Vincent J. Adesso
Ron A. Cisler
B. J. Larus
Brandon B. Hayes
The assessment of substance use is a task the general clinician is likely to face regardless of the population with whom, or the setting in which, he or she works. Even the clinician who does not specialize in substanceabuse issues needs to have some knowledge of substance-abuse assessment because of the impact of drug use and dependence on diagnosis, treatment planning, and treatment outcome. Estimates based on epidemiological data suggest that, depending on the mental health setting, between 29% and 50% of individuals also have substance-use disorders (Caton et al., 1989; Drake & Wallach, 1989; Kanwischer & Hundley, 1990; Mueser et al., 1990; Regier et al., 1990; Safer, 1987). Due to the high frequency of comorbidity between behavior disorders and drug dependence (e.g., Kessler et al., 1994, 1996, 1997; Regier et al., 1990), every clinician has a considerable likelihood of encountering cases in which substance use is an important factor in diagnosis and treatment. Furthermore, drug use and abuse also may influence health, may mimic behavior disorders, and may interact with medications and produce untoward behavioral effects.
Drug use is widespread among Americans, with between 14 and 18 million meeting DSM-IV criteria for alcohol abuse or dependence (NIAAA, 1997). Between 4 and 6 million Americans abuse or are dependent on