Drug Abuse Screening Test (DAST)

There also are a number of screening instruments available to evaluate drug use and abuse. John took the Drug Abuse Screening Test (DAST), one of the most widely used tools for screening for drug abuse and addiction. The DAST was modeled after the MAST and therefore similar information is obtained with the two questionnaires related to alcohol use and drug use, respectively. The questions on the DAST are as follows:

  1. Have you used drugs other than those required for medical uses?
    (Yes = 1, No = 0)
  2. Have you abused prescription drugs?
    (Yes = 1, No = 0)
  3. Do you abuse more than one drug at a time?
    (Yes = 1, No = 0)
  4. Can you get through the week without using drugs?
    (No = 1, Yes = 0)
  5. Are you always able to stop using drugs when you want to?
    (No = 1, Yes = 0)
  6. Have you had "blackouts" or "flashbacks" as a result of drug use?
    (Yes = 1, No = 0)
  7. Do you ever feel bad or guilty about your drug use?
    (Yes = 1, No = 0)
  8. Does your spouse (or parents) ever complain about your involvement with drugs?
    (Yes = 1, No = 0)
  9. Has drug abuse created problems between you and your spouse or your parents?
    (Yes = 1, No = 0)
  10. Have you lost friends because of your use of drugs?
    (Yes = 1, No = 0)
  11. Have you neglected your family because of your use of drugs?
    (Yes = 1, No = 0)
  12. Have you been in trouble at work because of your use of drugs?
    (Yes = 1, No = 0)
  13. Have you lost a job because of drug abuse?
    (Yes = 1, No = 0)
  14. . Have you gotten into fights when under the influence of drugs?
    (Yes = 1, No = 0)
  15. Have you engaged in illegal activities in order to obtain drugs?
    (Yes = 1, No = 0)
  16. Have you been arrested for possession of illegal drugs?
    (Yes = 1, No = 0)
  17. Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?
    (Yes = 1, No = 0)
  18. Have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding, etc.)?
    (Yes = 1, No = 0)
  19. Have you gone to anyone for help for a drug problem?
    (Yes = 1, No = 0)
  20. Have you been involved in a treatment program especially related to drug use?
    (Yes = 1, No = 0)

To score the DAST, add together items. The scoring, interpretation, and management guidelines for the DAST are summarized below:

Degree of problem related to drug abuse DAST 20-item scoring Action ASAM level
None
0
Monitor
Low
1-5
Brief counseling
Level I
Intermediate (likely meets DSM-IV criteria)
6-10
Outpatient (intensive)
Level I or II
Substantial
11-15
Intensive
Level II or III
Severe
16-20
Intensive
Level III or IV

ASAM - American Society of Addiction Medicine; DSM-IV - Diagnostic and Statistical Manual of Mental Disorders, 4th Ed.

John scored a 2 on the DAST, consistent with his only one-time use of methamphetamine and cocaine. Dr. Bryant reviews these findings with John and explains his recommendation for John to enter residential substance abuse treatment program for his alcohol dependence prior to being discharged back to the shelter. He also reviews with John his recommendations for treatment while he is undergoing substance abuse treatment and after.