Alcohol/Drug Evaluation The alcohol drug evaluation is critical to the success of your case. We want you to get the best evaluation possible with the least amount of treatment, or classes, necessary. In order to receive the best and most accurate result you must be prepared and aware of the questions you will be asked. The following are the keys to obtaining a fair and good evaluation. Further, please read the attached questions as these questions, in some form, will be asked during the evaluation. Additionally, please read all handouts related to the alcohol/drug evaluation that we have provided you. Remember, if you want a diagnosis that states you have no alcohol/drug problem, you must reflect that you do not and have never had such a problem. As always, if you have any questions prior to the evaluation please contact me directly. *IF YOU ARE DOING THE DEFERRED PROSECUTION PROGRAM, PLEASE CONTACT ME DIRECTLY PRIOR TO YOUR ALCOHOL EVALUATION. KEYS TO A SUCCESSFUL ALCOHOL EVALUATION 1. No family history of dependence 2. First alcohol drug experience after the age of 15 years 3. Never had a dependence problem 4. Drink no more than twice/week 5. Drink no more than 2 drinks/time 6. You must explain why the events of your DUI are unusual 7. No alcohol/drug related criminal history 8. BAC under 0.15 1
The alcohol evaluation will consist of a self-reporting questionnaire, largely consisting of questions from the MAST (alcohol) Test and DAST (drug) Test. Here are the two tests please read prior to your evaluation. Michigan Alcohol Screening Test (MAST) Developed in 1971, the Michigan Alcohol Screening Test (MAST) is one of the oldest and, according to "experts," most accurate alcohol screening tests available, effective in identifying dependent drinkers with up to 98 percent accuracy. Questions on the MAST test relate to the patient's self-appraisal of social, vocational, and family problems frequently associated with heavy drinking. The test was developed to screen for alcohol problems in the general population. The following is the 22-question, self-administered MAST. The MAST Test The MAST Test is a simple, self-scoring test that helps assess if you have a drinking problem. Answer yes or no to the following questions: 1. Do you feel you are a normal drinker? ("normal" is defined as drinking as much or less than most other people) 2. Have you ever awakened the morning after drinking the night before and found that you could not remember a part of the evening? 3. Does any near relative or close friend ever worry or complain about your drinking? 4. Can you stop drinking without difficulty after one or two drinks? 5. Do you ever feel guilty about your drinking? 6. Have you ever attended a meeting of Alcoholics Anonymous (AA)? 7. Have you ever gotten into physical fights when drinking? 8. Has drinking ever created problems between you and a near relative or close friend? 9. Has any family member or close friend gone to anyone for help about your drinking? 10. Have you ever lost friends because of your drinking? 11. Have you ever gotten into trouble at work because of drinking? 12. Have you ever lost a job because of drinking? 13. Have you ever neglected your obligations, family, or work for two or more days in a row because you were drinking? 2
14. Do you drink before noon fairly often? 15. Have you ever been told you have liver trouble, such as cirrhosis? 16. After heavy drinking, have you ever had delirium tremens (DT), severe shaking, visual or auditory (hearing) hallucinations? 17. Have you ever gone to anyone for help about your drinking? 18. Have you ever been hospitalized because of drinking? 19. Has your drinking ever resulted in your being hospitalized in a psychiatric ward? 20. Have you ever gone to any doctor, social worker, clergyman, or mental health clinic for help with any emotional problem in which drinking was part of the problem? 21. Have you been arrested more than once for driving under the influence of alcohol? 22. Have you ever been arrested, or detained by an official for a few hours, because of other behavior while drinking? Scoring the MAST Test Score one point if you answered "no" to the following questions: 1 or 4. Score one point if you answered "yes" to the following questions: 2, 3, 5 through 22. A total score of six or more indicates hazardous drinking or alcohol dependence and further evaluation by a healthcare professional is recommended. 3
The Drug Abuse Screening Test (DAST) The Drug Abuse Screening Test (DAST) was developed in 1982 and is still an excellent screening tool. It is a 28- item self-report scale that consists of items that parallel those of the Michigan Alcoholism Screening Test (MAST). The DAST has exhibited valid psychometric properties and has been found to be a sensitive screening instrument for the abuse of drugs other than alcohol. Directions: The following questions concern information about your involvement with drugs. Drug abuse refers to (1) the use of prescribed or over-the-counter drugs in excess of the directions, and (2) any non-medical use of drugs. Consider the past year (12 months) and carefully read each statement. Then 1. Have you used drugs other than those required for medical reasons? 2. Have you abused prescription drugs? 3. Do you abuse more than one drug at a time? 4. Can you get through the week without using drugs (other than those required for medical reasons)? 5. Are you always able to stop using drugs when you want to? 6. Do you abuse drugs on a continuous basis? 7. Do you try to limit your drug use to certain situations? 8. Have you had blackouts or flashbacks as a result of drug use? 9. Do you ever feel bad about your drug abuse? 10. Does your spouse (or parents) ever complain about your involvement with drugs? 11. Do your friends or relatives know or suspect you abuse drugs? 12. Has drug abuse ever created problems between you and your spouse? 13. Has any family member ever sought help for problems related to your drug use? 14. Have you ever lost friends because of your use of drugs? 15. Have you ever neglected your family or missed work because of your use ofdrugs? 4
16. Have you ever been in trouble at work because of drug abuse? 17. Have you ever lost a job because of drug abuse? 18. Have you gotten into fights when under the influence of drugs? 19. Have you ever been arrested because of unusual behavior while under the influence of drugs? 20. Have you ever been arrested for driving while under the influence of drugs? 21. Have you engaged in illegal activities in order to obtain drug? 22. Have you ever been arrested for possession of illegal drugs? 23. Have you ever experienced withdrawal symptoms as a result of heavy drug intake? 24. Have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding, etc.)? 25. Have you ever gone to anyone for help for a drug problem? 26. Have you ever been in a hospital for medical problems related to your drug use? 27. Have you ever been involved in a treatment program specifically related to drug use? 28. Have you been treated as an outpatient for problems related to drug abuse? Scoring and interpretation: A score of 1 is given for each YES response, except for items 4, 5, and 7, for which a NO response is given a score of 1. Based on data from a heterogeneous psychiatric patient population, cutoff scores of 6 through 11 are considered to be optimal for screening for substance use disorders. Using a cutoff score of 6 has been found to provide excellent sensitivity for identifying patients with substance use disorders as well as satisfactory specificity (i.e., identification of patients who do not have substance use disorders). Using a cutoff score of <11 somewhat reduces the sensitivity for identifying patients with substance use disorders, but more accurately identifies the patients who do not have a substance use disorders. Over 12 is definitely a substance abuse problem. In a heterogeneous psychiatric patient population, most items have been shown to correlate at least moderately well with the total scale scores. The items that correlate poorly with the total scale scores appear to be items 4, 7, 16, 20, and 22. 5