Screening, Evaluation, and Diagnosis of Substance Use Disorder

Patients with substance use often have a complex clinical picture, and screening, evaluation, and a psychological assessment can help to guide detection, diagnosis, and treatment in individuals with SUD. In this chapter, we first review screening practices and recommended screeners for standard of care that can help identify a potential SUD. Next, we describe the more in-depth assessment process necessary to further diagnose SUD if results of screeners warrant such assessment. First, clinical screeners are utilized to identify the population of patients with potentially harmful substance use or SUDs who may not otherwise be identified for intervention or treatment. Brief screeners can be used as standard practice in many settings for new or returning patients to help identify harmful behaviors. When a patient has been identified as being at risk for problem substance use or SUD, longer neuropsychological tests or a comprehensive clinical interview focused on past and current substance use patterns can be used for diagnosis. Based on severity of symptoms, patients are then triaged to appropriate levels of care for treatment.