 across languages and populations, indicating that the instrument has strong internal consistency. This indicates that each ASSIST item is measuring the same construct.
The term “validity” is used to describe how well a test really measures its target variables. Several research have identified substantial relationships between ASSIST scores and other measures of drug use and associated disorders, lending credence to the ASSIST’s construct validity. The ASSIST, for instance, has been shown to correlate highly with other assessments of substance abuse, addiction, and associated issues.
Research has also shown that the ASSIST has predictive validity. Adolescents’ ASSIST scores were revealed to be predictive of later drug use disorder onset by the same research.
Evidence suggests that ASSIST is a useful screening tool for spotting potential cases of drug abuse. Nevertheless, it should be noted that a positive screen on the ASSIST does not always imply the existence of a drug use problem, and that additional examination is typically required to establish a diagnosis.

Administration, Scoring, and Interpretation of ASSIST


  1. Provide the ASSIST self-administered questionnaire to the individual being assessed.
  2. Explain that the questionnaire assesses lifetime and current use of various substances, as well as related problems.
  3. Instruct the individual to complete the questionnaire by answering all of the questions honestly and to the best of their ability.
  4. Ensure privacy and confidentiality during completion of the questionnaire.


  1. Assign a score to each question based on the response. The scores range from 0 to 6, with higher scores indicating greater levels of risk.
  2. Add up the scores for all eight questions to obtain a total score, which ranges from 0 to 39.
  3. Use the scoring guidelines to determine the level of risk for each substance assessed.


  1. Compare the total score obtained to the cutoff scores that have been established based on research for each substance being assessed.
  2. Interpret the results based on the level of risk indicated by the total score. For example, a total score between 11 and 26 for alcohol indicates moderate risk, while a score of 27 or higher indicates high risk.
  3. Consider the individual’s responses to each question in order to tailor intervention strategies to their specific needs.


If an individual completed the ASSIST and received a total score of 15 for alcohol, the clinician would interpret this score as moderate risk. This indicates that the individual may benefit from some level of intervention or further assessment. If the same individual also received a total score of 8 for cannabis, the clinician would interpret this score as low risk. Based on these results, the clinician may recommend further assessment or intervention related specifically to the individual’s alcohol use, but not necessarily related to cannabis use at this time.


Alcohol, Smoking, and Substance Involvement Screening Test, or ASSIST is a valuable screening tool meant to detect persons who may be at risk of developing substance use disorders. ASSIST screens for smoking as well as drug use. It has been determined that the ASSIST has favorable psychometric features, such as reliability and validity, which enables it to function as a useful instrument in clinical and healthcare settings.
For the sake of getting accurate findings and directing further evaluation and action, it is critical that the ASSIST be administered, scored, and interpreted in the correct manner. Clinicians may utilize ASSIST to identify patients who could benefit from additional evaluation or intervention linked to their drug use, and then personalize the therapies they provide to the patients’ unique need with the use of this software.
A positive screen on the ASSIST does not necessarily indicate the presence of a substance use disorder, and further assessment is typically required to confirm a diagnosis. This is an important point to keep in mind because it is important to note that a positive screen on the ASSIST does not necessarily indicate the presence of a substance use disorder. Yet, the ASSIST may be a helpful first step in recognizing possible concerns with drug use and enhancing early intervention efforts. This is because it acts as a screening tool.

Frequently asked Questions

Q: What does the ASSIST screen for?

A: The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) screens for lifetime and current use of various substances, as well as related problems. This includes alcohol, tobacco, cannabis, cocaine, amphetamines, inhalants, sedatives, hallucinogens, opioids, and other substances.

Q: Who can administer the ASSIST?

A: The ASSIST can be administered by healthcare professionals or clinicians who have experience working with individuals who may be at risk for substance use disorders. The test can also be self-administered by the individual being assessed.

Q: How long does it take to complete the ASSIST?

A: The time it takes to complete the ASSIST can vary depending on the individual being assessed. However, it typically takes between 10 and 15 minutes to complete.

Q: Is the ASSIST a diagnostic tool for substance use disorders?

A: No, the ASSIST is not a diagnostic tool for substance use disorders. It is a screening tool that can help identify individuals who may be at risk for substance use disorders and guide further assessment and intervention.

Q: How reliable and valid is the ASSIST?

A: The ASSIST has been found to have good psychometric properties, including reliability and validity. Studies have shown that the internal consistency of the ASSIST is high, and that the construct validity and predictive validity of the test are also supported.

Q: Can the ASSIST be used with adolescents?

A: Yes, the ASSIST can be used with adolescents aged 12-17 years old. However, some modifications may be necessary to make sure the questions are age-appropriate.

Q: What happens if someone scores high on the ASSIST?

A: If an individual scores high on the ASSIST, this indicates that they may benefit from further assessment or intervention related to their substance use. The clinician or healthcare professional may recommend further assessment or refer the individual to specialized services for additional support


Psychological Measurement Database
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