Substance Use Screening and Evaluation

• Screening is the process of evaluating the possible presence of a problem. The outcome is typically yes or no.
• Evaluation is the process of defining the nature of the problem, determining the diagnosis, and developing specific treatment recommendations for addressing the problem or diagnosis (SAMSHA).
• Alcohol and substance abuse is one of the more prevalent needs individuals exhibit on community supervision.
• Substance use behavior is often a symptom of other needs the client has (e.g., mental health).
• Clinical experts recommend that all clients receive a substance-use screening upon intake to supervision.

Screening Tool

• When possible, an evidence-based screener should be used (e.g., Drug Abuse Screening Test [DAST]). (See additional sources for more information.)
• Most risk-need assessment tools are not effective screeners.
• Substance use screening should focus on use within the past 30 days.
• When an evidence-based tool is not available, departments should develop a screener that includes the following domains:
  • type of substance used (alcohol, marijuana, opioids, other hard drugs)
  • frequency of use by substance category
  • negative impact (social, legal, employment, family) of substance use
  • negative impact by substance category
• Officers should discuss the results of any screenings. Clients should then be informed if an evaluation is necessary.

Evaluation Tool

• Evaluations should be administered with all clients identified by the screener as potentially having a problem.
• In-depth substance use evaluations are best administered by a trained clinician.
  • If administered by an outside practitioner, evaluation results should be communicated to the supervising officer.
• Officers should discuss the evaluation results with the client and work collaboratively with them to incorporate those results into the client’s case plan.

How Can They Be Used to Monitor Compliance?

• Officers should not use treatment evaluation as a form of punishment for their clients.
• When a client is referred to treatment through the evaluation process, officers should discuss the consequences of noncompliance (e.g., relapse, not completing).
• Emphasis should be on helping the client address substance use need.
• Officers should minimize the use of authoritarian communication when using these tools or discussing their results.

How Can They Be Used as Supervision Tools?

• Screening and evaluation are best viewed as a therapeutic process.
• If administered correctly, the screening and evaluation process can solidify an officer as a helper, improving the working alliance.

• Screening and evaluation should never be used as a control tool.

What Are the Costs of Screening and Evaluation?

• There may be a cost of obtaining an evidence-based screener or evaluation and for training staff on the use of the tool.

• Supervision staff report that Substance Use Screenings and evaluations are
  • sometimes appropriate for all low-risk clients and
  • always appropriate for all medium- to high-risk clients.

What Should You Expect When Using Substance Use Screening and Evaluation?        

• Screeners/evaluations identify whether a client has a substance use disorder and the proper treatment.
• When used in response to noncompliance, screeners/evaluations should be presented as a way to help the client succeed.
• Using screeners and evaluations as punishment can limit the effectiveness of the prescribed treatment.

Are Screenings and Evaluations Evidence-Based Practices?

• Yes, there is strong evidence supporting the effectiveness of using evidence-based Substance Use Screenings and evaluations.

What Do People Formerly Involved in the Criminal Legal System Think About Screening and Evaluation?

• People with lived experience in the criminal legal system (the “criminal justice” or “legal” system is referred to as the criminal legal system in this document) report that Substance Use Screenings and evaluations are
  • sometimes appropriate for all low-risk clients and
  • sometimes appropriate for all medium- to high-risk clients.

Communication That Strengthens the Officer-Client Relationship (Messaging)

• Officers should explain why the screening/evaluation is being used and how they benefit the client.
• If screening is a standard procedure, officers should explain this to clients.
• Officers should present themselves as helpers and use their experience on the job to counter clients’ ideas when dealing with conflict surrounding screening/evaluations.
• Officer should explain precisely how they will respond to noncompliance.