Substance Abuse Assessment

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Recommended Service Levels

A substance abuse assessment is an interviewing tool that helps professionals at our Charlotte facility find the right substance abuse treatment and addiction counseling to fit the individual.  Some assessments are like a questionnaire while some are done orally, either way, the information provided guides the professional to the specific form of treatment necessary.  On a positive note, you can neither pass nor fail this test, so no worries there is not a grade given.

If you or someone you know needs a drug or alcohol evaluation, please contact Behavioral Health Intervention Center about substance abuse treatment in Charlotte at (704) 458-9292.   Assessments are provided same day and during times that fit your needs.

For many, this type of interview can seem intimidating because in depth questions are going to be asked about personal details of your life.  The drug and alcohol assessment questions are not used to judge the individual themselves but to give the Charlotte addiction counselor a clearer view of the right form of substance abuse treatment appropriate to fit the type of person.  Additionally, no one will be pointing a finger of judgment or rejection at you for the personal information you disclose.

At the Behavioral Health Intervention Center (BHIC), you will meet with a Certified Substance Abuse Counselor to complete your 5 step assessment.

Registration

In the beginning of the assessment, you will be asked to provide your demographic and contact information.  In this packet of forms, the counselor will go over your confidentiality and HIPAA rights which include protection of your personal information, information gathered during the assessment, and future exchanges and treatment progress. You are the only one allowed to provide permission to release your information.

Screening

This part of the assessment includes tools that the counselor uses to determine appropriateness for a treatment level. At BHIC in Charlotte, our addiction counseling team we use evidence-based SAMHSA screening tools including the Substance Abuse Subtle Screening Inventory (SASSI), the Michigan Alcohol Screening Test (MAST), and the Drug Abuse Screening Test (DAST).  These three tools use self-reported information to determine possible substance dependency.  In addition, chemical screening through urine and breathe are conducted to identify recent drug and/or alcohol use.

Clinical Interview

After the registration and screening parts of the drug and alcohol evaluation, the counselor then completes an oral clinical interview.  Questions asked in the substance abuse assessment will relate to medical and mental health history, social relationships, family influences, educational and employment history, criminal background, and substance use history.

Diagnosis

This part of the drug and alcohol assessment is when the counselor determines the appropriate diagnosis for the current drug and alcohol use.  Common diagnosis include Alcohol Use Disorder, mild and moderate, Cannabis Use Disorder, mild and moderate, Stimulant Use Disorder, mild, and Opioid Use Disorder, mild.  The mild, moderate, and severe designations acknowledge the intensity of the drugs affects on the individual’s lifestyle.  Most patients we see are below the severe mark and can benefit from the services we provide.

Recommendation

Based on all the information gathered from the registration, screening, and clinical interview, the counselor will utilize the substance use diagnosis to create a recommendation for substance abuse treatment and addiction counseling in Charlotte.  Recommendations include short term and long term outpatient treatment, detox, and/or rehabilitation.  The recommendations are then used to refer you to services appropriate for your level of need.  Additionally, the assessment allows the substance abuse counselor to provide additional resources for the individual that may present through the session.

ASAM Treatment Recommendation Levels

Level (.05) Early Intervention: Education (15-18 hours)

Early Intervention for Adults and Adolescents, this level of care constitutes a service for individuals who, for a known reason, are at risk of developing substance-related problems, or a service for those for whom there is not yet sufficient information to document a diagnosable substance use disorder.

Level (1) Outpatient Services:  Short (20-39 hours) and Long Term (40-89 hours) Treatment)

Outpatient Services for adults, this level of care typically consists of less than 9 hours of service/week for adults, or less than 6 hours a week for adolescents for recovery or motivational enhancement therapies and strategies. Level 1 encompasses organized services that may be delivered in a wide variety of settings.

Level (2.1) Outpatient Services:  90 plus hours of psycho-education and process groups and case managment

Intensive Outpatient Services for adolescents and adults, this level of care typically consists of 9 or more hours of service a week or 6 or more hours for adults and adolescents respectively to treat multidimensional instability. Level 2 encompasses services that are capable of meeting the complex needs of people with addiction and co-occurring conditions. It is an organized outpatient service that delivers treatment services during the day, before or after work or school, in the evening, and/or on weekends.

Level (2.5) Partial Hospitalization Services:

Partial Hospitalization Services for adolescents and adults, this level of care typically provides 20 or more hours of service a week for multidimensional instability that does not require 24-hour care. Level 2 encompasses services that are capable of meeting the complex needs of people with addiction and co-occurring conditions. It is an organized outpatient service that delivers treatment services usually during the day as day treatment or partial hospitalization services.

Level (3.1) Clinically Managed Low-Intensity Residential Services:

Clinically Managed Low-Intensity Residential Services, this adolescent and adult level of care typically provides a 24 hour living support and structure with available trained personnel, and offers at least 5 hours of clinical service a week. Level 3 encompasses residential services that are described as co-occurring capable, co-occurring enhanced, and complexity capable services, which are staffed by designated addiction treatment, mental health, and general medical personnel who provide a range of services in a 24-hour living support[DM1]  setting.

Level (3.3) Clinically Managed Population-Specific High-Intensity Residential Services:

Clinically Managed Population-Specific High-Intensity Residential Services, this adult only level of care typically offers 24-hour care with trained counselors to stabilize multidimensional imminent danger along with less intense milieu and group treatment for those with cognitive or other impairments unable to use full active milieu or therapeutic community. Level 3 encompasses residential services that are described as co-occurring capable, co-occurring enhanced, and complexity capable services, which are staffed by designated addiction treatment, mental health, and general medical personnel who provide a range of services in a 24-hour treatment setting.

Level (3.5) Clinically Managed Medium-Intensity Residential Services Services:

Clinically Managed Medium-Intensity Residential Services for adolescents and Clinically Managed High-Intensity Residential Services for adults, this level of care provides 24-hour care with trained counselors to stabilize multidimensional imminent danger and prepare for outpatient treatment. Patients in this level are able to tolerate and use full active milieu or therapeutic communities. Level 3 encompasses residential services that are described as co-occurring capable, co-occurring enhanced, and complexity capable services, which are staffed by designated addiction treatment, mental health, and general medical personnel who provide a range of services in a 24-hour treatment setting.

Level (3.5) Medically Monitored High-Intensity Inpatient Services:

Medically Monitored High-Intensity Inpatient Services for adolescents and Medically Monitored Intensive Inpatient Services Withdrawal Management for adults, this level of care provides 24-hour nursing care with a physician’s availability for significant problems in Dimensions 1, 2, or 3. Counseling is available 16 hours a day. Patients in this level of care require medication and have a recent history of withdrawal management at a less intensive level of care, marked by past and current inability to complete withdrawal management and enter into continuing addiction treatment. This is the appropriate setting for patients with subacute biomedical and emotional, behavioral, or cognitive problems that are so severe that they require inpatient treatment. Level 3 encompasses residential services that are described as co-occurring capable, co-occurring enhanced, and complexity capable services, which are staffed by designated addiction treatment, mental health, and general medical personnel who provide a range of services in a 24-hour treatment setting.

Level (4) Medically Managed Intensive Inpatient Services:

Medically Managed Intensive Inpatient Services for adolescents and adults, this level of care offers 24-hour nursing care and daily physician care for severe, unstable problems in ASAM Dimensions 1, 2 or 3. Counseling is available to engage patients in treatment.